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Revelations have shed light on an opioid crises in the United States that remained largely hidden until recently. These drugs have affected the lives of children and adults nationwide. Unfortunately, the inappropriate use of medication – legally or illegally – is not limited to opioids in its multigenerational reach. As the New York Times reports in “A Drug Problem Among the Elderly,” the use of benzodiazepines has “risen among older people, even though they are particularly vulnerable to the drugs’ ill effects.”[1]

The article highlights that, in 1999, there were “63 benzodiazepine-related deaths among those 65 and older.”[2] In 2015, there were 431 deaths, with more than two-thirds of these deaths also involving opioid use.[3] An epidemiologist at the National Institutes for Health told the Times that, even without the opioid issue, “[w]ay too many older Americans are getting benzos. And of those, many—more than half—are getting them for prolonged periods.” The article adds that such use can lead to falls and fractures, or memory and other cognitive problems.[4]

The New York Times article, however, is not alone in finding alarmingly inappropriate drug use among the nation’s elderly. Human Rights Watch published a devastating report in February 2018 that found, on average, 179,000 nursing home residents are being given off-label antipsychotic medications every week.[5] Remarkably, these findings come in the wake of a decision by the Centers for Medicare & Medicaid Services (CMS) to place an 18-month moratorium on certain enforcement remedies for violations of standards of care related to pro re nata (PRN)[6] psychotropic drug use in nursing homes.[7]

March 29, 2018 – D. Valanejad


[1] Paula Span, A Quiet Drug Problem Among the Elderly, NY Times (Mar. 16, 2018), available at https://www.nytimes.com/2018/03/16/health/elderly-drugs-addiction.html.
[2] Id.

[3] Id.
[4] Id.
[5] Hannah Flamm et al., “They Want Docile:” How Nursing Homes in the United States Overmedicate People with Dementia, Human Rights Watch, (Feb. 5, 2018), available at https://www.hrw.org/report/2018/02/05/they-want-docile/how-nursing-homes-united-states-overmedicate-people-dementia.
[6] To be provided “when necessary.”
[7] Temporary Enforcement Delays for Certain Phase 2 F-Tags and Changes to Nursing Home Compare, CMS (Nov. 24, 2017), available at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-18-04.pdf (“[T] there will be a 18-month moratorium on the imposition of civil money penalties (CMPs), discretionary denials of payment for new admissions (DPNAs) and discretionary termination where the remedy is based on a deficiency finding of one of the specified Phase 2 F-tags…”).

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