New Concerns About Senior Medication Safety

Related topics: Medications

Seniors trying to organize their medications

If you follow the headlines, you've probably read about the skyrocketing number of deaths caused by the abuse of opioid prescription painkillers such as morphine, codeine, oxycodone (Oxycontin) and hydrocodone (Vicodin, Percocet). Federal data shows that the rate of overdoses has even slightly lowered the life expectancy for Americans. This overdose epidemic is partially fueled by the increased prescribing of these narcotic drugs, which has quadrupled since 1999. According to the American Society of Addiction Medicine, each year doctors write 259 million prescriptions for opioids, enough for every American to have a bottle of pills!

The Centers for Disease Control and Prevention (CDC) has just released new guidelines to help protect patients from the dangerous side effects of these drugs. CDC director Dr. Tom Frieden explains, "More than 40 Americans die each day from prescription opioid overdoses. We must act now. Overprescribing opioids — largely for chronic pain — is a key driver of America's drug overdose epidemic."

When we think about drug abuse, we are likely to picture the stereotype of a young addict on a street corner. But according to a recent study from New York University, older adults now make up the majority of patients who seek help for addiction to opioids. Said study author Dr. Benjamin Han, "We are facing a never-before-seen epidemic of older adults with substance use disorders and increasing numbers of older adults in substance abuse treatment."

Side Effects, Overdoses Due to Polypharmacy

Opioids aren't the only drugs that can threaten the health of seniors. In March 2016, the Journal of the American Medical Association (JAMA) published a University of Illinois at Chicago study revealing that one in six older adults now takes a combination of medications that could be deadly. Part of the problem is that today, over one-third of older patients takes five prescription drugs or more. (You may have heard this referred to as "polypharmacy.")

Head researcher Dima Mazen Qato says, "The risk seems to be growing, and public awareness is lacking." She explains that a single medication that is safe and effective on its own may be dangerous when mixed with other medications. And it's not only prescription drugs that can cause problems. Qato's team reported that over-the-counter drugs can also cause dangerous side effects. This includes supplements, which more and more seniors are taking. Supplements are unregulated and untested, and though most people think they are harmless since one can just buy them off the shelf, they actually can reduce the effectiveness or change the function of prescription drugs. For example, fish oil supplements and St. John's wort have been found to interfere with blood thinners, heart medications and HIV/AIDS drugs.

Taking Medications Safely

When taken properly, medications help seniors manage their health conditions and can vastly improve their quality of life. Here are some ways to ensure these powerful substances help, rather than harm, our health:

Ask your doctor or pharmacist to review your medications. Many overdoses or negative interactions happen when a senior sees multiple doctors, who might inadvertently prescribe medicines that have the same effect or otherwise don't safely combine. Keep a record of the medicines you take, and have your doctor or pharmacist review it each year. Or bring in all your pill bottles and other containers.

Tell your doctor about nonprescription drugs and supplements you take. In the JAMA study above, researchers from the University of Minnesota reported that many seniors fail to tell their doctor that they are taking supplements — doctors don't ask, and patients don't tell, perhaps fearing disapproval. Be sure those medications are on the list you share.

Use a single pharmacy if possible. Though it might be easy to pop into the hospital pharmacy after an outpatient appointment, or fill a prescription at an unfamiliar drug store right by a specialist's office, it's better to have all your prescriptions filled at the same place. Most pharmacists today have a computer record of all the drugs a patient takes, making it easier to spot any possible "red flag" combinations.

Take medications as prescribed. Take the correct amount, at the recommended time, and in the way your doctor suggests (such as with water, with food, at bedtime, avoiding alcohol, etc.). Don't skip a dose — but know what you should do if you accidentally forget a dose. Never cut pills in half unless your doctor recommends it. And if you're not sure about something, ask your doctor. For example, if you're instructed to take a medicine "four times per day," does this mean you need to take a dose in the middle of the night?

Devise a system for keeping track of medications.  It can be quite a challenge to juggle more than one or two prescriptions! And if seniors have visual impairment or memory problems, this just adds to the challenge. Look into charts, pill boxes, calendars, pill dispensers with an alarm, even apps for your smartwatch.

Check your Medicare drug program's offerings. If you are in a Medicare drug program, you may be eligible for a free Medication Therapy Management program, in which a pharmacist or other health professional provides you with a comprehensive review of all the drugs you take, and makes suggestions on managing your medications — and even on how to save money. (Learn more here.)

Be alert for side effects. When you start taking a new drug, ask your doctor and pharmacist about possible side effects, such as dizziness, drowsiness, headache, nausea or a rash. Find out what you should do if side effects occur. Retain any literature that came in the drug packaging or from the pharmacy. (Ask your pharmacist to supply large-print information if you have trouble reading the labels on pill bottles.)

Clean out your medicine chest periodically. Drugs that are past their pull date could be ineffective or even dangerous to take. Ones we no longer need could fall into the hands of people who shouldn't have access to them. If a senior is taking multiple medications, it's easy to get confused when there's a jumble of bottles in the cabinet! Ask your pharmacist about the safe, recommended way to dispose of these unwanted drugs.

If you're having trouble paying for prescription drugs, check into your options. Begin by checking whether any newly prescribed drug is covered by your Medicare Part D program. Talk to your doctor about options if it's not covered, or if the copayments are high. Your doctor might prescribe a generic or a similar, cheaper drug instead. Seniors may qualify for Medicare Part D Extra Help. Your state also may have a program to help people with limited incomes pay for prescriptions; visit this National Council on Aging directory to find out.

For More Information

The U.S. Food and Drug Administration offers a number of easy-to-read publications for senior consumers, and the agency has recently updated their safety information about supplements.

The information in this article is not meant to take the place of the advice of your healthcare provider. Talk to your doctor or pharmacist about the drugs you take, and before beginning or stopping any prescription or nonprescription drug.

Source: IlluminAge Communication Partners; copyright 2016 IlluminAge

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