Tuesday, August 2, 2016

Drugs: Risks, Benefits, Alternatives

People age 60 and over make up 15% of the United States population, but take 30% of all prescription drugs and 40% of all sleeping pills. Older adults account for 30% of all hospitalizations and 51% of all deaths due to drug side effects. Because unlike younger people (who are bombarded with drug information from an early age) older people are often overlooked when it comes to information on chemical abuse. In recent years, a good deal of interest has focused on the use of drugs by older adults. Older adults are America’s largest group of drug users. Over 600 million prescriptions a year are written for people over 60. That’s an average of 15 prescriptions per person per year. In fact, 37% of older Americans use five or more prescriptions at the same time. Nineteen percent use seven or more. And these figures don’t include over-the-counter drugs like aspirin, laxatives, and sleeping pills. One result according to experts is over medication and risks to health. The risks become even clearer when they’re considered alongside aging-related changes that affect the way drugs work in the body. From about the age of 30 on, our bodies begin a process of change that fundamentally alters the internal environment in which drugs and alcohol act and produce their effects. We accumulate more body fat; as a result fat-soluble drugs stay in the body longer, often at higher concentrations than in younger people. Organs that eliminate drugs also become less efficient. For example, the heart becomes less efficient and pumps less blood to brain, kidneys, and liver. In the kidneys, cell loss lowers efficiency in filtering blood and eliminating waster. And in the liver, less blood flow reduces metabolism, ability to eliminate toxins. Additionally, some drugs may hit the older individuals harder than they do younger people; alcohol, caffeine, penicillin, and Valium (among others) trigger stronger effects. Anesthetics and hormones don’t hit as hard. There are many solutions worth considering: Be aware that every drug carries risks and benefits, and the risks change as our bodies change. Don’t assume that there’s a pill for every problem and a fast fix for every sleepless night. Become an informed, active participant in your own health care. Remember that no one is better suited to the task of keeping us well than we are ourselves. Sometimes the best solution to a health or emotional problem is activity – not a pill. The combination use of drugs is another source of problems for many older people. In fact, according to a recent study one in five Americans over 60 has had an adverse reaction to prescription drugs, and many are the product of interactions between different drugs. Most involve people who would never consciously overuse drugs. That does not make the problem any less real when it happens. The simplest way to reduce risk is to avoid mixing drugs – including over the counter cold pills, allergy drugs, and sleeping pills. And it’s a really good idea to stay away from alcohol if you are taking anything. Also, be aware of the risk of an accidental overdose if you see more than one doctor for more than one condition. A good way to avoid problems is to remember to tell your doctor or doctors about all the drugs you are using. Or conduct a “brown bag” inventory and let your doctor sort things out. Simply put all the drugs you’ve taken in the past month in a paper bag and review them with your doctor during your next appointment. This is particularly a good idea if you see more than one doctor. If drugs are a problem for you – do something about it. Talk it over with a friend or get professional help if you need it. If drugs aren’t a problem – do something anyway. You’ll feel better for it and you’ll push potential problems that much further away.

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