Risky Medications and Overprescribing Trends in Older Adults

Older adult medical care faces persistent safety hazards as national data reveals that patients continue to receive potentially inappropriate medications including benzodiazepines, antibiotics, and aspirin. According to health researchers, medical inertia and ingrained habits often keep these drugs entrenched in clinical practice long after medical associations revise their guidelines.

The Drawbacks and Persistence of Benzodiazepines

Medical researchers have raised safety alarms about benzodiazepines for more than two decades due to significant risks for older patients. Prescribed frequently for insomnia and anxiety, they offer prompt relief, according to Mark Olfson, a psychiatrist and epidemiologist at Columbia University, as reported by KFF Health News.

Despite that prompt relief, benzodiazepines—along with related Z drugs like Ambien and Lunesta—carry heavy drawbacks. Olfson noted that these medications may impair balance, coordination, and cognition that can translate into falls and fractures and motor vehicle accidents. Furthermore, when combined with opioids for pain management, benzodiazepines can cause fatal overdoses. Prolonged use also builds chemical dependence, leading to withdrawal symptoms when patients attempt to stop taking them.

Recent data published in the Annals of Internal Medicine shows some national progress in reducing these prescriptions. Among adults aged 65 and older, the rate of patients filling prescriptions for benzodiazepines dropped to 11.5% in 2024, down from about 14% in 2015. However, that downward trend stalled following 2020. Prescribed use actually climbed among individuals over 75, moving from 12% in 2020 to roughly 13% four years later, while pharmacy dispensing in long-term care facilities more than doubled. About a third of users remained on the drugs for longer than six months.

It’s worrisome, Olfson said, though he cautioned that patients must never stop taking benzodiazepines suddenly on their own. Instead, stopping requires supervised tapering with a medical professional over the course of many weeks.

Antibiotics and Medical Inertia in Aging Patients

Overprescribing antibiotics remains a parallel concern across geriatric healthcare. For years, standard medical treatment for conditions like diverticulitis—the inflammation or infection of small pouches forming in the colon—relied heavily on antibiotics such as fluoroquinolones like Cipro and Levaquin, or amoxicillin-clavulanate known as Augmentin. It was unquestioned, according to Jesse Sutton, a pharmacist and researcher at the Minneapolis Veterans Affairs healthcare system, as cited by KFF Health News.

Similar challenges affect other commonly used preventive drugs and prescribing cascades, where a new medication is prescribed simply to treat the side effect of a previous one. According to Michael Steinman, a geriatrician at the University of California-San Francisco and co-director of the U.S. Deprescribing Research Network, medications are like barnacles. Steinman explained that they’re easy to start, but they can be hard to stop.

This persistence stems largely from medical inertia. Clinicians face vast amounts of incoming information and time constraints, while both doctors and patients easily fall into ingrained treatment habits. As guidelines evolve and independent panels like the American Geriatrics Society update criteria for potentially inappropriate medications, translating those updates into everyday clinical practice remains a slow and complex challenge.