While news reports focus on an epidemic of opioid abuse among young adults, another totally legal and usually hidden drug epidemic is occurring at the other end of the age spectrum: the fistfuls of remedies — both prescription and over-the-counter — taken by older adults.
According to the American Society of Consultant Pharmacists, people aged 65 to 69 take an average of 15 prescriptions a year, and those aged 80 to 84 take 18 prescriptions a year. And that’s in addition to the myriad over-the-counter drugs, herbal remedies, vitamins and minerals they may take, any of which — alone or in combination — could cause more problems than they cure.
Among people over 65, 44 percent of men and 57 percent of women take five or more nonprescription and/or prescription drugs a week, and 12 percent take 10 or more.
Many of these supposed remedies are unnecessary or used incorrectly and can result in distressing and even dangerous side effects. For example, taking aspirin or a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen could increase the risk of bleeding in patients on a prescribed anticoagulant like coumadin.
The problem of polypharmacy, as the multitude of drugs is called, and the side effects they cause is largely a result of our fragmented health care system, rushed doctor visits, and direct promotion of drugs to patients who are ill equipped to make rational decisions about what to take, what not to take, and when.
This means it is often up to patients and their caregivers to assure that minimum risk accompanies whatever medications or remedies may be prescribed or taken on their own. Even when older patients are discharged from the hospital to a skilled nursing facility, one study found they were prescribed an average of 14 medications, one-third of which had side effects that could worsen underlying conditions common among the elderly.
The complexity associated with the use of multiple medications frequently results in patients failing to follow medical instructions accurately or not taking recommended drugs at all.