More disturbing data on over-prescription of powerful pills to seniors

prescription-bottles-1-300x170Some diligent, grown-up sons and daughters may want to check in on mom, dad, and grandma, grandpa, all the aunties and uncles, too. That’s because there’s yet another warning that too many doctors are whipping out their prescription pads all too readily and writing scripts for retirement-age Americans, who now take on average three psychiatric drugs without any mental health history.

Research published in the JAMA Internal Medicine shows that over-prescribing of powerful psychotropic drugs, including sleeping pills, painkillers, and anti-depressants may be more common than believed. The study was based on an analysis of data from a big number of doctors’ office visits, with researchers finding the number of “polypharmacy” incidents (cases in which seniors received scripts for multiple drugs) increased between 2004 and 2013 from 1.5 million to 3.68 million.

This doubling resulted from seniors’ greater openness in talking with their doctors about mental health issues, and, in instances where visits were related to “anxiety, insomnia, or depression,” the researchers write. But, in disturbing fashion, a high number of women and rural patients were involved in cases where multiple psychotropics were prescribed, and many of the prescriptions were for painkillers.

The nation is combatting an epidemic of opioid painkiller abuse. It is proving lethal in exurban areas and with older men and women who are suffering what some experts have dubbed the “disease of despair.”

Experts quoted by the New York Times expressed dismay that, despite repeated warnings to doctors about the dangers of prescribing powerful psychotropics, especially painkillers, and in combinations, researchers had found so many patients 65 or older who were ordered multiple meds like Valium, Prozac, OxyContin and Ambien for psychiatric, sleep or pain control reasons.

Besides cautioning caregivers and patients about the dangers of mixing opioid painkillers and anti-anxiety drugs (benzodiazepines like Valium and Xanax), experts also warn that many medications can increase seniors’ confusion and dizziness. This can contribute to falls, which pose increasing dangers to seniors, as California emergency medicine experts are noting. (I’ve written before about fall dangers and how to prevent them).

Although rural doctors may be dispensing drugs and doing the best they can to address older women patients’ serious mental health issues (concerns that may otherwise go untreated in areas where resources for counseling or other therapy may be sparse), I also have written about physicians’ abusive prescribing of powerful anti-psychotics for tots and seniors.

Cost-cutting, profit-hungry, under-staffed nursing homes, abetted by overzealous Big Pharma, have pushed to use of drugs like Risperdal and Seroquel to reduce their aged, vulnerable patients to zombie-like compliance and ease in care. It is incomprehensible how some physicians also prescribe these drugs, off label, for hard to handle children, some as young as 2.

In my practice, I see the great harms that dangerous drugs can cause. I’ve written about polypharmacy, the propensity of physicians to overprescribe medications, especially for the aged. Hospitals and nursing homes are trying to improve electronic health records to flag problem cases. But physicians, nurses, and pharmacists need to be front-line guardians to ensure polypharmacy doesn’t result in adverse drug reactions, which affect as many as 400,000 patients annually and add an estimated $3.4 billion to health care costs each year. Patients and their families should alert caregivers to everything seniors are taking, not only prescription drugs but also herbal remedies and supplements, too. We need to stop dispensing so many drugs with too little thought and care. It doesn’t make sense to take something that only makes us sicker—or worse.

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