National Study of Prescription Poisoning with Psychoactive and Nonpsychoactive Medications in Medicare/Medicaid Dual Enrollees Age 65 or Over

Abstract

The purpose of this study is to assess prescription medication poisoning among psychoactive and nonpsychoactive medications used by elderly (65 years or older) Medicare & Medicaid dual enrollees as well as examine contextual components associated with poisoning. Our primary research goal was to compare medication poisonings among psychoactive medications to nonpsychoactive medications. Our second research goal was to identify components influencing medication poisonings and how they interrelate. The approach used a cross-sectional retrospective review of calendar year 2003 Centers for Medicare & Medicaid Service's Medicaid Pharmacy claims data for elderly dual enrollees. Poisonings were identified based on ICD-9-CM categorizations. Poisonings associated with the psychoactive medications were proportionally over twice as high as compared to nonpsychoactive medications (14.3 per 100,000 enrollees and 6.6 per 100,000 enrollees, respectively). Additionally, the two contextual components of (a) use of many drugs and (b) familiarity with the medication have a direct, but competing impact on poisoning. The reasons behind unintentional poisoning in the elderly have been somewhat a mystery. This study is among the first to attempt to distinguish between poisoning events associated with psychoactive medications versus nonpsychoactive medications as well as assess the impact of differing contextual components on medication poisoning.

Deliberate self-poisoning with drugs among adolescents in Morocco

“…Most of these cases do not requires intensive medical treatment, but needs caring approach, psychiatric treatment and social assessment. Our findings are consistent with studies that showed the drugs such as psychoactive family and antidepressant family drugs act mainly on central nervous [37]. Most studies showed that suicide is closely associated with mental disorders [38,39].…”

Short-Term Risk of Unintentional Poisoning After New Initiation of Central Nervous System Medications in Swedish Older Adults: A Register-Based Case-Crossover Study

“…Possible mechanisms for medication-related poisonings can be summarized as either direct side effects of CNS medications or indirect effects due to drug–drug interactions and disease–drug interactions [ 2 , 9 ]. In addition, accidental overdosing and medication errors are other common reasons in clinical practice of poisoning.…”

“…Factors that could potentially modify the effect of CNS medications on the risk of unintentional poisoning were identified based on previous literature [ 2 , 6 , 9 ]. The modifying factors in this study included sex, age, comorbidity, neuropsychiatric disease, and concurrent use of other medications.…”

“…The pathways between medication and accidental poisoning are complex and remain to be explored. Possible mechanisms might include acute drug–drug or drug–disease interactions, accidental overdosing, or medication errors [ 2 , 9 ]. Most of the unintentional poisoning events are acute (86.8%) while a much smaller proportion seem to be due to chronic exposure (9.55%) [ 10 ].…”

“…Prescribed medications acting on the central nervous system (CNS), such as opioids, antidepressants, benzodiazepines, antipsychotics, and antiepileptics are among the leading causes of unintentional poisoning for adults aged 25 years and above [ 5 , 9 ]. It has also been found that poisonings associated with CNS medications were more than twice higher compared with those due to non-psychoactive medications in older adults [ 9 ]. The use of CNS drugs is widespread, especially among older adults [ 13 ].…”