Messenger - Vol. 2, No. 3, Page 11
Summer 1993
On Research
Older Americans tend to under-medicate

     Older Americans misuse their prescripton medicines, tending to
under-medicate rather than overdose themselves, a four-year survey by
University of Delaware researchers shows.
     According to sociologists Cynthia Robbins and Steven Martin of the
University's Center for Drug and Alcohol Studies, preliminary survey
results indicate that, while only one-half of 1 percent of the respondents
reported taking more than the prescribed dosage of medication, 10 percent
reported taking less than prescribed dosages and 15 percent said they had
quit early on prescriptions.
     "Under-medication is a big problem," Robbins says. "A person might
take a prescribed psychoactive drug only when he or she feels sad. Or
worse, they cannot afford to buy the drug so they cut the pills in half. In
such cases, the pills are probably doing them no good at all."
     Eleven percent of those surveyed experienced serious side-effects
because of not taking medications as directed, Robbins says, and 10 to 15
percent of those respondents who were hospitalized cited problems with
drugs as the reason for their hospitalization.
     Robbins and Martin are part of a research team analyzing biological
and psycho-social factors that interact with alcohol and drug use by the
aged. Data for the federally sponsored study was collected over three years
in the Lexington, Ky., metropolitan area.
     Although they represent only 13 percent of the population, people over
65 consume 30 percent of all prescription drugs, and 40 percent of
Americans aged 60 and older use over-the-counter drugs every day.
     Moreover, according to an earlier study by Robbins, older Americans
formed their drinking habits during a period of relatively heavy aggregate
drinking in the U.S., and some 10 percent of the aged are thought to have a
drinking problem.
     "There are two reasons for concern," Robbins says. "As they age,
people have more physical conditions that require prescriptions and
over-the-counter drugs. These drugs can interact with alcohol and so put
people at risk. Plus, drug absorption rates change among older adults, so
older people can become drunk on a smaller amount of alcohol, and drugs can
take longer to clear the system, resulting in a potential for more
alcohol-drug interaction."
     A partial profile of those participating in the survey reveals:

       * About 25 percent of the respondents reported drinking alcoholic
         beverages regularly.
       * Four percent of the respondents reported using other people's
         prescriptions.
       * Over one-half the respondents reported some former tobacco use.
         Twenty-two percent are current smokers, while about a third were
         previously smokers.
       * Men were found to drink more often, while women take more drugs.

     "There is a curvilinear relationship in that those who drink the most
are the wealthiest and the poorest in the sample," Martin says. "And
economic factors seem to play a role in under-consumption of prescribed
dosages."
     Also participating in the study, which is funded by the National
Institute of Alcoholism and Alcohol Abuse of the U.S. Department of Health
and Human Services, are researchers at the University of Arizona, Oregon
State University and the University of Kentucky.
                                   -Michael Hail, Delaware '94 Ph.D.