Senior Peer Program

West Yavapai Guidance Clinic

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More than 80% of older adults (ages 57 – 85) use at least one prescription medication on a daily basis

More than 50 % take more than 5 medications or supplements daily

About 25% use prescription psychoactive drugs and for longer periods than younger

adults. Mostly for anxiety and depression

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Unintentional misuse

Intentional nonmedical use

More chronic illness in older

adults, dealing with pain

Age related change in metabolism

Potential for drug interactions

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Research indicates that there is a rise in use of alcohol in older adults. Particularly binge drinking

The combination of alcohol and medication misuse has been estimated to affect up to 19% of older adults

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Prescription medication abuse by teens is at epidemic proportions: One out of four teens has admitted to taking a prescription drug not prescribed to them

Over 70% of those who abused prescription drugs got them from friends or family

Medicine cabinets are easily accessible

Teens are abusing prescription drugs more than cocaine, heroin and meth combined 5

Reasons for unintentional misuse of medications may include:

◦ difficulties in reading and following prescription directions,

◦ cognitive deficits,

◦ cost of meds, and

◦ complexity of drug treatment.

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Medication management problems are different than misuse.

Management problems include taking the wrong dose at the wrong time of day, forgetting to take the medication, or failure to read warning labels.

Misuse of medications include using a medication in higher doses than recommended, continuing to take it beyond the prescribed time limit or sharing it with others.

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The spread of marijuana use and the opioid epidemic over the past 10 years have affected middle-aged and older adults

Prescription opioid and benzodiazepine misuse has increased older adult’s risk for suicidal thoughts, and accidental overdose which often occurs with alcohol use.

Older adults have the highest suicide rate of all ages. Yavapai County has the highest suicide rate among all ages.

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People over 50 read warning labels less often than those 20-29

Researchers tracked eye movements while people scanned the warning labels

Younger people actively scanned label while older adults stared with a fixed gaze

All were tested following the label reading Therefore, those 50 and beyond did not see,

“don’t take this medication and drive,” etc. Older adults have more medications and

complicated dosing yet read warnings LESS

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What medication you are taking

Why you are taking it

When during the day you take it and what dose

How long you should take it

Side effects you should look for with meds

Interactions with other meds, supplements and herbs.

Foods or drinks (including alcohol) you need to avoid while taking the meds

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↓ in the % of water in body weight

Changes in digestion

Changes in liver and kidney function

Allergic reactions

Complicated dosing schedules with chronic disease

Interaction risks

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Metabolism of alcohol by the liver

Alcohol is metabolized slower; blood alcohol levels stay higher longer

Metabolism of prescription medications by liver or kidneys

Mixing alcohol and medications can be deadly

Taking medications of other family members

Drinking to cope with loss and isolation

Alcohol is a depressant; can increase depression

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Benzodiazepines (valium, ativan, centrax)

Sleep Aides (ambien)

Pain medicines (codeine, oxycodone, anti-seizure, anti-psychotic, antihistamines--over-counter)

Alcohol can increase the symptoms of dementia when mixed with anti-anxiety or anti-depression medications

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Don’t attribute to AGING Not everything is AGING

Worried or crabby

Memory loss

Can’t make a decision

Concentration

Lack of interest

Sad or depressed

Mood swings

Chronic pain

In trouble with law

Falls, bruises, burns Incontinence Headaches Dizziness Poor hygiene Poor nutrition Do not relate to family

or friends Suicidal ideation Unusual response to

pain

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For men, the average prevalence of binge drinking was stable from 1997 to 2014.

For women, it increased an average of nearly 4 percent per year.

Overall, women are more sensitive to the negative health consequences of alcohol.

Consequences include liver disease, high blood pressure, stroke, heart disease cognitive impairment and developing a substance use disorder

Study published March 24, 2017 in the journal Alcoholism:: Clinical and Experimental Research

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5 drinks for men and 4 drinks for women within a two hour period. Recommended alcohol intake for older adults is 2 drinks for men and 1 drink for women on a daily basis. Some health conditions and taking certain medications would indicate less or no alcohol intake .

Some health risks include alcohol poisoning,

Increased risk for falls and serious injury.

Drinking and driving crashes.

Kidney and liver damage

Over dose when combined with certain medications

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1 can of beer, 12 oz

1 single shot of whiskey, vodka, 1.5 oz

1 glass of wine, 5 oz

1 glass of sherry, 4 oz

1 glass of liqueur, 4 oz

Moderate use of alcohol of alcohol refers to two drinks per day for men and 1 drink a day for women who are older adults.

As Americans, we SUPERSIZE our alcohol, one beer today is a 16-24 oz can!

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1. Have you ever felt you should cut down on your drinking?

2. Have people annoyed you by criticizing your drinking?

3. Have you ever felt bad or guilty about your drinking?

4. Have you ever had a drink first thing in the morning to steady your nerves or to get ride of a hangover (eye opener)?

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Item responses on the CAGE are scored 0 for “no” and 1 for “yes” answers, with a higher score an indication of alcohol problems. A total score of 2 or greater is considered clinically significant.

However, a positive response to any one of these questions should prompt further exploration among older adults.

Ewing 1984

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Gingko has blood-thinning properties and should not be used with other blood thinners

Gingko and aspirin together may cause bleeding

St. John’s wort may interact with HIV and organ transplant drugs besides interacting with anti-depressants

Kava herb for anxiety intensifies depressants like alcohol, prescription sedatives and herbal relaxants plus Kava can increase liver toxicity

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Double dosing on stimulants like bitter orange or kola nut and weight loss drugs, caffeine, or pseudoephedrine can speed metabolism/increase anxiety, heart rate, blood pressure or insomnia

Mushrooms may counteract corticosteroids or drugs that suppress immune response

If taking herbal laxatives they can deplete body of potassium and if taking diuretics you may experience a double depletion of potassium; psyllium or flaxseed do not deplete potassium

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Some foods can affect how well your medications work.

Avoid fish oil supplements if you take blood thinners. Large amounts can also thin blood

Avoid grapefruit and grapefruit juice if you take certain Statins for high cholesterol.

If you take medicine for diabetes, avoid too much cinnamon ( it can lower blood sugar)

If you take certain heart medicines, avoid too much calcium.

Don’t Eat This if You’re Taking That, AARP Publication

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Connie Boston, MSW

Manager, Senior Peer Program

505 S. Cortez

Prescott, AZ 86303

c.boston@wygc.org

928-445-5211 Ext. 2672

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