No wonder so many have pounding headaches

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James M. Berklan
James M. Berklan

A very wise man once told me that when your only tool is a hammer, everything looks like a nail.

That has to be at least part of the reason that the number or older Americans taking three or more psychiatric drugs more than doubled in the decade ending in 2013.

On top of that, get this: Almost half (46%) of the people found to be in this boat had no mental health diagnosis.

That's a lot of drugs flowing where they previously had not.

Are there legitimate uses for antipsychotics and similar substances? Of course. But is there abuse of prescribing powers going on here? I think one can safely assume so.

A key aspect of this study, which was led by University of Michigan and Columbia University researchers, is they used physician office visits to track the prescribing. That takes some of the self-righteous finger pointing away from long-term care providers. Some, but not all.

Long-term care operators must remain vigilant and not get lazy on their residents' behalf. Sure, the horrible physical restraint numbers of just a few short decades ago have been nearly wiped from the public's mind. But chemical restraints must not be the reason.

Investigators noted that the biggest jumps in questionable prescribing occurred in rural areas, perhaps an open indictment that there are too few specialty clinicians to make rounds frequently enough.

Researchers have known for a while that the use of antidepressants, painkillers and sleeping pills have generally increased among the elderly. But they were stunned to learn just how much the use of multiple psychotropic drugs has expanded.

Office visits among the elderly that led to prescriptions for psychiatric, pain, anxiety and sleep meds — think Prozac, Xanax, Ambien, Valium and OxyContin — have boomed. Such doctor consultations soared from 1.5 million in 2004 to 3.68 million in 2013.

Sure, the general population is getting older and adults may be getting more comfortable discussing and medicating their problems. But manipulative marketing also has matured — some would say to a troubling level.

Medical organizations that serve the elderly and groups such as the American Society of Consultant Pharmacists have warned against overprescribing since seniors are more susceptible than others to bad drug interactions and adverse side effects.

Diversions such as stress management, talk therapy, massage and other non-pharmaco solutions can lessen the reliance on some drugs. They can be part of the solution, agree most experts not tethered to a drug manufacturer.

Anything to stop all the hammering.

Follow James M. Berklan @JimBerklan.

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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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