Skip to content

Why Can't I Take My Meds?

2025-09-23 · letter vlog · John · 6:36 · watch on YouTube

Topic: Health · mode: Explainer · tags: heavy topic

John explains why so many people, himself included, fail to take medication as prescribed (cost, feeling fine, side effects, stigma around a 'natural' unmedicated state, depression), argues that natural is not what humans are going for, and says the one strategy shown to work is tying medication to an existing daily habit.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — John's three daily pills and how hard he finds it to take them

  • ★★ John says he is supposed to take three pills a day, one for cholesterol and two for OCD and depression; they are good pills, yet many days taking them feels like climbing a mountain. — 00:00:00

00:00:29 — Scale of non-adherence, cost as a system failure, about 80 factors

  • ★★ John says he has at various times stopped taking these pills entirely, though he understands they are literally life-saving for him. — 00:00:29
  • ★★★ John says failure to take medication appropriately is a huge problem: something like 50% of prescriptions for chronic conditions are not taken as prescribed. (hedged) — 00:00:29
  • ★★★ John says so-called patient non-compliance contributes to over 125,000 deaths a year in the United States alone, about as many as die from murder and diabetes combined. — 00:00:29 · United States
  • ★★★ John says cost is one of the biggest factors: in the US and many other countries people can't afford their medication, which he calls medical unaffordability rather than patient non-compliance. — 00:00:58 · United States
  • ★★★ John says we often blame individuals for failures of human-built systems; if half of all patients struggle, individuals can't be blamed for what is clearly a broader problem. — 00:00:58
  • ★★ John says cost can't be the whole story, since non-compliance is still very common even in countries where medication is free. — 00:01:27
  • ★★ John says researchers have identified about 80 factors that keep people from taking their medication, from forgetfulness to pills too big to swallow. — 00:01:27

00:01:56 — Feeling fine: antibiotics, tuberculosis treatment and John's statin

  • ★★★ John says many major barriers to adherence are psychological: it is hard to take a pill when you feel fine, as with skipping the last days of an antibiotic course. — 00:01:56
  • ★★★ John says tuberculosis, the deadliest infectious disease, shows this: patients often feel fine within a month, but must take pills for four to six months or longer, sometimes over a thousand pills. — 00:01:56 · tuberculosis
  • ★★ John says TB patients must take the pills as prescribed to maximize the chance of cure and minimize the chance the infection returns with drug resistance. — 00:02:26 · tuberculosis
  • ★★ John says that while patients feel fine the medicine's side effects make them feel worse, so they may stop, especially if they don't trust the healthcare system. — 00:02:26 · tuberculosis
  • ★★ John says the same happens with his statin: he feels fine and struggles to take it, though he can easily afford it and its side effects are basically non-existent. — 00:02:55

00:03:24 — Stigma and the idea that the unmedicated state is natural and better

  • ★★★ John says stigma matters too: our culture says the healthiest people take no medicine, and being unmedicated is seen as a natural, more desirable state. — 00:03:24
  • ★★ John says this is especially true of medicines for heavily stigmatized conditions such as type 2 diabetes or certain mental health conditions. — 00:03:24 · mental disorder
  • ★★ John says he has wrestled for years with needing psychiatric meds to be himself, when being himself supposedly means his natural, unmedicated state. — 00:03:24
  • ★★★ John grants it is unnatural for him to be free of OCD and depression, as it is to be free of pain on Advil, but argues natural is not what humans are going for as a species. — 00:03:53
  • ★★ John says it is natural for about half of children to die before five, and for people to die of polio and smallpox or catch bovine tuberculosis from raw cow milk. — 00:04:22 · child mortality
  • ★★★ John says we don't want a natural world but one where health conditions can be treated effectively and affordably with a wide array of tools. — 00:04:22
  • ★★★ John concludes that he does need to take his medication every day to become himself, and that is okay. — 00:04:22
  • ★★ John says depression itself is a significant risk factor for non-adherence, a cycle for him: skipping his depression medication deepens depression, making it harder to take. — 00:04:22

00:04:52 — Depression, mistrust and fear of side effects; tools that don't work

  • ★★ John says patients may also mistrust their provider's advice or fear side effects, and many factors can overlap to make taking medication very difficult. — 00:04:52
  • ★★★ John says researchers have tested tools from pill bottles that record their last opening to pill boxes, and none works; in the data only habit tracking does. — 00:04:52

00:05:21 — Habit tracking, John's self-judgement and takeaway; sign-off

  • ★ John says the pillbox works for him, but data is not the plural of anecdote. — 00:05:21
  • ★★★ John advises tying medication to something done every day, such as putting the pillboxes where you brush your teeth or make breakfast, as a visual cue. — 00:05:21
  • ★★ John says he sometimes judges himself for struggling, since he has fewer risk factors than almost anyone: he trusts his healthcare system and has good insurance. — 00:05:50
  • ★★ John says it helps to know he is not alone and that something that seems easy is in fact hard for many people, yet still work worth doing. — 00:05:50
  • ★★★ John's takeaway: taking these medicines isn't easy, but tying it to a habit makes it easier, and the work is worth doing regardless. — 00:06:19

In the description and comments

  • ★ In a later channel comment John notes that Pizzamas starts on Monday. — creator comment · Pizzamas
  • ★ In a later channel comment John says these are the last few days to get the Quadragocon shirt. — creator comment

Threads in this video

Where the stories that moved here went next

Mentioned

Central: appeal to nature · habit · medication adherence · social stigma

Also: Works: Everything Is Tuberculosis

Concepts: anecdotal evidence · Antibiotic · antimicrobial resistance · bovine tuberculosis · child mortality · culture · depression · diabetes · health care prices in the United States · health insurance · homicide · infectious disease · mental disorder · myocardial infarction · obsessive-compulsive disorder · polio · psychiatric medication · raw milk · smallpox · statin · tuberculosis

Places: United States

Products: Advil

Only in the description or credits: Pizzamas · Quadragocon shirt

Also centred on appeal to nature: Did Natural Cancer Treatments Save My Life?

Also centred on social stigma: 'end the stigma' · My Physicalmental Illness · TAKE IT UP A NOTCH · Talking Tuberculosis, GeneXpert, J&J, and more with MY HEROES · I've Been Pooping All Wrong

← Previous: Let's Just Be Stupid For a Moment · Next → I've Not Been Doing Well