a6 Page 4-Wednesday, January 16, 1980-The Michigan Daily ~brEtdtigan i t~ Ninety Years of Editorial Freedom Vol. XC, No. 86 News Phone: 764-0552 Edited and managed by students at the University of Michigan' S--" piralng inflation leaves no Choice but dorm -rate hike Miracle drugs are harmful to the nation's elderly. E VEN AFTER weekend meal con- solidation programs, energy conservation campaigns, and various service cutbacks, students living in University residence halls will pay nearly $300 more for their leases if the Regents approve several Housing Of- fice recommendations next month. The staggering 13.2 per cent room and board rate hike - the largest University dormitory cost increase ever - seems at first glance terribly unfair and excessive. Not only will such an increase very likely scare even more students away from the Univer- sity because of its high costs, but it will also anger those already here who must face tuition jumps of 8 to 10 per cent each year. It is very unsettling that a student service so basic as housing must in- crease in cost so much. Looking at the 13.2 per cent figure broken down into its component increases, however, it becomes apparent that the rate hike is not an attempt by the University to bleed students for money. Rather, it is the unfortunate, but inevitable, result of inflation. Fully 11.8 per cent - about $220 - of the increase is directly at- tributable to increased costs resulting from spiraling inflation. There is sim- ply nothing the University can do about this figure. This leaves about 1.4 per cent of the increase that can be controlled by the Regents. The discontinuation of weekend meal consolidation, in- stallation of cable television, and deconversion of converted (over- crowded) rooms comprise this flexible 1.4 per cent. It would be easy to dismiss the proposed cable television hookups as frivolous. Or the cancelling of weekend meal consolidation as needless luxury. Or the planned installation of energy- saving showerheads, which would save each student about $8 per year but also reduce hot water pressure, as not worth the inconvenience. I Yet, precisely because each of these proposals involves some controversy -each sets those who favor cutting corners wherever possible against those who desire certain services from residence halls - it would seem ap- propriate that the plans be submitted to some sort of student vote before they are presented to the Regents for what many expect to be their rubber stamp of approval. The 13.2 per cent increase is the recommendation of the Housing Of- fice's Student Rate Study Committee, a group composed of five students and two residence hall staff members. It is undoubtedly a careful analysis presen- ting rational proposals. But the studen- ts who will be affected should have in- put into the plans that will cost them money and/or inconveniences. She seemed like perfect proof that modern medicine can work wonders: 73, years old, afflicted with high blood pressure and a heart condition, but kept clear- headed and functioning with the help of two miracle drugs prescribed by tier doctors. But when irregularity prom- pted the elderly woman to use a heavily advertised, over-the- counter laxative, the miracle almost killed her. THE LAXATIVE transformed the digitalis prescribed for her heart into a toxic substance, and increased the loss of potassium associated with the thiazide diuretic which controlled her blood pressure. The result was cardiac arrhythmia-an irregular heart beat. It put her in- to a hospital emergency room, close to death. Her story is not unusual in the annals of medicine today. Many elderly people whose deaths are attributed to heart failure and old age may in fact be victims of prescription drugs that, com- bined with other drugs, foods or alcohol, make them sick, in- capacitated or even kill them. Because of inadequacies in U.S. medical practice, a quantum leap in pharmaceutical produc- tion, and public ignorance of its hazards, older Americans regularly consume too many medications in doses and com- binations that are often deadly. DR. MICHAEL REITER, a staff specialist in pharmacology for the elderly at the San Fran- cisco Mental Health Depar- tment, said many- of the drugs prescribed through Medicare can cause side-effects in the elderly, including hazy vision, loss of coordination, confusion or depression. "This creates a danger that adverse reactions could be wrongly diagnosed as senility or even mental illness," he warns. A number of changes take place as the body ages, and they can make pharmaceuticals more dangerous, he says. "Organ systems function less efficiently, causing drugs to be absorbed, distributed, broken down and ex- creted at slower rates." A normal adult dose can be too high for an elderly person. "The same dose you and I might take successfully could make an 80-year old quite agitated," according to Dr. Jack Segal, acting chief of medicine at Long Beach General Hospital, and co-author of a Southern California -survey of nursing home patients. "The elderly brain is exquisitely sensitive to the toxic side effects of some of these drugs. You've got this en- By Gregory Bergman tire population that responds to ces of older patients. Further- medication quite differently than more, 80 per cent of the drugs you would expect from the stan- now used in treating the aged dard textbook." were not available to medical students graduated before 1956, THESE RISKS ARE compoun- so that a substantial number of ded when several drugs are used doctors are unfamiliar with their simultaneously, says Vera Labat, side effects or possible toxic director of the Over Sixty reactions with other substances. Geriatric Clinic in Berkley, And most American doctors sim- California. "Multiple medication ply do not do a good enough job of is a big problem among older informing their patients of risks people. Often, medicines associated with medication. prescribed years earlier are still being used; people have changed A 1976 study by the respected towns, changed doctors, run Cathedral Foundation of short of money to buy new Jacksonville, Floridarevealed prescriptions and continue taking that the aged frequently neglect old ones, or are going to two or to discuss all of their prescrip- more physicians for different tions, or the use of over-the- ailments." counter products, or diet foods Moreover, it's a problem of with their physicians. They also enormous proportions. Although save drugs, use them without ad- they comprise only ten per cent of vice, or share them with friends. the U. S. population, eld- erly citizens (over 65) BUT DOCTORS weren't consume 25 per cent of all asking their patients many prescription drugs. A Michigan questions about drug use either. study found that one out of four The Michigan study found that 67 senior citizens in its survey took per cent of its responding Fphy- "Some 70 per cent of the elderly now use prescription drugs, most of which are administered in amounts appropriate for an average, 150-pound middle-aged adult in good health. On all counts, the profile does not fit the typical senior citizen." regulating of drug use. Segal's California study calls for changes in medical education and for peer review procedures to ensure that practitioners are competent. THE PUBLICATION and distribution of informative books on health for the elderly can b encouraged by smedical care providers. Some elderly people, before turning to any prescrip- tion, consult handbooks including The Doctors and Patients Han- dbook of Medicine and Drugs, by Peter Parish, M.D. (Knopf); The People's Pharmacy, by Joe Graedon (Avon); and The Truth About Senility-And How To Avoid It, by Lawrence Galton (Crowell). Pharmacists can also be help- ful. The California State Board of Pharmacy considered a by-law requiring that customers be provided with verbal directions for each original prescription dispensed. But the proposal met with bitter opposition from cor- porate chain drugstores eager to keep contact with individual customers as brief as possible from the California Medica3 Association and the California Hospital Association, and, sur- prisingly, from the American Association of Retired Persons, which feared that it would no longer be able to dispense drugs to its members by mailunder the new by-law. The Board eventually withdrew the proposal. The activist Gray Panthers organization, which helpe4 establish Berkeley's innovative Over Sixty Clinic, advocates much more drastic changes. They support the creation of a national health service Wvhich will take medical care out of the hands of private, vested interests such as professional associations and pharmacy companies, and foster new approaches which might depend less on drug treat ment. Along these lines, U.S. Congressman Ronald Dellums (D., Cal.) has sponsored a Health Services Act to fund publicly- owned, locally-controlled con.- munity health centers, where the emphasis would be on health maintenance and prevention. At this point, however, solutions are far less in evidence than poblems-and efforts t resist solutions. In a limited way, the Berkeley clinic, which deliberately teaches elderly people what questions to ask their doctors, offers a model for the future. Gregory Bergman wrote this piece for the Pacific News Ser- vice. The politics of George 5Meany's NE THING about George Meany -he sure knows how to get Democrats together. In Meany's latest display of political prominence, the former plumber from the Bronx and late-president of the powerful AFL-CIO has succeeded in doing what the Des Moines Register could not - getting Jimmy Carter, Edward Kennedy, and Edmund Brown together, even after Carter had already refused a debate. It wasn't the cornfields of Iowa, and the national media wasn't there to tally oip debating points, but when funeral services for Meany were held yester- day at St. Matthew's Cathedral in Washington, Jimmy Carter was pried out of his White House sanctuary and forced on the same stage with his op- ponents. It was an accomplishment of sheer political brilliance only George Meany could have pulled off. Coming only a week before the Iowa caucus votes, his untimely death was perfectly timed. Admittedly, a funeral service is hardly a forum for free exchange of ideas and debate among competing candidates for office. Some would even go so far as to say that politics and funerals should be kept separate. But politics was already mixed in with George Meany's funeral, and that's the way George Meany ob- viously wanted it, having timed his death right at the start of the 1980 primary season. Consider, for instan- ce, Gov. Brown arriving at the church with United Farm Worker President Cesar Chavez - surely Brown's way of flaunting an eventual endorsement. And consider Carter, sitting in the pew next to none other than Muriel Hum- phrey, the late Senator's widow, as if to remind Brown that he already has her funeral key endorsement. There was Ted Ken- nedy, making the sign of the cross (in- dicating who he expects to support him) over Meany's casket, with Meany's successor Lane Kirkland standing at his side. There was even politics outside the church, as several young protesters threw leaflets on Meany's casket. Con- troversy, and George Meany was loving every minute of it. And what a blow for party unity to force Carter, Kennedy and Brown to put aside their verbal sparring to join in a common chorus of praise for one of the nation's most influential Democrats. Just when the gloves star- ted coming off in the cornfields, Meany, by his death, put an element of civility back into the race, as if to remind all assembled that despite dif- ferences, they were all in the same party. It was not only coincidence that Meany timed his untimely demise to correspond with the United Auto Workers conference in Washington. With the AFL-CIO often at odds with its labor counterpart, the UAW, Meany's last blow for working class unity was to have his Washington funeral on the very day the UAW came to town. The nation's two largest labor organizations were brought together in the capital city - one to bury a past leader, the other to choose leaders for the future. George Meany was a political genius, capable of exercising political clout up to, and even after, his death. Somewhere, the former plumber from the Bronx must have looked down on the political landscape, that familiar cigar in his mouth, to observe the scene of unity he created by his death. And he saw that it was good. four or more prescription drugs at once. Half reported using over- the-counter analegesics, laxatives, or antacids which might interact toxically with prescribed drugs.( Among the in- stitutionalized, it was not un- common for elderly patients to receive eight or ten different daily medications. Some 70 per cent of the elderly now use prescription drugs, most of which are administered in amounts appropriate for an average, 150-pound middle-aged adult in good health. On all coun- ts, the profile does not fit the typical senior citizen. THE RESULT; much too often, is too many drugs, in too large doses. And unless -something is done about it soon, the problem will only become more enormous. By the year 2000, the over-65 por- tion of the U.S. population is ex- pected to double. Little is being done at the moment. Few American medical schools have separate depar- tments of gerontology, or offer adequate training in the treat- ment of the elderly. Medicaltex- tbooks seldom provide specific information on the drug toleran- sicians did not believe senior citizens were more likely to have problems with drugs than other, age groups. And 80 per cent of allied health professionals-nur- ses, pharmacists and gerontology specialists-agreed that doctors failed to provide adequate infor- mation about medications. "The majority of physicians that treat the large number of geriatric patients are very often the least competent in the community," Long Beach Hospital's Segal charges. "Physicians are so highly revered among the aged that they would not consider questioning the need for a specific medication, nor do they seem to be aware of possible side effects on contra-indicated contents that these might contain," adds the Cathedral Foundation's John Lefler. What might be done? The Michigan study's authors have made 20 recommendations, in- cluding the distribution of more information to the public, special training programs in care for the elderly, legislation requiring geriatric dose guidelines, and more thorough monitoring and Fr om the drawing 4ISIkIJN OK! WE'VE 0TCAR board ... /FOR SPYING, OUR T4UBL1E N NORTHWEST IRAN, THE THE COMMON COLD! AN9'THING ELSE YOUR HOLINESS? N.WE MUStNY APPEAR/ IRRATONAL. -- SEE!I WAS RIGHT! YOU CAN'T TRUST A OPEC A:> -E FOQW7EVSFREE PRESS! S, 01 be Atcbigan B at-1V ... . ski. Grpwo Haddad. l.PsiiP Harric_ Rnnnia Its-yknvity Maroarat I I