consequences if it's not included in the investigation of that crime. and cuban president raul castro looks address to the future of relations between havana and washington. all that straight ahead on al jazerra america. keep it here.

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>> welcome back, we're talking about an important new study that says one in five older americans that says one in five older americans take prescription that's work against you. my husband and i laugh about it because the disclaimer is longer than the product. has america caplized on the instant gratification and caused you us to think there's a medicine to fix everything. >> i think it's our culture to think there's a magic pill. when we exercise and drink more water and all of the things that mother said are good for us, but we have evolved into a syndrome

where a problem happens, and we want an instant solution, whether it's financial or medical. and there are so many innovagues that people think there's a cure for everything, and while medications, also safe, have risks and that's a balance that needs to be discussed with a physician. so we want it to be true, but i think it's the responsibility of the fda and pharmaceutical companies and healthcare professionals and the media to set the record straight. >> latino politics, it's bizarre to think that each back in the 90s, there were not as many farm commercials and now thia bound. and speaking of that, 70% of americans are on a prescription pill. i'm sure that there's a farmer saying what? why is it only 70%? and then we have a video comment from elizabeth. >> my mother was given a sample of a new medication and had a

stroke the next day. the neurologist diagnosed her stroke as being specifically to the drug interaction with this new drug with her other medications. conversely my doctor only uses samples to help patients who might not be able to afford new medications in the marketplace. i'm concerned that this is a marketing problem. how do we alleviate that? >> joining us now is dr. natalie bowler, a hosting physician who focuses on treatments. and dr. bowler, you heard elizabeth's question. >> i think that. people look to diagnoses themselves based on what they see on fev, and i tv, and it's important for people to look at what may be their healthcare needs based solely on what they are possibly missing from from their

nutrition and lifestyle habits, and not just what they see on tv. >> an important point to clarify is that when it comes to advertising, the fda has done numerous research studies that show that even though a patient may ask for a drug by name, if the patient doesn't have the condition that drug treats, the drug is not prescribed, and though a powerful marketing technique if the patient has the condition, inappropriate prescribing is not going on. >> i disagree with matt. two major problems that describe our prescribing in this country are the direct consumer promotion that are occurs, and we're only one of two countries that allow the direct consumer advertising that you see on television. that's a problem, it influences the patient's behavior and the expectations. let me give you an example. testosterone drugs for hyper

gotten addism in men, which is an uncommon condition, and it's approved for those disorders, and those drugs for testosterone are being taken by millions of men who don't have hypogonadism. and they're being checked before going on the drugs, and many are not having their testosterone level checked. and you can't be diagnosed with that without a blood test, so there are patients going out there because of the advertising that durs directly to them. >> dr. alexander, you want to weigh in on this? it picked up in the late 90s, and there are vocal advocates for it, and opponents for it.

and it's a vexing issue. it's something that opponents argue, just as some of what we have heard, as overprescribing. it's concentrated. two-thirds of it occurs for just about 20 medicines on the market, and there are several thousands, and direct advertising only detects for 15% of promotion. so while it's a lightning rod for controversial, it's pretty mild compared with the much more common detailing and free samples that occurs in the physician practicing. >> and a second factor, the promotions for physicians that contact between the pharmaceutical industry and the physicians, and that clearly is another major driver of overprescribing, and we know that many many drug deputies have been found guilty of criminal and civil of violations

of the law, many times leading to misleading promotion to promoting for off-label uses, which is clearly illegal and inappropriate prescribing behavior. >> well, doctor -- >> what it does, to get in here, it drives people to see their doctor, and many visits that are prompted by consumer advertisement in a previously undiagnosed condition is diagnosed. so the generation of people visiting their doctors to discuss their own health is incredibly important. and it adds to the benefit of that interaction. >> and i wonder, dr. caron, dr. alexander mentions that there are only 20 medications that are heavily advertised. but they're for of the most common ailments, like heart disease and diabetes with these dangerous interactions and is that the case? the medications for the most common illnesses? >> it is.

you see one of the newer diabetes medications, that we advise people not to use. and that's a drug prom odd television, and it's a drug for commondies, and then this low t syndrome, reported on sports shows and news shows. every night i see commercials for that. and many of the people getting the drug do not have the disease or the disorder for which the disease is approved for. >> 80% of the drugs that are sold in this country are generic drugs for largely cardio vascular diseases that are not advertised so i would disagree that they are. and that's not true. >> this one just came in: >> coming up, america is fend

ant on its meds, and would we be happier with less pharmaceutical? >> "consider this". the news of the day, plus so much more. >> we begin with the growing controversy. >> answers to the questions no one else will ask. >> why did so many of these people choose to risk their lives? >> antonio mora, award winning and hard hitting. >> people are dying because of this policy. >> there's no status quo, just the bottom line. >> what is the administration doing behind the scenes? >> real perspective. "consider this". monday through thursday, 10:00 eastern. only on al jazeera america.

>> welcome back, we're talking about the negative drug interactions that occur when people are taking several drug prescriptions, and especially in older americans. and it's not just to the cost of our health but the whole industry. dr., you said that the entire system is struggling, and what are the obvious costs of too many meds? >> i think that first and foremost patients struggle because millions of americas are burdened by their out of pocket costs, and often patients are

faced with difficult decisions, skipping or stretching medicines, so the direct costs of the drugs themselves, the costs to the insurance plans that ultimately we have to pick upick up bills and are financed by patients, and them when you're talking about an adverse event lake lie heart attack or a stroke or other maim convenient, it can cost tens or hundreds of thousands of dollars that are shouldered by the general public and accounter our whopping healthcare bill in this country. we're talking about alternatives for medicine:

so speak about that, dr. bowler. >> i think one of the challenge was naturopathy is this is truly a profession that blends a lot of our african/eastern medical traditions which are really related to pharmacology, and which are about a mind-body-spirit connection, and oftentimes when it comes to our medical system, there's not enough time in the day for our doctors to interface patients in a real way. >> what are the benefits to getting off the chemicals? >> i think that the first one, absolutely quality of life. i think many patients who are living with these challenges and conditions really are sometimes complaining of fatigue, and just not feeling like themselves, and often times, it's exciting to watch a person go through a healthy transition and begin to feel like themselves again.

>> dr. cronen, what are suggestions that you have for your patients? i'm you're that there are a lot of people out there right now, thinking holy cow, i have all of these meds in my cabinet. >> just a word of caution, now, based on what you hear here stop taking your medication because a lot of medications are important. you should have a brown bag session with your doctor. gather all of the medications from your medicine cabinet. including the over-the-counter medications and review all of the medicines that you're on. and that should be done at least annually to make sure that you're not on drugs that are conflict in a harmful way and to make sure that everything that you're on, you need to be on. to make sure that the doctor knows that the specialist put on you two other things to be aware.

a brown bag session with all of your medicines. >> i would also in that same session, with your doctor of integrated medicine. far too often our patients don't bring up their hersalls into those, it's important that you the consumer know the acupuncture or what the cranial sake ral therapist put you o. that you bring someone who is a specialist in the field to assist you. >> that brings us to what everybody says, you have to be your own best advocate and take the first step and be out spoken about your medical care. thank you to all of our guests. see you next time. >> start with one issue ad guests on all sides of the debate. and a host willing to ask the

tough questions and you'll get... the inside story ray suarez hosts inside story weekdays at 5pm et / 2pm pt only on al jazeera america this is al jazerra america live from new york city i am richelle carey. here are today's top stories. four men being held without charge at the guantanmo bay detention certainty have been releasereleases and returned to afghanistan. cuba's president praises his american counterpart. north korea denies its involvement in the cyber attack on zone and he insists it must be part of any investigation of that hack. and fighting isil, an an exclusive report to the front lines we'll take to you row