Many older persons are not aware of the age related changes that make their bodies more vulnerable to the effects of alcohol, drugs and medications.  As we age, our bodies experience changes (i.e. enzyme, metabolic and body composition) that impact the absorption, processing and excretion of medications.

Some drugs may actually have the opposite effect in an older body than they do in a younger body. Most drug testing is done on younger people and dosage recommendations are often based on the effects measured in younger bodies.

Over 75% of people over the age of 65 take a prescription medication.  The average number of medications an older adult may be using at any given time is five.  More than half of these prescriptions have some sedating side effects. 

The cost and accessibility of medications result in many people skipping doses, sharing medications or altering a prescription.  This can be very dangerous and it can worsen illnesses.  If you cannot take a medication as prescribed, tell your health care professional and be honest about the reasons – there might be another way to meet your medication needs.

Older adults are the greatest consumers of over-the-counter (OTC) medications (antacids, cold remedies, laxatives, sleep aids, etc.) and "nutriceuticals" (herbals, dietary supplements, vitamins, etc) accounting for 30% of all OTC sales.  A common myth is that they are "safe" because they are readily available and not subject to the same FDA (Federal Drug Administration) standards.  OTC's and nutriceuticals can have significant side effects and negative interactions with other drugs.  Some can be habit forming and some can be dangerous to individuals with dementia and other illnesses.

Dangerous substance misuse / abuse by older adults in our culture is under-estimated, under-identified, under-diagnosed and under-treated.  This happens due to confusion of symptoms with other problems, lack of education, denial, ageism, myths, stigma and limited research and data.

Anyone who has been on a long-term medication should have the medication and dosage reviewed.  The types of medications or dosage strength of long term medications should be changed with age and onset of other illnesses. 

Responsible medication use includes:

• Informing the doctor of all prescription and non-prescription substances you take, including the amount of alcohol you drink
• Following the directions on the label
• Knowing what time of day, and how many times per day to take a medication
• Knowing if you should take the medication with or without food
• Asking if any of your medications might react with other prescriptions, over-the-counter medications, vitamins, alcohol or foods
• Keeping track of any side effects you experience and report these to your health care provider
• Reviewing all medications with your health care provider every six to twelve months to evaluate their necessity, therapeutic effect and dose appropriateness