A ScienceDaily alert from 2009 references a study conducted by a specialist from the University of British Columbia that suggests many types of drugs to help treat sleep problems and sedatives can cause more falls among older patients.

Published in Archives of Internal Medicine, the study suggests hip breakages and other injuries related to falling rank fifth in primary causes of fatalities among older adults. Drugs to treat depression may carry an especially high potential for falls, as they have higher sedation qualities than other drugs.

Sedative prescriptions in the benzodiazepines category are listed as having a notable potential of inducing falls, as well as medications that treat personality disorders. It is believed the drugs may make users more unsteady on their feet or dizzy, which can lead to falling. However, a Johns Hopkins Health Alert report says other research indicates the connection between benzodiazepines and hip injuries related to falling is not yet fully confirmed.

During the study, data was analyzed from nine categories of prescription medications, in conjunction with reports from more than 79,000 participants. Non-prescription medications were also evaluated. Study lead researcher, Carlo Marra, University of British Columbia, said that older adults may have higher rates of side effects from medications because their bodies may metabolize drugs at a slower pace.

Further complicating the connection between falling and medications for seniors is the fact that many are taking multiple prescriptions at once. Marra encourages carefully monitored use of certain medications for working with older patients and suggests things like counseling may be a better option.

The research comes as prescriptions for emotional problems like depression are increasing among older adults. In 2006, it was estimated that for every seven persons aged 80 years and over, one had a prescription for an antidepressant drug. Marra’s team plans to further investigate how health experts can determine which older patients may have a greater chance of falling, and then teach them about the best ways to use their medications.

Additional research from Gothenburg University, Sweden, suggests that some antidepressants, medications for psychosis and other drugs in the sedatives category may make older adults more likely to attempt suicide.

The research team’s findings say patients in the study group (aged older than 65) who were using hypnotic-type drugs or sedative drugs to help with sleep issues committed suicide at a rate of up to four times higher than people not taking the medications.
For reasons that are still unclear, study researchers believe the drugs can bring on unplanned actions or certain types of aggression and can increase the risk of overdose.

Previous research has explored a connection between these types of drugs and suicide rates among younger adults, but this research leads experts to recommend that health practitioners carefully examine if an older patient may have suicidal tendencies before prescribing drugs for sleep and anxiety problems.
 

As people age, they generally develop a variety of medical problems that require the regular use of medication (prescription and over the counter). Unfortunately, there are a number of risks associated with the use of multiple medications, particularly over an extended period of time.

Senior citizens account for approximately one quarter of the prescription drugs that are sold in the United States, and that number continues to rise every year. Most drugs for the elderly are prescribed for conditions such as insomnia, anxiety, and chronic pain. Unfortunately, it is very easy for overuse to occur with the types of medications.

When using several different types of medications, there is always an increased risk of negative effects due to drug interactions. While your doctor should be able to alert you to any potential problems with the medications he or she is prescribing, you should realize that doctors do not necessarily always alert their patients to these types of issues. To be safe, you should always ask your pharmacist if any of your medications are going to interact with one another.

The other problem that exists is the possibility of developing an addiction. The likelihood of this is especially great when pain medications are prescribed to the elderly on a regular basis. In regulating chronic pain, it is very common for individuals to gradually need increased dosages of their medications in order to feel the same sense of relief. If this continues for an extended period of time a physical dependency, and sometimes a psychological addiction, may develop.

In addition to drug interactions and addiction, simply monitoring pain medication among the elderly can be a great task all by itself. As people age, their bodies go through a variety of physiological changes that alter the way they are able to process medications. Metabolism slows down, the kidneys become smaller in size, and there is a greater chance of gastrointestinal bleeding. These factors can all play a critical role in determining whether a particular drug (or the long-term use of a drug) is safe for an elderly person.

The elderly are also at a greater risk for experiencing side effects from medications. Even something as basic as acetaminophen (the main ingredient in Tylenol®) can produce toxic effects more rapidly than it might in a younger adult. Older adults need to be aware of these increased risks that are associated with drugs, both over the counter and prescription, so that they can discuss their options with their doctor.

If you know an elderly person who is addicted to prescription drugs, the safest way to handle the situation is to convince them to seek the assistance of a substance abuse professional.

While most people do not automatically think of the elderly when they think about people with drug problems, this age group is at particular risk for developing addictions to both drugs and alcohol.

The primary reason that the elderly are at such a great risk is because they are generally given a multitude of prescription medications to deal with the health problems that crop up during the aging process. The older people get, the more likely they are to have to take at least one regular medication on a daily basis.

Also, elderly people tend to suffer from chronic pain. As they continue to age, they may experience several different types of pain. With pain often comes the need for regular doses of pain killers, as well as the likelihood of developing an addiction.

The most challenging aspect of addictions among the elderly is simply realizing that there is a problem. The majority of older adults are either embarrassed to talk about their addictions or they honestly do not have any idea that they have an addiction. This makes it extremely important for friends and family members to pay close attention to the behaviors of their loved one so that they can step in and offer help if such a situation arises.

If an elderly person you know does have an addiction to drugs or alcohol, you should approach any conversation with them cautiously. Try not to be accusatory or aggressive during your conversation, and do not talk down to the person, either. You must realize that the elderly are generally very sensitive about the fact that they have developed an addiction, so they are likely to be reluctant to discuss the issue.

A huge challenge in working with elderly individuals who have drug or alcohol addictions is trying to figure out which of their pains are legitimate, and which ones are a result of the drugs or alcohol (or withdrawing from the drugs or alcohol). Any legitimate pain that someone is experiencing will still need to be managed even through the process of withdrawal. This can be a very complex issue, and it is always best dealt with by medical professionals.

In many instances, it is recommended that elderly patients be admitted to substance abuse facilities so that they can receive around-the-clock care during their treatment process. There are treatment centers that specialize in the needs of the elderly, particularly in determining methods of treatment that do not involve the continued regular use of prescription drugs. Keep in mind, however, that these types of decisions must always be made by medical professionals. It is not recommended that anyone stop using a prescribed medication without the recommendation or assistance of a qualified physician.

If this is not a possibility for you or your loved one, consider enlisting the services of a substance abuse counselor in your area.

Statistics from the National Institute on Drug Abuse (NIDA) reveal that persons aged 65 and older represent only 13 percent of the U.S. population. Yet they account for approximately one-third of all the medications prescribed in this country. The potential for abuse of these prescription drugs among the elderly is very high.

Not Me

The first thing you’ll probably hear is your parent stressing in no uncertain terms that they don’t abuse prescription drugs. They know every pill they take and certainly wouldn’t just take them without having to. They need their pills. After all, the doctor prescribed them. Recognize that you’ll face strong resistance if you confront your parent outright about overusing their prescribed medications. A better way to handle it is the indirect approach.

Do an Inventory of all Medications

You can call this whatever works for you but the simple fact is that you need to take an accounting of all the medications your parent or parents take. If both your elderly parents take medications, and chances are they do, you’ll need to make separate lists. Write down the name of the medication, the manufacturer, strength, dosage and any contra-indications mentioned on the container. Also write down the prescribing doctor’s name and phone number and if there are different pharmacies used, include that as well. Don’t forget to include all nonprescription over-the-counter drugs and vitamins and herbs. Many of these have contraindications when taken in combination with prescription drugs.

Research the Medications

Once you have the list(s), research the medications online. What you’re looking for is specific mention of side effects, long-term consequences, addiction potential, any recalls or negative mentions. A good resource is the National Institute on Drug Abuse (NIDA). Prescription drug abuse among the elderly, states the NIDA, is a growing problem in America due to the fact that this population takes more medications than their younger counterparts. With a variety of illnesses and conditions, physicians prescribe painkillers (opioids), central nervous system depressants, and stimulants to a dizzying extent. All of these medications have the potential for drug dependence and addition. Add to this the fact that the medications are also available over the Internet and the problem compounds. Some Internet “pharmacies” even dispense these medications without a doctor’s prescription.

Make notations on drugs that have negative effects when they are taken with other drugs and/or alcohol. These are the particularly worrisome drugs, as they can prove lethal or lead to serious psychological and/or physiological conditions.

Discuss with your Parents

Based upon what you’ve learned about the dangers of combining certain drugs, or the warnings attendant on prolonged use, discuss these concerns with your parents. Use a calm and loving voice and don’t be threatening or chastising. After all, these are your parents and they need to be treated with dignity and respect. What they may not realize, especially after taking prescribed medications and renewing them for years, is that they may not need them any longer, or that there are sound reasons why they shouldn’t take certain medications at the same time. End the discussion with an action plan. Tell your parent you want to make an appointment with their primary doctor, and you’ll go with them on the visit.

Accompany your Parent to the Doctor

Take the list of all the medications your parents have been taking, and go over all of them with the doctor to ensure their medical necessity (or lack of). See if some of the medications can be eliminated. Keep in mind that our parents have probably been to several doctors and specialists over the years, and prescriptions will have come from a number of sources. You parents’ primary doctor may not have been the one to prescribe them, and he or she may need to consult with the prescribing doctor in order to safely recommend discontinuing the medication. The end result you’re looking for is a reduction in the overall prescription medicines your parents take. It may be a while before this can be accomplished, but the results will be worth it – not only for your parents’ health, but for your overall peace of mind as well.

Prepare a Schedule for Weaning Off

Your parents’ doctor will provide instructions on how/when to wean off particular medications on the list. This is very important since sudden discontinuation of a medication your parent has been taking for a long time can have serious, even life-threatening consequences.

Buy a Pill Organizer

Another tip is to help your parents safely manage their prescription drug intake is with a pill organizer. Allocate the medications they must take on a daily basis (and keep those that are only occasionally taken out of the organizer completely). If rarely taken, lock up the medications. Access is sometimes as great a contributor as accidentally taking too much medication. If all the pill containers are sitting on a shelf, it’s too easy to just take one from here and one from there and all the way down the line.

Monitor Progress

As days and weeks go by, monitor your parents’ progress in responsible pill taking. Carefully assess whether they’re feeling confident in their new-found ability to conscientiously manage their medication intake. If your parent has a condition that makes this impossible, such as Alzheimer’s, is bedridden or has another impairment that clouds judgment, make arrangements for the other parent or a caregiver to enforce the medication schedule and monitor progress.

Celebrate Accomplishment

We all like to feel we’ve achieved a particularly difficult accomplishment. The same holds true with our elderly parents. Take time to celebrate their progress in weaning off or responsibly managing their prescription medications. This shows your parents you love and respect them – and makes them feel more confident in their own abilities as well.