Prescription Drug and Substance Abuse Among Seniors on the Rise

The prescription drug epidemic is a well-known issue in society today. It’s not uncommon to hear of teenagers in a small, rural town overdosing on prescription painkillers, or worse, on an illicit substance such as heroin. Prescription painkillers are often noted as a gateway drug to more substantial substance abuse, involving stronger prescription medications like fentanyl or illicit drugs like heroin.

Even heroin treatments are now causing concern. Suboxone, a widely-used prescription treatment for heroin addiction, prescribed to reduce cravings in patients in recovery and block the effects of heroin should the individual use during treatment, has been found to be the cause of overdoses in victims for whom the drug was not prescribed. In other words, it’s being used illegally. Prescription Drug Abuse in the Elderly

Why aren’t we hearing about prescription drug dangers in the elderly?

This news is heard across the country, but even most of the statistics focus on drug abuse among teenagers. What we don’t often hear about is prescription drug abuse among the elderly. It’s a growing problem that is often overlooked. According to the Centers for Disease Control (CDC), 36,000 people died of a drug overdose in 2008. Most of those overdoses were caused by prescription drugs.

According to a brief from the Substance Abuse and Mental Health Services Administration (SAMHSA) and Administration on Aging (AoA), “the prevalence of medication misuse, abuse, and dependence among older adults range from 1 percent to 26 percent.” This wide range in findings is due to the variations in definitions of medication misuse and abuse among studies. Other research has found that up to 11 percent of women older than 60 misuse prescription medications, according to the same brief.

Factors contributing to prescription drug abuse in the elderly

Consider the fact that adults aged 65 and older make up 13 percent of the population, yet consume about 33 percent of prescription drugs. Older adults are also frequently prescribed more than one medication, a factor that largely contributes to overdoses and deaths from prescription drug overdoses due to dangerous drug interactions.

Additionally, many over-the-counter medications commonly taken by older adults can have serious adverse interactions with prescription medications. That’s why it’s extremely important to discuss all the medications you or your loved one are taking with your doctor or pharmacist, who can quickly identify potentially dangerous combinations and suggest safer alternatives.

The elderly are also commonly prescribed a few types of drugs with a high potential for addiction, such as opioids, commonly known as painkillers, and benzodiazepines, drugs which are typically used to treat insomnia, anxiety, and panic attacks. What begins as a legitimate medicinal use of a prescribed medication can quickly turn to a dangerous addiction if not carefully monitored.

How prescription drug use can turn problematic

Prescription drugs with a high potential for addiction create problems because the body develops a tolerance to the medication. So when a senior is prescribed a medication and takes it as prescribed, soon, the body requires more of the drug in order to achieve the same effects. So, for example, a senior may start to take an increased dose of pain medication in order to achieve the same symptomatic relief that the lower, original dose provided.

According to Johns Hopkins Health Alerts, drugs with significant addiction potential can be used safely. That is, in limited quantities for short periods of time. But short-term treatment isn’t sufficient for elderly patients suffering from chronic pain or anxiety, and that’s where the problem often begins.

The aging Baby Boomer demographic and illicit drug use

One possible contributing factor to the increase in prescription drug abuse in older adults is the aging Baby Boomer demographic. According to 2009 data from the Substance Abuse and Mental Health Services Administration (SAMHSA), the Boomer generation “has a much higher lifetime illicit drug use rate than earlier cohorts.” Nearly 90 percent of those who reported illicit drug use within the previous year stated that they had initially used drugs prior to the age of 30.

Between 2002 and 2007, the rate of current illicit drug use among people aged 50 to 50 nearly doubled, from 2.7 percent in 2002 to 5.0 percent in 2007. Specifically, non-medical use of prescription drugs in this age group grew from 2.2 percent in 2002 to 4.0 percent in 2007. And, the number of adults aged 50 and older with “past year substance use disorder (SUD)” is expected to more than double from the average annual rate of 2.8 million (between 2002 and 2006) to 5.7 million by 2020 in the U.S.

Some individuals who have previously abused illicit substances are pre-disposed to addiction. As this demographic ages, more seniors with addictive tendencies will develop chronic pain and other issues. The standard course of treatment for these concerns can have dangerous consequences for a patient with an addictive personality or a pre-disposition to addiction.

Prescription drug abuse in the elderly is a major health concern

In older adults, the misuse of prescription medications can be even more dangerous than it is for younger users. As the body ages, metabolism slows and maintains a lower level of body water content. This leads to higher blood substance levels for longer periods of time compared to younger individuals, making the elderly more likely to suffer significant effects, such as cognitive and motor impairment that may lead to falls, injuries, or even a decreased ability to manage the activities of daily living (ADLs).

Due to the physiological and psychological changes that occur with aging, older adults are more likely to suffer from confusion or drug-induced delirium, which can often be confused with the symptoms of Alzheimer’s disease or dementia. Older adults are also more likely to experience excessive sedation and respiratory depression with misuse of prescription medications, common signs of overdose with potentially fatal consequences.

Preventing prescription drug abuse in the elderly

If you or a loved one is taking prescription medications with a high potential for abuse and dependence, there are a few precautions you can take to stay safe and reduce the likelihood of developing an addiction:

  • Take medications safely and only as prescribed. Avoid taking higher doses of prescription medications or taking medications more frequently than prescribed.
  • If your medication is not providing full symptomatic relief, talk with your physician before changing your dosage.
  • Never take a prescription medication not prescribed to you.
  • Always discuss all the medications you’re taking with your doctor and/or pharmacist, including over-the-counter medications, vitamins and supplements, and even alcohol.
  • Watch for signs of prescription drug abuse, such as increased confusion, the same medication prescribed by two or more different providers, behavioral or mood changes, and defensive or uncomfortable responses when asked about medication use.

If you’re concerned that a loved one has developed an addiction or is misusing prescription drugs or other illicit substances, talk with his or her doctor if possible. Ask questions, talk with other trusted family members and friends, intervene and seek outside resources. These conversations are uncomfortable, but you might be saving your loved one’s life.

Written by’s Angela Stringfellow.

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