PhotoData from the Centers for Medicare & Medicaid Services (CMS) show millions of senior citizens are taking powerful and addictive drugs, despite health officials' warnings that they shouldn't.

In an analysis of that data, researchers at have found that drugs paid for by taxpayers under Medicare Part D include barbiturates and benzos, two types of drugs the American Geriatrics Society (AGS) warns should not be given to people age 65 and older.

Both drug types are on the Beers List, a catalog of drugs seniors should avoid because of their potential for causing dependence and other negative side effects.


Benzodiazepines (benzos) are a class of psychoactive drugs that are sedative or sleep-inducing and remove anxiety. They include diazeparm, better known under its trade name Valium. When used by younger people in low doses for short periods, they are generally safe and effective.

Barbiturates act as a central nervous system depressant and produce a range of effects, from mild sedation to complete anesthesia. They can pose a danger because they are easily physically and psychologically addictive.

Older people can react adversely to any type of medication, but in particular, tend to experience more of the negative side effect profile of benzodiazepines – which can include memory problems, mood changes, daytime sedation, and impaired motor coordination.

The AGS strongly advises against the use of benzos by elderly people, yet a recent study in JAMA Psychiatry revealed that 9% of 65- to 80-year-old Americans use one of these sedative-hypnotics. Use is even higher among older women.

The problem with barbiturates for seniors is that they have a much narrower margin of safety than other drugs and are highly addictive. This is why they’ve largely been replaced by benzodiazepines. Medicare pays for them, but it places restrictions on what medical conditions they can be prescribed for, unlike benzos, which have no such restrictions.

Problem concentrated in one region

What the two drugs have in common is geography. The largest concentration of consumers 65 and older taking these drugs is located in the southeastern U.S. West Virginia, Tennessee, and Florida have the largest number of seniors taking Valium and Xanax in the U.S.

West Virginia, Kentucky and Louisiana have the highest rates of barbiturate prescriptions for consumers 65 and older.

In fact, when the researchers looked at four drug classifications on the Beers list, considered harmful to seniors, the 12 states with the highest senior prescription rate were all in the south. Are seniors in the south less healthy than the rest of the country? The researchers essentially rule that out.

Instead, they contend prescribers in the south just seem to be prescribing these drugs more often. The researchers conclude that inappropriate prescribing practices – which the CMS data has now confirmed extends to elderly people through the Part D program – must be identified and, ideally, changed.  

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