Characteristics of nursing home patients who receive medications with the potential for addiction on a regular and long-term basis: a retrospective pilot study
K. Solomon
Bok Engelsk
| Utgitt | K Solomon St Louis Univ Sch Med Geriatr Alco
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| Opplysninger | Benzodiazepines are among the most commonly prescribed drugs in nursing homes. Other potentially addictive drugs, including other sedative/hypnotics and oral narcotics, are also prescribed quite frequently. These drugs are not always prescribed for appropriate clinical indications, may be prescribed for extended periods of time and may cause significant side-effects. Among the concerns about the regular use of these medications is their potential for abuse and dependence. In this study, we examined the records of 253 consecutive psychiatric consultations in nursing homes. All consultations were performed by the senior author. At the time of consultation, one-third of the subjects were receiving a potentially addictive drug on a regular, and usually daily basis. We compared the group receiving these drugs and the group not receiving these drugs on several variables, including psychiatric and family histories, psychopharmacologic treatments, personal and family addiction histories, psychiatric diagnoses and clinical symptoms. This article presents the results of this study. There were 84 patients in the addictive drug use group and 167 patients in the addictive drug non-use group. We found that regular use of these drugs was associated with several variables. These included the possibility of a biologic vulnerability to addiction, the presence and severity of the psychiatric disorder(s) of the patients, and the third was the presence of major depression or depressive symptoms. The implications of these data are reviewed. In addition, methodologic and diagnostic issues are discussed. The implications for clinical practice and future research in this area are also discussed.
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