July 25, 2025
Deprescribing Pharmacy: DNA, Wellness & the Future of Healthcare with Dr. DeLon Canterbury
Send us a text What happens when two pharmacists challenge the medication-first mindset? In this 100th episode, Dr. Tamar Lawful and Dr. DeLon Canterbury unpack how deprescribing and DNA testing can reshape the future of care. What if we told you that reducing medications isn’t anti-pharmacy—it’s what pharmacy was meant to do all along? In this milestone 100th episode of Pivoting Pharmacy with Nutrigenomics, Dr. Tamar Lawful sits down with her colleague and friend Dr. DeLon Canterbury, known ...
What happens when two pharmacists challenge the medication-first mindset? In this 100th episode, Dr. Tamar Lawful and Dr. DeLon Canterbury unpack how deprescribing and DNA testing can reshape the future of care.
What if we told you that reducing medications isn’t anti-pharmacy—it’s what pharmacy was meant to do all along?
In this milestone 100th episode of Pivoting Pharmacy with Nutrigenomics, Dr. Tamar Lawful sits down with her colleague and friend Dr. DeLon Canterbury, known as The Deprescribing Pharmacist. for a powerful conversation about the future of pharmacy, the risks of overmedication, and how we can empower patients through personalized, medication-free wellness.
Together, they explore how deprescribing strategies, nutrigenomics, and DNA-based health insights are redefining what it means to practice pharmacy—and why this matters for patients, providers, and the healthcare system at large.
If you're a pharmacist, health coach, or wellness professional seeking to practice at the root-cause level, or someone ready to take control of your medications and metabolism, this conversation will inspire, challenge, and empower you.
BY THE TIME YOU FINISH LISTENING, YOU’LL DISCOVER:
- What deprescribing really looks like in practice
- How nutrigenomics can uncover hidden reasons behind poor med responses
- Why so many meds stay on profiles far too long
- How pharmacists can empower patients through personalized care
- What legacy in pharmacy looks like when we lead with curiosity not just credentials
CONNECT WITH DR. DELON CANTERBURY
LET'S KEEP THE CONVERSATION GOING
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FOLLOW DR. TAMAR LAWFUL ON SOCIAL MEDIA
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00:00 - The Problem With Traditional Pharmacy
08:47 - Dr. Canterbury's Journey to Deprescribing
17:21 - Understanding Deprescribing and Success Metrics
26:22 - Different Approaches to Patient Care
33:33 - The Power of Pharmacogenomics
39:41 - The Deprescribing Accelerator Program
45:26 - Redesigning Pharmacy Education
47:42 - Challenges and Mindset on the Entrepreneurial Journey
WEBVTT
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Now, medications certainly have their place, but what if there was a way to support your body naturally by working with your genetics?
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We are a pill for an ill society.
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We take 18 pills per person per American per day.
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It was so hard to find somebody who took my insurance and for me to get well it took thousands of dollars and I thought what do regular people do?
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This is not right.
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Despite my best efforts, I wasn't actually reversing disease and helping people to heal in the way that I thought I would.
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We want to empower yourselves to take care of this root cause.
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We don't just want to cover it up.
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If you want to break the mold of traditional pharmacy and healthcare, you are in the right place.
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Welcome to the Pivoting Pharmacy with Nutrigenomics podcast.
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Here's a little truth bomb.
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We're all unique, down to our DNA, so it's no wonder we react differently to the same medications, foods and environment.
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Here's a million dollar question how can you discover exactly what your body needs, which medication, what foods or supplements and which exercises are right for you?
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How can you manage chronic conditions like diabetes without more medications?
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How can you lose weight and keep it off?
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How do you tap into your genetic blueprint so you can stop surviving and start thriving in health and life?
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That is the question, and this podcast will give you the answer.
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I'm your host, Dr Tamar Lawful, doctor of pharmacy.
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Let's pivot into genomics and bring healthcare to higher levels.
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Welcome to Pivoting Pharmacy with Nutrigenomics.
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I'm your host, Dr.
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Tamar Lawful, and today we're celebrating our 100th episode.
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Can you believe it?
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Whether you've been listening since day one or this is your first episode, I just want to say thank you.
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To mark this milestone, I invited someone really special, a colleague, a friend and someone who's on a similar mission to mine but takes a different route.
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You may know him as the deprescribing pharmacist, r.
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DeLon Canterbury.
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He's making waves in the world of medication safety, especially among our aging population.
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Now we may use different tools he focuses on traditional deprescribing and I use nutrigenomics to get to the root causes but our goal is the same helping people live healthier lives with fewer unnecessary medications.
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So today we're pulling back the curtain on what deprescribing really looks like from both sides of the spectrum.
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Welcome, Dr.
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Canterbury.
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Thank you for joining us today.
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Hey, Tamar, it's such a pleasure to be here with you celebrating your 100th episode.
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Welcome all.
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Thanks for having me.
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You are welcome.
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Thanks for accepting my invitation to be my 100th guest and share this special moment with me.
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Now I want to take it back for a second.
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You know we both started in traditional pharmacy, but clearly something shifted right.
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I want to know what made you start focusing on deprescribing as your mission in pharmacy.
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Yeah, yeah, you know I could tell everyone.
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You know, we didn't really learn about deprescribing in school, right?
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We kind of got into the field, got your hands wet and you started seeing the problem firsthand.
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So for me, I came from the traditional community retail pharmacy route, finishing up from UNC School of Pharmacy in 2014, and being thrust into a very rural and aging community in Henderson, north Carolina, while I was serving as a pharmacy manager.
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And so, working as a pharmacy manager, of course, you see day in, day out the operations, the business side, but you get to be, you know, a key community stakeholder and a trusted confidant.
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And what I started noticing were my older patients were constantly in and out of the ER or the urgent care and in a community like this, there aren't that many providers and resources for care.
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This there aren't that many providers and resources for care.
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In fact, a number of them were torn between transportation to pick up their medications.
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There were these social barriers, like even getting a ride, a family member affording gas money, choosing between a medication or a light bill and I found a lot of them were my older adults.
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So it really helped me kind of have my red flags go up.
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You know, why is this population going through so much?
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Like what's the issue?
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And I started getting into studying for the certification in geriatric pharmacotherapy, so got my BCGP credential in 2017 while working as a pharmacy manager and, boom, my eyes opened to deprescribing medication safety.
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What are some of the common tools out there?
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Why does the aging body, or how does it, differ from people in our middle of 40s and 30s in age?
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And the pathophys, the pharmacology is just completely different and aging is completely different.
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So once I got that, it opened my eyes to inherently have known this concept, but it became really a buzzword in more recent years and eventually led to me starting Geriatrics, my company, in 2020.
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in a hospital setting, I noticed that people were frequently coming in.
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The hospital is a revolving door for certain patients and, yes, between certain ages, especially the elderly, they tend to be in a lot more medications.
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They're having more side effects and drug interactions, so of course they're going to end up back in the hospital because of the multi-use of those medications.
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So is there a specific moment that you remember that managing meds just wasn't enough anymore, when you said to yourself you know what this is not cutting it?
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Was there a specific moment that you recall?
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Yes, I remember the moment where it really stuck with me that there has to be a different way and it was when I was in Henderson, north Carolina, as a pharmacy manager and one of my favorite patients was a vet and he came in hobbling.
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He also had a wheelchair assistive device and he was taking between 360 Pcocet, 10, 325s or 540 it depend on the year, I guess, type of time of year.
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And you know, after a while I'm refilling this, I'm like this is insane numbers like is this normal?
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Every time he gets it right on time, never early, never late.
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And you know, one day I um just had to ask like man, is this, is this even?
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helping with your pain, Like what is this doing?
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And he's just like you know what Delon this.
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Honestly, this just takes off the edge.
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I'm still in chronic pain every day of my life, I mean all over, and he had like a major back injury and it was just horrible lifestyle for this guy.
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I mean, here's a vet who's now subjected to 360 percocets, having a whole bowel regimen, having all these quality of life issues, and I learned that he just hasn't explored any other type of way to heal.
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You know, nothing like chiropractor or energy healing or even type of spiritual healing or just trying a different approach.
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Right, and I think even with pain, we know sometimes the overuse of opioids can lead to sensitivities and eventually, chronically, we just find that they're not always the best option.
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So to me that was an element that was going home and wondering is this what I'm supposed to do for the?
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rest of my life.
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Am I supposed to just sign off and subject people to this?
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Only way to heal right, at least from the manager standpoint or the business of pharmacy, is keep those scripts coming.
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And it really, morally, was in this alignment with what I felt I could do or what I studied for and what I know our Caribbean roots have us introspect is the natural way to heal and other modalities.
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So that was a nail in the head for me.
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And seeing how a lot of my members in the community who were older were the ones choosing between, you know, a light bill and transportation, choosing between a prescription and food, you know that was the common complaint that I would see with older adults.
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And that was where I realized, you know, that these guys need an advocate.
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They need someone who's well experienced in the world of medicine safety and, more importantly, someone who can also advocate for less.
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And I mean imagine a pharmacy where people are deprescribing.
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I mean god, wouldn't that just change the way we do business?
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And that's what struck a chord with me and got me down this road.
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It's starting geriatrics well, not deprescribing, taking people off medications, dr Canterbury, uh, so much we could unpack there.
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I love that you were pretty much boots on the ground.
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You were there in a mixed scene the elderly patients, the amount of medications they're on, and many times it's just putting a Band-Aid on the problem that patient was in pain.
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The Band-Aid treating the symptom versus the cause, or even finding other ways that they can deal with their pain, is not the first go-to in traditional health care practice, and especially in america.
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But the fact of the matter is it's going to happen.
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Medication is going to be prescribed.
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That's just how it works.
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So why not be that advocate for them as you are, as you discovered you needed to be, to at least help them do it safely, to help them do it safely.
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And I know we've been saying de-prescribing, de-prescribing so much.
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But for those who are listening, maybe this is the first time they've even heard that terminology.
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How can you explain that?
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How do you define de-rescribing in a way that people can actually relate to?
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We like to describe it as essentially the safe and supervised removal of medications that are no longer helping you.
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Really, it's done, of course, with a provider, making sure, of course, there's no issues with withdrawal or any relapse of some of the symptoms or conditions you were once treating.
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But, in a nutshell, deprescribing is safely removing medicines that no longer are needed and as we age, you know, I like to tell people there's a general timeline for certain medications, and I think that's an underappreciated concept.
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But every medicine to me has a timeline, and so we are simply assessing the pros of you keeping this medication on board or the cons of potentially stopping this medication, and so, with de-prescribing, hand in hand comes good prescribing practices.
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So, again, it's simply removing medications that you really may not need anymore or, in fact, could be considered harmful.
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Thank you for explaining that.
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Breaking it down Now, how do you personally measure the success with a patient when it comes to deprescribing?
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What's the deprescribing win?
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The biggest win for me and for my clients and the providers is quality of life.
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That is key for patients coming to us, and we were taking on clients all over the country who are coming with a problem.
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Is it constipation, is it incontinence, is it worsening memory?
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Is it a fall?
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Whatever the case is, there's some trigger point that's leading patients to seek out our services and get a consult.
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And so we start with the aging-friendly mnemonic, the four Ms what matters most to the patient?
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How are we preserving their mobility, how are we preserving their mindset?
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And, lastly, how are we looking at the medications and seeing if they conflict with any of the above?
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And so, really, when you leave with patient-centered care, we're leaving with what matters most.
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So if you're coming with me and you have an issue about wanting to see your grandbabies, you want to walk more, you want to hang out with your wife, we can align that to our treatment plan or deprescribing plan and see if the meds conflict with any of those above.
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And so when we're resolving a symptom, an issue, a side effect, or consolidating a med or two that were the causative issue, my friend, we're all winning and that makes me feel happy, and my patients, of course, are living much better, along with, of course, the caregiver, who's the one managing all this at the front lines.
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I love that, because it's not how many medications they were able to get off of.
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You're not measuring it by that.
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It's not how many medications they were able to get off of.
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You're not measuring it by that.
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Quality of life is so important because it plays into every aspect of their health the emotional health, the physical health, mental health.
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How is their quality of life?
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And, amazingly, when that quality of life is great, it starts improving all those other aspects the emotional, the physical and the mental as well.
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So that's like holistic care in a nutshell.
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You have to place it that way.
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But thank you for sharing that with us.
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Now I want to talk about what this actually feels like for the people that you help.
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You know what are the most common complaints or symptoms that they come to you with, especially when they're on so many medications.
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You know precisely what you just said.
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I feel like I'm on too many medications and no one really takes the time of day to do a deep dive into why they're on all of them, in fact majority admit to.
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Well, I just do what my doctor says and no one's told me otherwise for the last 20, 30 years.
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Frankly, with older adults, or seasoned ones, I like to call them, it could be a multitude of issues I'd say.
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Commonly there are osteoarthritis pains.
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There are general dizziness or fatigue during the day, sometimes nauseousness when taking certain medications, sometimes more severe, sometimes it's concerns about memory loss, sometimes it's signs of incontinence at night or insomnia.
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I definitely get a good number of people with difficulty sleeping and you start unearthing that there may be some unresolved anxieties or untreated depressions that haven't been addressed in your lifetime.
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So it can really range.
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I would say to ask the patient let's talk about their bowels.
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That's a huge thing.
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So getting regular is always a topic of discussion, but it can absolutely vary.
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But I would say pain is one of your more common ones chronic pain or issues around bowel movements, incontinence, insomnia and yeah, I'm seeing like some general just tiredness and malaise throughout their days.
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Yeah, I could imagine that's what would happen, right, yeah, now I want to highlight our different approaches to what we do with each of our patients.
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I call them clients because I'm more in the coaching setting, where I'm just empowering them to really own their habits so that they can be empowered to make the changes in their life to eventually come off medications.
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So imagine this you've got a 52 year old woman with diabetes, high cholesterol and fatigue.
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She's on five medications.
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What would your process look like?
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She's on five medications for everything.
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I believe again, everything has a timeline.
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So if you're well managed on your five, my questions will be what are we doing in your lifestyle?
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So how are we approaching things from a nutrition standpoint, a food standpoint?
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What are you eating every day?
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How much water do you have?
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What is your general mental state?
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What's your attitude about diabetes?
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Do you think you can actually reverse this?
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Have you heard of people reversing this?
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Same for your cholesterol?
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What are your thoughts on plant-based diets?
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Is there a nutritionist or an amazing specialist I know, like Dr Tamar, who can guide you through the process of this and help you get to those goals holistically?
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I will ask questions to assess buy-in, because not everyone is fully on board with that and some aren't really given the tools right, which I know you do.
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But people don't always know that there's an option and sometimes I feel Western medicine.
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We don't always embolden and give people the power to take those steps.
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We tell them we should do diet and exercise, but we don't guide them through that process and it's a huge opportunity and gap in our care.
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I'm not an expert in all those things, so I generally would refer or partner with people that can fill in the gaps where I can't.
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But the number one thing I'm not an expert in all those things, so I generally would refer or partner with people that can fill in the gaps where I can't.
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But the number one thing I'm going to ask is how are you moving?
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How are you keeping active?
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How are you keeping your mind busy?
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What's good for the heart is good for your brain, and I'm going to want to know you know what types of exercise are you employing?
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You know what meds are you on?
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If it's five, okay, we can work with five.
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What does your blood pressure or cholesterol look like without the blood pressure medicine or statin?
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Is it still at goal?
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Are we doing this for cardiovascular purposes or are we doing this just because someone said you had diabetes and the guidelines quote unquote say you have to be on a statin for the rest of your life?
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These are the type of ways we kind of roll back some of the guidelines and really get to the nitty-gritty and see is this actually applicable for our patient in front of us, versus everyone painted with a broad pen?
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So once we have all that in mind and get the buy-in, we kind of assess what meds they're on, all that in mind and get the buy-in, we kind of assess what meds they're on, we start looking at goals and we start looking at some of the behavior and lifestyle pieces that we could switch up.
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So that's how I usually start that.
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So I like to see one are the meds necessary?
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Are they appropriate?
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Have we attempted a drug holiday?
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If they are well managed, with one or two meds over a couple months, and then we kind of methodically go through each and see if they are well managed with one or two meds over a couple months and then we kind of methodically go through each and see if they're maintaining that lifestyle change, if they don't need them anymore.
00:18:39.108 --> 00:18:40.233
I love that, dilan.
00:18:40.233 --> 00:18:48.143
I love that Definitely asking them questions to see where they are, what they've already been doing for their health and also their buy-in as well.
00:18:48.143 --> 00:18:52.593
How ready are they to possibly accept doing it a different way?
00:18:52.593 --> 00:18:56.683
How ready are they to possibly accept doing it a different way?
00:18:56.683 --> 00:18:59.288
And, of course, you're doing this alongside with the knowledge of their doctor as well.
00:18:59.288 --> 00:19:09.124
So similar approach is exactly what I do, and I take it a step further with the nutrition and the lifestyle changes by being the active guide for them for 90 days.
00:19:09.183 --> 00:19:17.811
I'm right by their side, helping them implement the recommendations that are in their Nutrigen omics report regarding the areas that they should really focus on.
00:19:17.811 --> 00:19:19.423
Is it a methylation issue?
00:19:19.423 --> 00:19:24.531
Potentially, is it an oxidative stress issue?
00:19:24.531 --> 00:19:28.383
Is it a blood glucose insulin regulation issue?
00:19:28.383 --> 00:19:43.423
The tests will identify that and then give them very specific nutrition recommendations, lifestyle recommendations, even exercise, like what type of exercises will be better for them and supplements that they could try.
00:19:43.423 --> 00:19:51.949
So I work with them for 90 days to implement that part that we're not really taught the details in pharmacy school.
00:19:51.949 --> 00:20:03.393
It's just yeah, make sure they're eating healthy, they're they limit if their heart failure are limited to X amount of sodium or, but you know, make sure you exercise, but we need.
00:20:03.393 --> 00:20:10.332
We don't get specific and then we send them off and unfortunately we do see for their physicians is physicians are doing the same thing.
00:20:10.332 --> 00:20:15.971
They're not necessarily referring them to a dietician or a fitness trainer.
00:20:16.881 --> 00:20:18.945
I've never seen a prescription for a fitness trainer.
00:20:19.488 --> 00:20:20.169
That'd be nice.
00:20:20.169 --> 00:20:21.132
It'd be nice.
00:20:21.132 --> 00:20:41.203
You know, social prescribing is a thing and we have some evidence where providers are starting to do more of that in England, you know, through the NHS are starting to do more of that in England, you know, through the NHS they're writing scripts to say, go walking with your friends or do some exercise X amount of days or time a week, and so it's showing results.
00:20:41.203 --> 00:20:42.326
It does work.
00:20:42.326 --> 00:20:47.363
So social prescribing can be a thing and I agree we got to have on it.
00:20:48.124 --> 00:20:52.703
I love that you also take a genomic approach, at times right With pharmacogenomics.
00:20:52.703 --> 00:20:54.048
Can you tell us about that?
00:21:02.720 --> 00:21:05.085
Yeah, yeah, huge fan of precision medicine and I like to offer it for those who want that finer look I offer to all.
00:21:05.085 --> 00:21:08.692
But not everyone has beds that really qualify, so to speak.
00:21:08.692 --> 00:21:16.486
But I think it's always nice to have, especially if in some instances it can be covered by your plan based on what you're on.
00:21:16.486 --> 00:21:22.263
So I like to use precision medicine or pharmacogenomics as a tool for deprescribing.
00:21:22.263 --> 00:21:32.872
A lot of times you get people with quote-unquote allergies and you go back in time and you start realizing, hmm, a lot of these are 2D6 pathway drugs or 2C19.
00:21:32.872 --> 00:21:36.250
And you start wondering hey, I wonder if there could be a genetic component here.
00:21:36.250 --> 00:21:50.310
And we've been able to unearth so many mysteries with quote-unquote coding allergies or morphine deficiencies or, you know antidepressants that they've failed multiple times just from having that panel done.
00:21:50.310 --> 00:22:03.349
And again it's the future of medicine is that we need to know what's going on at a cellular level, the genetic level and all the drugs that we're on aren't made for all of us equally right.
00:22:03.579 --> 00:22:07.228
Some are poorly responded in a certain population.
00:22:07.228 --> 00:22:09.528
You know, asian, black, white, what have you?
00:22:09.528 --> 00:22:15.852
People respond differently and that very much goes for how the medications may work.
00:22:15.852 --> 00:22:22.894
And with older adults, especially a more diverse, older population, there's no room for error.
00:22:22.894 --> 00:22:30.413
There's no room for just, you know, hoping that this works for an 80-year-old who's dealing with cognitive issues.
00:22:30.413 --> 00:22:32.787
We don't have time to just put people at risk.
00:22:32.787 --> 00:22:35.493
Old who's dealing with cognitive issues.
00:22:35.493 --> 00:22:37.038
We don't have time to just put people at risk.
00:22:37.058 --> 00:22:43.606
So I always, always, always ask patients and caregivers to advocate for this if they have medications that are actionable.
00:22:43.606 --> 00:22:46.333
So when we use these results, we get this beautiful report from our lab.
00:22:46.333 --> 00:22:49.349
We have all the medications in their portfolio.
00:22:49.349 --> 00:22:52.921
We're not only doing a DDI or drug interaction screen, but we're doing a pharmacogenetic interaction check as well.
00:22:52.921 --> 00:22:56.131
We're not only doing a DDI or drug interaction screen, but we're doing a pharmacogenetic interaction check as well.
00:22:56.131 --> 00:23:01.625
We're looking to see if there are any combinations of meds that may change the phenotype.
00:23:01.625 --> 00:23:03.288
Or how do people physically present?
00:23:03.288 --> 00:23:09.674
You can have multiple moderate or low responders and your phenotype you can present differently clinically.
00:23:09.674 --> 00:23:27.585
So knowing that, having a pharmacist's knowledge around that super critical when it comes to intense PGX drug-drug interactions, and they also are interactions with herbal medications too, so there are tons of ways that this can play a role, and I think pharmacists are the champion for it.
00:23:28.247 --> 00:23:29.690
Yeah, definitely, definitely.
00:23:29.690 --> 00:23:39.146
Pharmacogenomics is a powerful tool to use, especially I was want to say especially with polypharmacy, but just in general, just in general.
00:23:39.227 --> 00:23:49.213
Definitely knowing that your profile before a certain type of therapy is started can avoid so many side effects, ineffective treatments.
00:23:49.213 --> 00:24:00.893
I know I had a client that did pharmacogenomic testing in my program and she had been on a variety of antidepressants and each time ended up in the hospital.
00:24:00.893 --> 00:24:16.946
When we did that report she finally understood why she ended up in the hospital and she was in tears because she was like if the doctors had known that they could have done this test, I would have avoided those hospital visits and they would have started me on the one that the test is going to tell me it would work.
00:24:17.568 --> 00:24:20.580
Yeah, I hate hearing those stories, man.
00:24:20.580 --> 00:24:25.130
It's such a widely available tool but how?
00:24:25.130 --> 00:24:25.851
It just isn't.
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