Polypharmacy and Seniors
Polypharmacy refers to the taking of multiple drugs by a single patient. As more and more drugs are introduced on the market that address the diseases and chronic conditions associated with aging, it is no surprise that it is the elderly who are most affected by polypharmacy. According to a Toronto Star article that appeared as part of their 2008 Atkinson Series, 23% of seniors over the age of 65 take at least five drugs, while 12% are taking 10 or more drugs. Generally, these individuals are seeing more than one specialist for more than one ailment and the issue is simply a lack of oversight in order to keep the ‘larger picture’ in view.
Delving deeper, however, USA Today cited a report by the Center for Substance Abuse Prevention that 17% of Americans over the age of 60 are abusing prescription drugs. In such instances of substance abuse, it is not unusual for the individual to visit numerous physicians (‘doctor shopping’) and process their prescriptions through a variety of pharmacies in order to hide the abuse. Particularly addictive drugs in the elderly population are the benzodiazepines (prescribed for anxiety and insomnia) and narcotic painkillers. Risk factors include a prior history of alcoholism or substance abuse. The effects of prescription abuse include confusion, memory impairment and an increased incidence of falls. In 1995, the Canadian Medical Association Journal reported that the doctors who wrote the most prescriptions also had the highest death rates amongst their patients.
So where does one draw the line between prescription use and prescription abuse? When a drug is used for a non-prescribed purpose or when use increases beyond the prescribed dose, then addiction is an issue. If you have a concern about an aging relative, stay connected and informed and periodically check for drug compliance (this is as simple as looking at the fill date and counting the number of pills thus far consumed). Assess alternatives (a pain management specialist, perhaps) and if necessary, express your concerns to the prescribing physician.
Jennifer Hartman, Guest Blogger