MW

Maureen Wendt

We are taught at a young age that taking medicine is supposed to make us feel better. However, when used incorrectly, some medications can do more harm than good.

People aged 60 and older 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.

Older adults are America's largest group of drug users. More than 600 million prescriptions a year are written for people older than 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 the brain, kidneys and liver. In the kidneys, cell loss lowers efficiency in filtering blood and eliminating waste. And in the liver, less blood flow reduces metabolism and the ability to eliminate toxins.

Additionally, some drugs may hit 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.

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.

When it comes to medicine, the more you know, the safer you are. One of the ways to stay informed is by talking with your doctor. Some questions to ask your doctor include:

— Why do I need to take this medication? Keep a list of your medications and update the information with each new prescription. This is important, especially if you are seeing more than one doctor. Review your list and confirm what each medication is for, why you are taking it and exactly how you should be taking it. Remember to include non-prescription and over-the-counter medications on your list.

— Do I need to be on this medication indefinitely or can I stop taking it? Many people continue to take a medication they no longer need simply because no one told them to stop. There may be medications that are no longer necessary or some that could have been discontinued. Additionally, as people age, the way their body uses and breaks down drugs changes. As a result, some drugs that worked fine for a long time start to cause problems. If that is the case, you may need to stop taking the medication or switch to a new drug.

— Will this medication interact with something else I'm taking? Before taking any drug, you should always ask if it is safe to take with your other medications. Drug interactions and double dosing are serious issues. For example, taking certain over-the-counter drugs and prescription drugs at the same time can be very dangerous. According to a recent study one in five Americans older than  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.

Also, be aware of the risk of an accidental overdose, especially 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.

And it's a really good idea to stay away from alcohol if you are taking anything.

Remember, doctors are there to ensure their patients' safety. Don't be afraid to talk with your doctor if a medication doesn't seem to be working or you are having problems.

Maureen A. Wendt is president and CEO of The Dale Association, a non-profit organization that provides senior, mental health, in-home care, caregiver support services and enrichment activities for adults. For more information, call 433-1937 or visit www.daleassociation.com .

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