America's Seniors Are Overmedicated --- One in six seniors enrolled in Medicare's drug benefit were prescribed eight or more medications at the same time, Wall Street Journal analysis of Medicare data finds

 

“For years, Barbara Schmidt's family feared an illness was behind a pattern of terrifying falls that repeatedly landed the 83-year-old great-grandmother in surgery with broken bones. Instead, Schmidt's frequent tumbles might have been tied to something else: medications intended to make her better.

 

Schmidt, who lives with her husband of 65 years in Lewes, Del., filled prescriptions for more than a dozen different drugs in the past year, according to pharmacy and medical records.

 

That isn't unusual for America's seniors, according to a Wall Street Journal analysis of Medicare data.

 

One in six of the 46 million seniors enrolled in Medicare's drug benefit, which pays for most drugs taken by older Americans, were prescribed eight or more medications.

 

In 2022, 7.6 million seniors were simultaneously prescribed eight or more medications for at least 90 days.

 

Of those seniors, 3.9 million took 10 or more drugs at once.

 

And more than 419,000 of them were prescribed 15 or more drugs at the same time.

 

Schmidt considers herself healthy -- she still works a few days a week at a Marshalls store, and she is a dedicated crafter who creates intricate birthday cards for her four children, 14 grandchildren and eight great-grandchildren. But osteoporosis has made her bones brittle, while arthritis and back problems sometimes cause agony. Schmidt counts nine different operations over the years, including replacements for both hips and knees. She has also suffered from anxiety and sleep issues, largely related to the pain.

 

Doctors layered on medications to help.

 

Among the earliest was gabapentin, which she says started about a decade ago for lingering back problems. The drug seemed to help with her pain, and she wanted to continue her active life, so she kept taking it, getting up to three 300-milligram doses a day.

 

For years, records show, Schmidt also took diazepam for anxiety. The drug is better known as Valium, from the class of medications called benzodiazepines.

 

More recently, she has had prescriptions for hydroxyzine, an antihistamine sometimes used as an anxiety treatment, and methocarbamol, a muscle relaxant that she typically took daily with the gabapentin. For sleep, she got trazodone, an antidepressant, though she had no depression diagnosis.

 

Some of the drugs Schmidt took are on a widely used list of medications that might be dangerous for seniors. The guidelines, maintained by the American Geriatrics Society and named the "Beers Criteria" after the doctor who first led their development, suggest some drugs should almost never be taken by older patients. That includes Schmidt's benzodiazepine diazepam, antihistamine hydroxyzine and muscle relaxant methocarbamol.

 

Other drugs, the guidelines say, still pose risks for patients with certain medical conditions or when combined with other medicines. They warn, for instance, that seniors should minimize the number of drugs they take simultaneously that affect the central nervous system, including gabapentin.

 

Among the seniors in the Journal analysis who were taking eight or more drugs, 3.6 million had prescriptions for at least one medication that geriatricians say elderly patients should generally avoid.

 

Many patients, like Schmidt, were on multiple types of these drugs.

 

Among seniors prescribed eight or more drugs, 1.6 million got benzodiazepines, sedatives that appear on the Beers list.

 

In addition, 568,000 of those seniors were prescribed gabapentin or a similar drug. Gabapentin can have sedating effects.

 

More than 310,000 of the benzodiazepine patients also received muscle relaxants, another type of drug the Beers guidelines say seniors should avoid.

 

The Journal found 147,000 seniors took all three categories of drugs at once.

 

Mixing multiple medications that affect the central nervous system can magnify their side effects, leading to falls, say the Beers guidelines.

 

As Schmidt added more drugs with sedative effects, she began having regular falls.

 

She shattered her hip after tripping on the edge of a driveway. During a family vacation in Germany, she ended up at a hospital after toppling down an escalator. Another time, she fell off a ladder while working on Christmas decorations, knocking herself out and severely bruising her face. Her family grew increasingly alarmed, but Schmidt refused to use a walker or a cane, blaming the falls on outside causes like uneven ground.

 

Schmidt's recent prescriptions came from at least five different healthcare providers. Most were affiliated with the nearby hospital system Beebe Healthcare, including a nurse practitioner whom she sees for primary care and a gastroenterology office. An orthopedic surgeon who has treated her back problems and prescribed medications to help with her pain works for an independent practice, First State Orthopaedics.

 

A Beebe spokesman said it has reviewed its prescribing patterns and, this November, added a new electronic medical record that will allow doctors to "view consolidated medical and medication histories" for patients and deliver "safer, more informed care." First State Orthopaedics said it doesn't comment on matters of patient care unless it is legally required to do so.

 

Pharmacists who work with seniors say doctors might not be aware of their patients' full medication list. Patients don't always mention what their other doctors have prescribed when a history is taken, and specialists might not have access to a shared medical record.

 

The Journal analysis found that, among seniors taking eight or more drugs, it was common for the prescriptions to come from a large number of doctors.

 

Some doctors prescribe medications to their patients at alarming rates, at times single-handedly ordering eight or more drugs for a single patient. The Journal found doctors who prescribed the most drugs were concentrated in rural areas across the South, where chronic disease is prevalent.

 

Schmidt's daughter Debra Schindler, who works in Maryland for the hospital system MedStar Health, thought her mom needed to go to a specialized clinic that focuses on seniors. "I just knew it wasn't normal for her to be falling all the time," Schindler says.

 

In March 2023, Schmidt met with George Hennawi, the MedStar system's physician executive director of geriatrics and senior services, as well as others, including a pharmacist who went through her medications.

 

Hennawi zeroed in on three of her prescriptions: hydroxyzine, methocarbamol and gabapentin. The drugs were likely a cause of her confusion and falls, he told her. "They all work somewhat the same way," Hennawi says. "Combining all of them is a higher risk for complications."

 

Schmidt was shocked. No one had previously raised the danger of her multiple prescriptions.

 

A drug rundown such as the one received by Schmidt, part of a process known as medication therapy management, is supposed to be a requirement under Medicare. The insurers that sell drug coverage must provide the service.

 

The federal mandate applies to only a limited subset of enrollees, and Schmidt didn't qualify, likely because she didn't have enough chronic health conditions.

 

The Journal's analysis found that what are known as the comprehensive medication reviews mandated by Medicare didn't affect the average number of drugs prescribed to patients.

 

A spokesman for the Centers for Medicare and Medicaid Services said the comprehensive reviews can identify many different potential problems and their impact "may not be reflected in a simple count of prescriptions over time."

 

Schmidt says that after her 2023 appointment, she largely stopped taking gabapentin and methocarbamol. She takes the hydroxyzine only when she feels stressed. She says she hasn't had a fall since, and feels more clearheaded.

 

Schmidt had earlier quit the benzodiazepine, after experiencing withdrawal symptoms during a hospital stay and learning it was a controlled substance.

 

"I'm better than what I was," she says.

 

Schmidt says she is still stockpiling medicines she doesn't take regularly, including the gabapentin. "I hang on to it in case a time comes when I might need it," she says. "You get old and you don't throw drugs away."” [1]

 

1. America's Seniors Are Overmedicated --- One in six seniors enrolled in Medicare's drug benefit were prescribed eight or more medications at the same time, Wall Street Journal analysis of Medicare data finds. Anna Wilde Mathews; Weaver, Christopher; McGinty, Tom; Ulick, Josh.  Wall Street Journal, Eastern edition; New York, N.Y.. 23 Dec 2025: A10.