As the recession deepens, many Americans are facing impossible decisions over which everyday necessities are the least devastating to pass up. As belts tighten, many are choosing not to refill their medical prescriptions, the New York Times reported yesterday:

“People are having to choose between gas, meals and medication,” said Dr. James King, the chairman of the American Academy of Family Physicians, a national professional group. He also runs his own family practice in rural Selmer, Tenn.

At the end of the piece, the Times highlights one such case from Champaign. Lori Stewart, a 45-year-old self-described  "insomniac textbook compositor, artist, and mother of [a] U.S. soldier" is deciding whether or not to discontinue her mother's Alzheimer’s medications, which she says only provide a marginal benefit. The reporter learned about Stewart's story from this heart-wrenching blog post she wrote earlier this month:

We discussed medication. There's nothing out there, really, that will help this. I asked him, then, about the medication she's on, Razadyne. It costs $182 a month for this one prescription. 1 pill a day, $6 a pill.

Have I mentioned that my Mom lives on Social Security? She has health insurance. She has Medicaid. And still this 1 prescription alone takes up roughly 1/5 of her annual income. (Oh, and she has 5 other prescriptions, but let's don't get me started.)

Razyadyne, then, Doc: Is it doing any good?

Probably not, he told me. The effects are most likely minimal, and not changing the quality of her life in any way. She scored 8 out of 30 on the test he gave her that day. He said she may score a 7, without the Razadyne. In essence, she may or may not be able to name the season, or the day of the week.

"It's up to you," he told me, about continuing onthe Razadyne. Each family feels differently. Personally, he said, "Skip the Razadyne and put the money towards good food or something she enjoys. Cable TV, books, movies."

This has been a torturous decision for me. Man, when you only have 8 points left in that little head of yours, it kind of seems like every one is kind of precious. If I take her off the meds, it may not affect her, but what would it be like, at this point, to have even slightly more deterioration?

Also important to note is that while Stewart's mother is in the latter stages of a degenerative disease, the majority of people who choose not to pay for their drugs likely suffer from preventive or controllable illnesses. If a critical mass of patients go off their meds and their conditions worsen, it could wreak havoc on the nation's health care system. "If enough people try to save money by forgoing drugs," the Times writes, "controllable conditions could escalate into major medical problems. That could eventually raise the nation’s total health care bill and lower the nation’s standard of living."