---
title: "Three Common Drugs Older Adults May Be Overusing: Benzodiazepines, Antibiotics, Aspirin"
id: "kff-health-news-2-3-common-drugs-older-adults-might-be-overusing"
canonical_url: "https://medichelpline.com/clinical-feed/kff-health-news-2-3-common-drugs-older-adults-might-be-overusing"
content_type: "clinical_feed_article"
specialty: "General"
source_name: "KFF Health News"
source_url: "https://kffhealthnews.org/aging/3-common-drugs-older-adults-might-overuse-new-old-age-column/"
published_at: "2026-09-17T09:00:00.000Z"
evidence_level: "Verified Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Three Common Drugs Older Adults May Be Overusing: Benzodiazepines, Antibiotics, Aspirin
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/kff-health-news-2-3-common-drugs-older-adults-might-be-overusing
- **Specialty:** [General](https://medichelpline.com/clinical-feed/general.md)
- **Primary Source:** KFF Health News
- **Source URL:** [Original Journal Publication](https://kffhealthnews.org/aging/3-common-drugs-older-adults-might-overuse-new-old-age-column/)
- **Published At:** 2026-09-17T09:00:00.000Z
- **Evidence Rating:** Verified Feed
## Executive GIST (TL;DR)
- Researchers and guideline panels have repeatedly found that some widely used medications offer limited benefit or increased harm for older adults, yet prescribing often declines slowly or not at all. - Habit, clinical inertia, and slow dissemination of evidence contribute to continued use; medications can be easy to start and hard to stop, according to geriatric experts. - **Benzodiazepines** and related “Z” drugs (for example, Valium, Xanax, Ativan, Ambien, Lunesta) raise concerns about impaired balance, cognition, falls, fractures, motor vehicle accidents, dependence, withdrawal, and dangerous interactions with opioids; prescribing declined modestly overall but rose in some groups and in long-term care. - For **uncomplicated diverticulitis**, randomized trials and guideline updates have shown antibiotics provide little or no benefit for most patients; despite guidance from gastroenterology societies, antibiotic prescribing remained nearly universal in a large Veterans Affairs study. - Antibiotics are also commonly overused for asymptomatic bacteriuria and viral upper respiratory infections, carrying risks such as side effects, C. difficile infection, and contribution to antimicrobial resistance. - **Aspirin** remains appropriate for secondary prevention after heart attack, stroke, or revascularization, but guidelines now recommend against routine aspirin for primary prevention in older adults (with age thresholds cited), because bleeding risks increase with age and benefits are limited. - Use patterns vary: aspirin use for primary prevention has declined but a substantial fraction of older adults still take it without clear indication; some high-risk older adults may still benefit and stopping aspirin can be complex. - Experts emphasize individualized conversations with primary care clinicians before stopping or continuing these medications; benzodiazepines require supervised tapering to avoid withdrawal. - Data and examples cited come from recent trend analyses and guideline statements reported in the source, including examinations published in the Annals of Internal Medicine and guidance from specialty groups and the U.S. Preventive Services Task Force.
## Clinical Analysis & Structured Key Points
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More studies follow, confirming those findings. [ ![Partner logo](https://kffhealthnews.org/wp-content/uploads/sites/8/2019/09/The_New_York_Times_logo.png?w=500) ](https://www.nytimes.com/2026/09/05/well/older-people-drugs-overuse.html) This story also ran on [The New York Times](https://www.nytimes.com/2026/09/05/well/older-people-drugs-overuse.html). It can be [republished for free](https://kffhealthnews.org/republish/aging/3-common-drugs-older-adults-might-overuse-new-old-age-column/). About “The New Old Age” “The New Old Age” is produced through a partnership with [The New York Times](https://www.nytimes.com/column/the-new-old-age). [Read More Columns](https://kffhealthnews.org/series/the-new-old-age/) After a few years, medical associations revise their guidelines, warning that the drug in question should be avoided or at least prescribed more selectively. It might be added to the Beers Criteria, an influential list of potentially inappropriate medications for older patients, published by the American Geriatrics Society. If the drug’s role is preventive, the U.S. Preventive Services Task Force, an independent expert panel, may weigh in with cautions. The FDA may issue “black box” warnings about concerning side effects. After a few _more_ years, researchers look at broad national data to see whether use of this drug declined. Often, the answer is: Yes, but not enough. Sometimes, though, use didn’t decline much at all or actually increased. “Medications are like barnacles,” said Michael Steinman, a geriatrician at the University of California-San Francisco and co-director of the [U.S. Deprescribing Research Network](https://deprescribingresearch.org/). “They’re easy to start, but they can be hard to stop.” This medical inertia partly reflects the time lag involved in disseminating findings. “Clinicians have a million things they need to know and attend to, and information may take a while to get to them,” Steinman said. But it also reflects the way “clinicians and patients get used to treating conditions in certain ways,” he said. “They become ingrained habits.” Finding alternative approaches is challenging, so “it’s easy to go with what you know.” Recent studies of three medications or classes of drugs widely used among older Americans illustrate the problem. ![Newsletter Icon](https://kffhealthnews.org/wp-content/plugins/kff-shared/dist//images/newsletter-icon.png) #### Email Sign-Up Subscribe to KFF Health News' free Morning Briefing. Your Email Address Sign Up **The Drawbacks of Benzodiazepines** Scientists began [raising alarms](https://pubmed.ncbi.nlm.nih.gov/24733354/) about benzodiazepines more than 20 years ago. Prescribed for insomnia and anxiety, “they offer prompt relief,” said Mark Olfson, a psychiatrist and epidemiologist at Columbia University. [The problem](https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class)? Benzodiazepines (including Valium, Xanax, and Ativan) and the related “Z” drugs (Ambien, Lunesta) “may impair balance, coordination, and cognition that can translate into falls and fractures and motor vehicle accidents,” Olfson said. In patients also taking opioids for pain, benzodiazepines can cause overdoses. Moreover, “once you’ve taken them for a period of time, you develop a dependence,” Olfson added. “When you come off them, you may develop withdrawal symptoms.” So what’s happened to [benzo use among older adults](https://www.nytimes.com/2018/03/16/health/elderly-drugs-addiction.html), who are more sensitive to these effects? In a [recent examination of prescribing trends](https://www.acpjournals.org/doi/10.7326/ANNALS-25-05594), published in the Annals of Internal Medicine, Olfson and his team reported progress. Among people 65 and older, the rate of patients filling prescriptions for benzos dropped to 11.5% in 2024, from about 14% in 2015. But that decline has stalled since 2020, perhaps related to the covid-19 pandemic. Moreover, prescribed use actually rose among those over 75, from 12% in 2020 to about 13% four years later. Dispensing through pharmacies in long-term care facilities more than doubled. And about a third of users were taking the drug for longer than six months, increasing the likelihood of dependence. “It’s worrisome,” Olfson said. But he cautioned that patients shouldn’t stop benzodiazepines suddenly or on their own, which can provoke withdrawal. “It requires supervised tapering” with a medical professional, he said. “It takes many weeks.” **Overprescribing Antibiotics** For years, the standard treatment for diverticulitis, the inflammation or infection of small pouches that form in the colon, was antibiotics, primarily fluoroquinolones (like Cipro and Levaquin) or amoxicillin-clavulanate (Augmentin). “It was unquestioned,” said Jesse Sutton, a pharmacist and researcher at the Minneapolis Veterans Affairs healthcare system. “Antibiotics are safe and effective, great, lifesaving drugs, so the mindset was: When in doubt, use them.” But in 2015, the [American Gastroenterological Association recommended](https://gastro.org/clinical-guidance/management-of-acute-diverticulitis/) against routinely prescribing antibiotics for “uncomplicated” diverticulitis, which represents a great majority of cases. Other [medical groups followed suit](https://journals.lww.com/ajg/pdf/10.14309/ajg.0000000000004047~acg-clinical-guideline-colonic-diverticulitis). Clinical trials had shown that, for this condition, antibiotics [had little or no effect](https://academic.oup.com/bjs/article/110/3/373/6904580) on mortality, the need for surgery, complications, or recurrences. “They hadn’t improved anything,” Sutton said. And as with any drug, “[there are downsides](https://pubmed.ncbi.nlm.nih.gov/28604925/), unintended consequences,” he said. “Side effects from antibiotics account for a [substantial amount of emergency room visits](https://pubmed.ncbi.nlm.nih.gov/18694344/)” for symptoms like nausea, vomiting, and diarrhea. Antibiotics heighten the risk of the virulent C. difficile infection, too. Plus, “the more you use antibiotics, the less they work in the future,” Sutton said. The World Health Organization has [deemed antimicrobial resistance](https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance) “a major global health threat.” So Sutton and his colleagues, studying treatment in 70,000 visits to 120 VA facilities, expected to see antibiotic use for uncomplicated diverticulitis decline over 10 years. Instead, they [reported recently](https://www.acpjournals.org/doi/10.7326/ANNALS-25-05583) in the Annals of Internal Medicine that antibiotic prescriptions remained nearly universal at 97% of visits, guidelines or no guidelines. The patients would most likely have done as well with a few days of Tylenol and a clear liquid diet. [Antibiotic overuse remains common](https://www.nytimes.com/2019/03/15/health/antibiotics-elderly-risks.html) for other conditions of later life, too, including the kind of [urinary tract infections](https://www.nytimes.com/2019/10/14/health/urine-tests-elderly.html) that cause no troublesome symptoms and upper respiratory infections that are typically viral, not bacterial. In such cases, when a doctor prescribes an antibiotic, “I’d encourage patients to say, ‘Please explain the rationale for doing this,’” Sutton said. “If they don’t, it’s OK to press pause.” **When Aspirin Isn’t the Answer** Aspirin is different. Because it’s cheap and sold over the counter, anybody can start taking it on their own — and [millions of older Americans do](https://www.nytimes.com/2022/05/21/health/elderly-aspirin-heart-attack.html), thinking it will help prevent cardiac problems. For people who’ve already had a heart attack, stroke, or cardiac intervention like a stent or bypass surgery, daily low-dose aspirin for “secondary prevention” does lower the odds of another event, studies have demonstrated. But for “primary prevention” in people who haven’t had one, the guidelines changed in 2019, when the American College of Cardiology and the American Heart Association [recommended against aspirin](https://www.jacc.org/doi/full/10.1016/j.jacc.2019.03.010) for this purpose in those 70 or older. The [U.S. Preventive Services Task Force went further](https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-to-prevent-cardiovascular-disease-preventive-medication), warning against aspirin for primary prevention starting at age 60. Large clinical trials had shown scant benefit for aspirin as a primary prevention measure, but there were harms, notably gastrointestinal bleeding. “As we age, the risks of bleeding go up,” said Timothy Anderson, an internist at the University of Pittsburgh who co-directs its Prescribing Wisely Lab. More rarely, but more seriously, aspirin can cause bleeding in the brain. In a [JAMA study](https://jamanetwork.com/journals/jama/fullarticle/2829534) published last year, Anderson and his co-author found the message was getting through: Aspirin use for primary prevention, as reported in the National Health and Nutrition Examination Survey, had dropped substantially from 2011 to 2023. But more than a third of those 70 or older were still taking it. Some caveats: A subgroup of older adults with high risk factors for cardiovascular disease may benefit from aspirin for primary prevention. And, confusingly, some evidence suggests that older patients already taking aspirin face a higher risk of cardiovascular disease [if they discontinue it](https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065420). “Step 1 is a conversation with your primary care physician” about aspirin, Anderson said. “‘Is this still right for me as I get older?’” Older patients taking aspirin, [many without any medical guidance](https://www.jacc.org/doi/10.1016/j.jacadv.2025.101699), “are interested in reducing their risk of heart attack and stroke,” he said. “They’re trying to be proactive and healthy.” But with blood pressure medications and statins for cholesterol, “we have better strategies than aspirin for that.” _The New Old Age is produced through a partnership with_[ _The New York Times_](https://www.nytimes.com/column/the-new-old-age) _._ ### Related Topics [Aging](https://kffhealthnews.org/topics/aging/)[Health Industry](https://kffhealthnews.org/topics/health-industry/)[Mental Health](https://kffhealthnews.org/topics/mental-health/)[Drugs](https://kffhealthnews.org/tag/drugs/)[The New Old Age](https://kffhealthnews.org/series/the-new-old-age/) ### We Want To Hear From You Do you have a question or comment for the KFF Health News team? 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