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Prescription Drug Misuse/Abuse in the Elderly
Lisa Reisman • Aug 28, 2019
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Prescription Drug Misuse/Abuse in the Elderly
According to the National Institute of Health, the 65 and older population account for 13 percent of our total population, yet make up one than one-third of total outpatient spending on prescription medications in the United States. Many times, these prescriptions are necessary, and can help someone carry out their daily functions as normal. However older patients are often prescribed multiple, long-term prescriptions at once, and in return experience cognitive decline as well as many other complications.
Drug Abuse
When people hear the term “drug abuse,” they often assume a person has an addiction to street drugs; however, in the elderly community it’s referring to prescription pills. Unless you're 65 and older and in pristine health, chances are you have at least one prescription you take as needed. Whether it’s a muscle relaxer for lower back spasms, blood pressure medications, or sleeping pills— they’re made to help us live our lives. The problem is when people misuse prescribed medications, which could mean taking more than directed, or when they don’t need it at all. Prescription drug abuse can also mean mixing their medicine with other drugs and alcohol.
The older community is most as risk for developing an abusive relationship with their prescriptions because they take more medications than any other age group. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), about 3 in 10 people between ages 57 to 85 use at least 5 prescriptions. Additionally, growing older slows our body’s absorption and filtration rate down, making you think you need more of something when in reality it just takes longer for your body to process. This can lead to overdose, which can be lethal. In fact, of the nearly 23,000 deaths in the U.S. attributed to prescription drug overdose in 2013, more than 70 percent resulted from the abuse of opioid painkillers, according to figures released this year by the Centers for Disease Control and Prevention.
The 2 most widely prescribed prescriptions that elderly people are commonly develop dependencies on, are opioids mentioned above, and benzodiazepines. Opioids are used to control pain; some examples include: oxycodone (OxyContin), oxycodone with acetaminophen (Percocet), and hydrocodone with acetaminophen (Vicodin). Addictions to opioids form with long-term use, or using morn than directed at given times. Benzodiazepines on the other hand, are used to treat anxiety or severe panic attacks. Examples of these include Examples include diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan).
An Invisible Epidemic
Details like insufficient knowledge, limited research data, and hurried doctor visits are contributing factors to why health care providers often overlook the substance abuse crisis in our older community. It can be difficult to label an elder an addict because symptoms of substance abuse in older adults sometimes mimics symptoms of other behaviors common in the elderly population like depression, diabetes, and dementia.
In an article on NCBI’s (National Center for Biotechnology) website, it states younger adults often unconsciously assign different “quality-of-life standards” to older adults. We’re surrounded by a generation of caretakers with attitudes that are reflected in thoughts such as, “Grandmother's cocktails are the only thing that makes her happy," or "What difference does it make; he won't be around much longer anyway." There is this unhealthy idea when it comes to an elderly person’s life that it's not worth treating them for substance use disorders. “Behavior considered a problem in younger adults does not inspire the same urgency for care among older adults. Along with the impression that alcohol or substance abuse problems cannot be successfully treated in older adults, there is the assumption that treatment for this population is a waste of health care resources.”
Our older population is more independent than we give them credit for, in fact only 4.6 percent of adults 65 and older live in assisted living communities. Living alone, although making for an independent lifestyle, often allows an individual to “self-medicate” with their prescription drugs and alcohol because they’re reported as having a lower life satisfaction. Social Isolation
can have other upsetting side effects on a loved one other than misuse of prescriptions; the more you’re involved in your loved ones life the more you’ll understand how they handle emotional situations.
What to Look for & How to Help
Looking for symptoms of drug abuse in older adults can be hard to monitor because of their living arrangements or altered mental status. The American Academy of Family Physicians provides helpful warning signs to look for if you think someone in your life may have a problem. Be on the look out if they:
-Get a prescription for the same medicine from two different doctors.
-Fill a prescription for the same medicine at two different pharmacies.
-Take more of a medicine than they used to or take more than is instructed on the label.
-Take the medicine at different times or more often than is instructed on the label.
-Become more withdrawn or angry.
-Appear confused or forgetful.
-Often talk about a medicine.
-Are afraid to go somewhere without taking a medicine.
-Are defensive when you ask about a medicine.
-Make excuses for why they need a medicine.
-Store “extra” pills in their purse or in their pocket.
-Sneak or hide medicine.
-Have been treated for alcohol, drug, or prescription drug abuse in the past.
Contact a doctor right away if you think someone you know is abusing his or her prescriptions. Voice your concerns and the doctor will make an evaluation to help determine the treatment needed. Treatments vary person-to-person depending on age, degree of drug use, and by risk of going through withdrawals. A good measure to take is to be present at your family members doctors appointments— if they’re prescribed an addictive medication, help them monitor their dosage and use. Additionally, keep them talking to you. If they’re depressed or lonely, it could only help to be more present in their lives.
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