New York Times blog, July 2014: "Weaning Older Patients Off Sleeping Pills"

I don't believe this article has been shared yet. It's about "deprescription" for older patients in Montreal, which I heartily support and applaud. What bothers me, though, is this line in the article:

 

'If the risks of sedative-hypnotics are well established, why do so many older people keep taking them? “They’re psychologically addictive,” Dr. Tannenbaum said. “People believe they can’t function without them.” '

 

What about the physiological effects of the drugs? How could these patients get these medications if their doctors weren't continuing to prescribe them? Those are two questions that I'd like to pose.

 

This line is also interesting:  "Dependency is not just an American problem." My comment? No, of course it's not. I think it's a widespread issue due to prescribing practices and the chemical nature of benzodiazepines.

 

Here's the full article:

 

http://newoldage.blogs.nytimes.com/2014/07/02/weaning-older-patients-off-of-sleeping-pills/

I agree with you, Lapis. What about the physiological addiction these drugs cause? Why wasn't that mentioned?

 

One thing I've learned from all the pills I've taken, for whatever reason, is that there's a rebound - physiological - effect once the pills are stopped. And the physiological response brings on psychological distress. Not the other way around. 

Absolutely. Agreed. I'm not sure why the physiological effects weren't mentioned. The science backs it up. Perhaps the journalist missed it. Perhaps it didn't make the editing process. Perhaps it wasn't said in the first place. In my opinion, though, it affects one's understanding of the issue and puts the blame on the elderly person. Not fair! The word "iatrogenic" must be used where it's warranted, and I believe it's especially warranted with the elderly. There's NO WAY they should be expected to go rooting around online to figure out the effects of medications. In general, that generation of people trusts doctors implicitly.

 

I very much support this doctor's actions, but I'm wondering about some of the missing points.

A big issue that needs to be factored in is - is it in the best interests of these elderly patients to be weaned off benzos? The obvious thing is that they probably never should have been prescribed them in the first place, but once they’re on them, is it the right thing to do to take them off them? Quality and duration of life needs to be factored in.

 

I say this because my mother is almost 86, and has been taking a whole host of meds, including a benzo, for years and years.  Before I learned all about the problems with benzos, it never occurred to me to question her medications. However, what would be the point in doing anything about it now? Her health is failing. She has a lot of health issues, some which could be medication related or could just be because of her age. At her level of health and age I will not discuss her benzo use with her doctor because (a) her doctor won't be receptive to me interfering and (b) it will only upset my mother. There is no way she could handle doing a taper now, mainly because of her cognitive abilities, and because I doubt she would be able to handle the side effects. So I have to leave things are they are. Is it fair? No, but is it the right thing to do? Yes.

 

So I just hope elderly people aren’t just yanked off any of their meds, without weighing up the pros and cons first. Benzos are the devil's poison as far as I'm concerned, but sometimes it's better to just leave things alone.

 

I agree. Each case must be weighed individually. If it's the lesser of the two evils to stay on it, then that's the appropriate thing to do.

An 85 year Old Relative of mine has been on Valium for 50 plus years. She is now in a Nursing home and still doing pretty well mentally. To withhold her Benzos at this point would be disastrous in my opinion. As bad as Benzos are...at this point it would destroy her.  I hate benzodiazepines......she,  and many like her are in a lose-lose situation.                                                                                                                   

I'm glad she's doing well at 85, though! Great to hear! Let's hope it continues.

A big issue that needs to be factored in is - is it in the best interests of these elderly patients to be weaned off benzos? The obvious thing is that they probably never should have been prescribed them in the first place, but once they’re on them, is it the right thing to do to take them off them? Quality and duration of life needs to be factored in.

 

I say this because my mother is almost 86, and has been taking a whole host of meds, including a benzo, for years and years.  Before I learned all about the problems with benzos, it never occurred to me to question her medications. However, what would be the point in doing anything about it now? Her health is failing. She has a lot of health issues, some which could be medication related or could just be because of her age. At her level of health and age I will not discuss her benzo use with her doctor because (a) her doctor won't be receptive to me interfering and (b) it will only upset my mother. There is no way she could handle doing a taper now, mainly because of her cognitive abilities, and because I doubt she would be able to handle the side effects. So I have to leave things are they are. Is it fair? No, but is it the right thing to do? Yes.

 

So I just hope elderly people aren’t just yanked off any of their meds, without weighing up the pros and cons first. Benzos are the devil's poison as far as I'm concerned, but sometimes it's better to just leave things alone.

 

I totally agree with you Diaz.

 

I think too sometimes people tend to overlook the most important person in the equation ... i.e. the elderly person. Our society has a tendency to talk over and above elderly people. I find it very patronizing.

 

As someone who is approaching the winter of my life, that is something that greatly worries me. I don't want anyone, however well intentioned, making my decisions for me.

 

"I" decide what's in my best interest and what enhances the quality of my life.

 

Chinook 

 

 

My great- grandmother lived to be 90 took valium and Durand for as long as I can remember and after her husband died Christmas day 12 years ago just had a massive heart attack,,healthy as a horse and still drove,,go figure

Great story! Just goes to show how different we all are! You must have good genes too!

 

Lapis 2 I pray to God I have half her health

Did you ask her for her secrets....I mean, other than taking Valium?!