by Anthony Chicotel, CANHR Staff Attorney
I recently re-checked the American Geriatric Society’s updated Beers Criteria and was struck by its strong admonishment against the use of benzodiazapenes, including popular anti-anxiety drugs like Xanax, Ativan, and Restoril, for older adults. The list of inappropriate drugs states “all benzodiazepines increase risk of cognitive impairment, delirium, falls, fractures . . . in older adults” and recommends avoiding their use for treatment of agitation. The quality of supportive evidence is “high” and the strength of the recommendation is “strong.”
Reading this makes me wonder how in the world 21% (18% in California) of all nursing home residents in America are regularly receiving an anti-anxiety drug. The Beers Criteria, which has been around for over twenty years, makes it clear that using benzodiazapenes for older adults is presumptive malpractice and should be rare. Yet we see about 277,000 nursing home residents are drugged with anti-anxiety pills. That’s enough to make me anxious.