‘Worst Pills, Best Pills’ : Guide Warns Older Adults of Hazards in Excess Drugs

Millions of older adults suffer adverse drug reactions each year as a result of misprescribed drugs, and many people mistakenly believe drug-related woes are just part of old age, a consumer health advocate says.

The advocate, Dr. Sidney Wolfe, has written a new consumer guide aimed at changing doctor-patient relations and deflecting the marketing of drugs to doctors for the elderly, who make up a big share of the drug-consuming market.

“The drug industry is aware of the fact that for millennia, the doctor-patient relationship is one in which the doctor has the upper hand,” Wolfe said recently, adding that 9 million adults over 60 suffer unnecessarily every year because of prescription drugs.

A physician, Wolfe is the outspoken director of the Washington-based Public Citizen Health Research Group, which he co-founded with consumer advocate Ralph Nader.

“Only recently has the patient said, ‘Hey, maybe I’d be getting better care if I work with my doctor,’ ” Wolfe said shortly before the September release of the book, “Worst Pills, Best Pills,” distributed by Pantheon.

The book’s subtitle, “The Older Adult’s Guide to Avoiding Drug-induced Death or Illness,” emphasizes the severity of the problem, which Wolfe considers “an epidemic” for those over 60, who in this country number about 40 million.

The book lists the 287 most prescribed drugs and their possible good and bad effects for Americans over 60. Included are 104 drugs the book said should not be used at all and 183 safer alternatives, some of which do not involve taking drugs.

“Although older adults do have more chronic diseases than those who are younger . . . there is mounting evidence that many of our older citizens are getting prescription drugs which are entirely unnecessary . . . “ or could be used at a lower dose or in a safer form, the book says.

Over-drugging of the elderly is commonplace, other geriatric health experts agree.

“The way I make my living basically is by taking people off of drugs,” said Dr. William Burke, director of geriatric psychiatry at the University of Nebraska in Omaha.

He agreed with the book’s warnings about the widespread use of addictive drugs called benzodiazepines--so-called minor tranquilizers like Valium, Librium, Xanax--in addition to sleeping pills like Halcion.

Heart and blood pressure medications and gastrointestinal drugs also are over-prescribed, the book concludes.

Even before seeing the book, the American Assn. of Retired Persons in Washington welcomes Wolfe’s contribution, said Judith Brown, a health analyst for the group.

She said AARP has been disappointed by the failure of the Food and Drug Administration, which licenses all drugs and controls their labeling, to make more drug information available to consumers.

Wolfe’s book offers the kind of understandable information that was to have been required in the packaging of all prescription drugs, but the FDA dropped the proposal at the conclusion of the Jimmy Carter Administration.