We now take more pills than ever. Is that doing more harm than good?

If you’re like most Americans, you probably start your day with a hot shower, a cup of coffee—and a handful of pills.

More than half of us now regularly take a prescription medication—four, on average—according to a new nationally representative Consumer Reports survey of 1,947 adults. Many in that group also take over-the-counter drugs as well as vitamins and other dietary supplements.

It turns out Americans take more pills today than at any other time in recent history (see “Pill Nation: The Rise of Rx Drug Use”)—and far more than people in any other country.

Much of that medication use is lifesaving or at least life-improving. But a lot is not.

The amount of harm stemming from inappropriate prescription medication is staggering. Almost 1.3 million people went to U.S. emergency rooms due to adverse drug effects in 2014, and about 124,000 died from those events. That’s according to estimates based on data from the Centers for Disease Control and Prevention and the Food and Drug Administration. Other research suggests that up to half of those events were preventable.

All of that bad medicine is costly, too. An estimated $200 billion per year is spent in the U.S. on the unnecessary and improper use of medication, for the drugs themselves and related medical costs, according to the market research firm IMS Institute for Healthcare Informatics.

Our previous surveys have found that higher drug costs—including more expensive drugs and higher out-of-pocket costs—also strain household budgets, with many people telling us they had to cut back on groceries or delay paying other bills to pay for their prescriptions.