Consumer Reports has published a valuable article identifying common prescription drugs that can be dangerous for older patients. Healthcare consumers over age 65 are more than twice as likely to suffer from adverse drug reactions; the publication lists the following drugs as posing a high enough risk that they should be avoided if possible:

• Antianxiety drugs

  Chlordiazepoxide (Librium, Limbitrol); diazepam (Valium); quazepam (Doral)

  Recommended alternatives: alprazolam (Xanax), lorazepam (Ativan), and oxazepam (Serax)

• Antidepressants

  Amitriptyline, doxepin (Sinequan) and Fluoxetine (Prozac)

  Recommended alternatives: citalopram (Celexa), paroxetine (Paxil), and sertraline (Zoloft)

• Antihistamines

  Chlorpheniramine (Chlor-Trimeton); diphenhydramine (Benadryl)

  Recommended alternatives: Cetirizine (Zyrtec); fexofenadine (Allegra); loratadine (Claritin)

• High blood pressure and enlarged prostate drugs

  Doxazosin (Cardura); prazosin (Minipress); terazosin (Hytrin)

  Recommended alternatives: Diuretics for high blood pressure; tamsulosin (Flomax) for enlarged prostate.

• Pain relievers

  Naproxen (Aleve, Naprosyn); oxaprozin (Daypro); piroxicam (Feldene); Meperidine (Demerol)

  Recommended alternatives: acetaminophen (Tylenol); ibuprofen (Advil ); capsaicin cream (Zostrix); morphine

• Sleeping pills

  Barbituates (Butisol, Nembutal, Seconal); diphenhydramine (Sominex); flurazepam (Dalmane)

  Recommended alternatives: zaleplon (Sonata) and zolpidem (Ambien)

• Stomach drugs

  Bisacodyl (Dulcolax); Diphenoxylate (Lomotil)

  Recommended alternatives: Increased intake of fiber and fluids; change in diet; loperamide (Imodium AD)

I stumbled across this while reading Gawker: “Teen socialite” Peaches Geldof says the staff at the fashion magazine Nylon prefer prescription drugs over illegal drugs –

What’s the drug of choice at Nylon? “Klonopin.” Peaches was definitely the talky one. Why? “It’s just a very large prescription drug culture.”…

This confirms our highly anecdotal evidence of Klonopin as a mini-trend for the creative underclass, maybe better than Xanax—not that our shrink is offering to prescribe us any despite repeated inquiries.

Klonopin, classified as a “sedative-hypnotic,” is prescribed for epilepsy, panic and anxiety disorders, restless legs syndrome and other medical conditions. Unfortunately, such drugs are too easily obtained by young people, who often start taking them by raiding their parents’ medicine cabinets.

As Ritch Wagner of Purdue Pharma (OxyContin), who educates medical professionals and law enforcement officials about the dangers of prescription drug abuse, describes the growing problem:

More prescription drugs are creeping up the list of the 20 most widely abused substances, Wagner said, including the painkiller hydrocodone and methadone, a narcotic commonly used to treat heroin addiction that is now used to treat pain.

Abusers are beginning to learn it can “be more advantageous” to use prescription drugs to get high than drugs such as meth, cocaine and heroin. They are easier to obtain, and people think they are safe because doctors prescribe them.

“In my day and age, it was how many of Dad’s beers we can sneak out of the fridge,” Wagner said. “Now, it’s how many pills can I get out of the medicine cabinet.”

Wagner said children are taking whatever pills they can get their hands on, throwing them into a bowl and taking a handful. They’re called punch-bowl or grab-bag parties.

I think what really struck me about these stories was Geldof’s use of the term “prescription drug culture.” I hadn’t heard the term before.

My immediate reaction was to compare it to the “drug culture” of the ’60s and early ’70s, which we relate to young people — specifically, “hippies.” But upon reflection, the “prescription drug culture” isn’t confined to the young in our country today. It’s pervasive.

It starts with the billions of dollars in advertising that pharmaceutical companies spend to get us to stock our medicine cabinets with drugs — drugs that we might or might not really need.

Before the recent advertising campaign, for example, I’m guessing you’d never even heard of restless legs syndrome — let alone gone to the doctor and asked for Klonopin or Mirapex. The medical use of drugs like Xanax and Prozac have gone through the roof among adults of all ages. And don’t you suspect the Viva Viagra! advertising campaign has made Viagra an object of curiosity not only among middle-aged men, but among teenage boys?

When a teenager’s parents, as well as all of his or her friends’ parents, are stocking the medicine cabinet with these drugs, don’t you think what happens next is almost inevitable?

So, how do we solve the problem? Frankly, as I’ve stated here before, I would put an end to direct-to-consumer advertising by pharmaceutical companies.

Others may disagree with this approach, and that’s fine. But however we get there, we need to reach a point where we don’t expect a “pill for every ill.” Because if you believe there’s a pill for every ill, it’s a short step to believe that prescription drugs are the answer for everything — including having a good time at a party.

Here are those five medications, in order of searches:

1. Lexapro
2. Effexor
3. Cymbalta
4. Prozac
5. Paxil

So, which antidepressant is right for you? In addition to consulting your physician, here are two helpful resources:

1. The Mayo Clinic offers an excellent overview of your options and considerations in making a decision.

2. Dinah at Shrink Rap, a blog by psychiatrists, explains how she matches patients with a particular antidepressant.

The second resource should be of particular value before you discuss a prescription with your doctor or psychiatrist.

We strongly favor this proposed legislation and, though we are a bit cynical about its prospects, we thought we would detail its provisions and why the law would be a good thing for consumers and for public safety.

Specifically, the legislation would serve to:

(1) provide criminal penalties for those who unlawfully dispense controlled substances over the Internet;

(2) give state attorneys general a civil cause of action against anyone who violates the act if they have reason to believe that the violation affects the interests of their state’s residents; and

(3) allow the federal government to take possession of any tangible or intangible property used illegally by online pharmacies.

The hope is that this legislation would deter rogue pharmacies that do not require prescriptions or physician consultations to distribute controlled substances such as Hydrocodone, Valium, Xanax, OxyContin, and Vicodin.

The act refers to a 2006 study that states, “a staggering 89 percent of sites selling controlled prescription drugs have no prescription requirements. According to the study, 15.1 million adults admitted to abusing prescription drugs, including 2.3 million abusers between the ages of 12 and 17. Currently, there is no way to police this illegal activity.”

Earlier this month, The National Center on Addiction and Substance Abuse at Columbia University issued a study that revealed the following:

For three years straight the number of rogue Web sites selling controlled prescription drugs like OxyContin, Vicodin, Valium, and Ritalin has increased, according to a new White Paper released by The National Center on Addiction and Substance Abuse (CASA) at Columbia University.

The White Paper, “You’ve Got Drugs!” IV: Prescription Drug Pushers on the Internet, to be released today at the U.S. Senate Judiciary Committee hearing on “Rogue Online Pharmacies: The Growing Problem of Internet Drug Trafficking,” found a total of 581 Web sites advertising or selling controlled prescription drugs in 2007 compared to 342 sites in 2006. Sites advertising controlled prescription drugs increased by 135 percent, from 168 in 2006 to 394 in 2007. Sites selling these drugs increased by seven percent from 174 in 2006 to 187 in 2007. Of the 187 sites found selling controlled prescription drugs this year, only two were certified by the National Association of Boards of Pharmacy as Verified Internet Pharmacy Practice Sites.

Passage of the act should be a no-brainer and would do nothing but benefit consumers. As Feinstein and Sessions make clear:

The bill introduced today is designed to stop Internet pharmacies that sell controlled substances without a valid prescription, not pharmacies that sell drugs at a low cost to individuals who have a valid prescription from their U.S. doctors.

Unfortunately, chain pharmacies are opposing the legislation because they fear it will lead to greater federal regulation of pharmacies, which have traditionally been regulated by the states. And, as we’ve stated repeatedly here, Big Pharma and its political flunkies actually benefit from a fearful public when it comes to online pharmacies, so anything that makes online pharmacies safer actually works against Big Pharma’s financial interests.

Whether or not this bill becomes law, however, consumers do have a safe choice now: pharmacies in the eDrugSearch.com database. All must meet regulations and requirements that far exceed those in Feinstein and Sessions’ proposed legislation.

In general, the eDrugSearch Blog’s advice to U.S. healthcare consumers is that if you wait for the federal government to solve your problems, you may be waiting a very long time. We’re afraid the Feinstein-Sessions proposal may be the latest illustration of this.

The US Food and Drug Administration (FDA) has issued a warning to consumers about placing orders for prescription drugs over the Internet, saying that recent cases have shown that what was delivered is not what was ordered and is putting people in hospital. In a release, the FDA said it has become aware that a number of Americans who placed orders for specific drug products over the Internet (Ambien, Xanax, Lexapro, and Ativan), instead received a product that, according to preliminary analysis, contains haloperidol, a powerful anti-psychotic drug…

The FDA said laboratory analysis of the misrepresented tablets is ongoing, but preliminary analysis indicates they contain haloperidol, the active ingredient in a prescription drug used primarily to treat schizophrenia. FDA learned about the mislabeled and potentially dangerous products after their recipients complained to a US pharmaceutical manufacturer. The origin of the tablets is unknown but the packages were postmarked in Greece.

Here we go again: the FDA using the actions of a few rogue players to issue a broad-brush warning about Internet pharmacies. This is nothing new; the FDA is clearly in the pocket of Big Pharma and does its bidding at every turn.

Were the actions of these rogue pharmacies inexcusable? Absolutely. Does this have anything to do with licensed international pharmacies with verifiable third-party accreditations? No — absolutely not.

Would the FDA warn American consumers to not shop at the corner Walgreens because of what happened in San Antonio recently? No — in fact, they do very little to inform the consumer in such cases.

At eDrugSearch.com, we believe the best way to empower the consumer is to provide you with the information you need to make good decisions. And that includes making sure you know that we only allow safe, licensed pharmacies in our database.

As for the FDA’s agenda? We’re reminded of what Merrill Goozner told us in our recent chat with him:

I always find it curious that free traders are worried about the safety of drugs imported from Canada, but not lettuce from Mexico. I suspect Canada’s system for protecting its consumers against unsafe drugs is far superior to Mexico’s system for protecting consumers against contaminated food.

Makes you wonder, doesn’t it?