When an elderly patient on a smorgasbord of medications comes to see him for the first time, Dr. Joe Morelli often adjusts their medication downward.

"Seeing that kind of patient for the first time I'm more apt to take them off drugs than put them on it,'' Morelli said. "Generally speaking, the elderly are on too many medications.''

Needless to say he isn't the poster boy for the pharmaceutical industry.

In an age where pill-popping is seen as the answer for almost any ailment, Morelli represents a new trend in medicine that views prescriptions warily.

With offices in Hempfield Township and Stoneboro, Morelli has a family and geriatric practice where he sees scores of elderly patients daily.

To be sure, Morelli said, many of those seniors must be on multiple drugs for survival. Diabetics especially need extra medication because the disease often causes a number of other problems.

Morelli acknowledges he has several seniors on eight or nine different prescriptions who can't live without them.

But he also sees older patients walking through his office who got overloaded on drugs.

In a couple extreme cases after reviewing new patients' records he discovered they were on OxyContin. The powerful narcotic is designed to relieve excruciating suffering for the terminally ill and as short-term pain-reliever for those who underwent major surgery or have agony from certain ailments.

"When I asked them about it they didn't know what OxyContin was,'' Morelli said. "When I took them off it or gave them a milder substitute they were fine without it.''

Seniors are more likely to get pumped full of drugs compared to the general population for a number of reasons. Foremost, Morelli said, seniors grew up in an age with a mind-set that doctors were never questioned and there was no such thing as a bad drug. Top that with seniors hop-scotching from specialist to specialist, each treating them for a particular illness, the chain of communication breaks down.

Another pitfall for the elderly is falling victim to the immediate response drugs provide for symptoms like pain, inability to sleep and constipation. If a physician refuses to continually prescribe drugs for these conditions, the senior will often reach for an over-the-counter version.

"I see people in nursing homes end up on a gazillion drugs and a lot of these are comfort drugs,'' Morelli said. "Constipation is a big problem with elderly men and I see some who take a drug and get relief and think they should start taking it every day.''

Pharmaceutical companies bombarding the public with advertisements on prescriptions also sends seniors clamoring for the latest pills. Further, Morelli sees these same companies churn out studies for doctors showing upping the pill count on patients will improve their health.

A generation ago, if a 65-year-old man with high blood pressure was given a single medication that brought his pressure down to 140/85 that would probably have sufficed, Morelli said. But now pharmaceutical studies tout giving that same man three or four medications could bring his pressure down to 130/80.

That's a lot of drugs to get such a small return, he said.

"We all want to be on the cutting edge,'' Morelli said of physicians. "But if it takes me three extra medications to get down to 130/80 I'm not going to do it. You have to use some common sense.''

Morelli's advice to seniors is to talk with their doctor about all their medications.

"But talk to them in a reasonable way,'' Morelli said. "If we perceive a patient wants to be on a drug when it's appropriate, but only when it's appropriate, a physician is willing to work with them.''