Medication Misuse …The Other Drug Problem
by Linda R. Bernstein, Pharm.D.
One of the most important goals of Dr. Linda TV – Best of Health! is to offer practical tips on how to use your medicines safely, effectively and save money. This is the first of a series of articles that will address these subjects. Don’t forget to “Ask Dr. Linda” if you have questions about your medicines.
Let’s start by gaining a better understanding of a drug problem people don’t usually talk about, but which has a huge impact on consumer health. That is the misuse and abuse of prescriptions, nonprescription medicines and dietary supplements. This is particularly significant among seniors who use the most medicines.
Medication Use Stats
Almost 70% of Americans take at least one prescription drug, according to a recent Mayo Clinic study and 1 in 4 take 3 or more drugs, according to the Centers for Disease Control. One-fifth of Americans take five or more prescription drugs. The most common prescriptions are for antibiotics, antidepressants and opioid painkillers.
Seniors make up about 13% of the population but consume a third of all prescription drugs. Nine out of 10 Americans over age 80 use prescription drugs, filling 22 prescriptions annually and almost half report using an over the counter product or dietary supplement. More than 80 percent of older patients (ages 57 to 85 years) use at least one prescription medication daily, with more than half take more than five medications or supplements daily.
Adverse Drug Reactions
Adverse drug reactions (medicine side effects) are one of the leading causes of illness and death. Each year, more than 9.6 million adverse drug reactions occur in older Americans, many of which are preventable. Hundreds of thousands of these adverse drug reactions result in hospitalization.
Medication Misuse
Studies have consistently shown that 20% to 30% of medication prescriptions are never filled, that about half of medications for chronic disease are not taken as prescribed. Estimates are that approximately 125,000 deaths per year in the United States are due to not taking medicines as directed and that 33% to 69% of medication-related hospital admissions are due to poor adherence. The total cost estimates for medication nonadherence range from $100 billion to $300 billion every year, when both direct and indirect costs are included.
Why Do People Misuse Medicines?
There can be many reasons that people misuse their medicines. For example, people want to economize and skip doses due to the high cost of medicines and co-payments. The more medicines you take, the more likely you may take them incorrectly. Patients frequently have difficulty remembering or managing multiple medications or complex regimens, often prescribed by multiple doctors or they do not understand the reasons for and importance of drug therapy. Older adults are more prone to medication misuse due to taking multiple medications, poor vision, hearing, and memory that make managing medications and following instructions more difficult. This can result in poor disease control and preventable adverse drug reactions.
Medication Abuse...
Seniors also take more potentially addictive medications than any other age group. Factors such as living alone, and depression can contribute to drug abuse in the elderly.
Misuse of prescription opioids, depressants, and stimulants is a serious public health problem in the United States. Although most people take prescription medications responsibly, in 2017, an estimated 18 million people (more than 6 percent of those aged 12 and older) have misused such medications at least once in the past year. According to results from the 2017 National Survey on Drug Use and Health, an estimated 2 million Americans misused prescription pain relievers for the first time within the past year. Additionally, more than one million misused prescription stimulants, 1.5 million misused tranquilizers, and 271,000 misused sedatives for the first time.
Bad Medication Taking Habits
Consumers often don’t want to bother their healthcare provider with medication questions, so they turn to unreliable sources for advice. They hop around from one healthcare provider and pharmacy to another so no one person is aware of all the medicines they take. They start and stop their medicines without consulting their physician, mix over the counter medicines and herbal products with their prescription medicines, and some never even fill the prescription at all. They may take a higher or lower dose than prescribed.
Good Medication Taking Habits
Here are steps you can take to ensure that you use medications safely and effectively:
Follow medication directions as explained on the label or by the pharmacist, and make sure you know how to use it properly before taking that first dose
Be aware of potential interactions with other drugs, foods and beverages such as alcohol
Be able to recognize potential side effects and know when they should be reported
Do not stop or change a dosing regimen without first discussing it with your healthcare provider
Do not borrow medicines from others or loan your medicines to others
Be aware of what precautions you need to take while using the medicine, such as whether you can drive or operate machinery or avoid the sun
Store all medicines safely in their original, child-proof containers, in a cool, dark, dry, preferably locked cabinet out of children’s reach
Additionally, know how to properly discard unused or expired medications by following U.S. Food and Drug Administration (FDA) guidelines or visiting U.S. Drug Enforcement Administration collection sites. Inform your healthcare provider about all the prescriptions, over-the-counter medicines, and dietary and herbal supplements you take at all your healthcare visits and before obtaining any other medications.
Your pharmacist can help you understand medication use instructions, guide you in the selection of over-the-counter products, make sure you aren’t duplicating any medicines, help screen for drug interactions, teach you about what adverse drug reactions to watch for and report, and help you save money by suggesting equivalent, less expensive generic medication substitutions.
One of the best ways to reduce your risk of an adverse drug interaction is to show an updated list of all the medicines and products you take to your healthcare provider or the pharmacist at every visit. When you're done watching download the handy “My Medication List” form that you can use for this purpose.
Be a wise medication consumer and not a misuser!
Tune into Dr. Linda TV to receive more practical medication use and health information to help you achieve the Best of Health!
References
Health Policy Institute. Georgetown University. Prescription Drugs
https://hpi.georgetown.edu/rxdrugs/
Misuse of Prescription Drugs Research Report
https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/what-classes-prescription-drugs-are-commonly-misused
Mollison, Caitlin. Concerns About Medication Adherence Grow Amid COVID-19 Pandemic. April 3, 2020
https://www.pharmacytimes.com/view/concerns-about-medication-adherence-grow-amid-covid-19-pandemic
Almost 70 Percent of Americans Take at Least One Prescription Medication, Study Finds
https://drugfree.org/drug-and-alcohol-news/almost-70-percent-of-americans-take-at-least-one-prescription-medication-study-finds/
VADM Regina M. Benjamin, Surgeon General. Surgeon General’s Perspectives. Medication Adherence: Healping Patients Take Their Medicines as Directed. https://journals.sagepub.com/doi/pdf/10.1177/003335491212700102
Preventable Adverse Drug Reactions. A Focus on Drug Interactions.
https://www.fda.gov/drugs/drug-interactions-labeling/preventable-adverse-drug-reactions-focus-drug-interactions
U.S. Food and Drug Administration. Disposal of Unused Medicines: What You Should Know. Learn how to dispose of unused or expired. drugs.
https://www.fda.gov/drugs/safe-disposal-medicines/disposal-unused-medicines-what-you-should-know