Preventing Prescription Drug Abuse in Senior Citizens?
When bringing up the topic of prescription drug abuse in senior citizens, most will think of the irresponsible teenager or young adult. However, after many years of research studies suggest senior citizens are more susceptible to prescription drug abuse and addiction. Many will be surprised to learn that prescription abuse is becoming more common with seniors.
Our guide will cite more than 50 resources from government and education sites devoted to addiction research in seniors and the fundamentals of prescription abuse education.
Seniors are the largest demographic of prescription medication subscriptions in the United States.
Per AgingCare.com: However, 40 percent of the prescription drugs sold in the United States are used by the elderly, often for problems such as chronic pain, insomnia and anxiety. According to the National Clearinghouse for Alcohol and Drug Information, as many as 17% of adults age 60 and over abuse prescription drugs.
Seniors aged 65 years and older comprise of 13% of the United States population, but account for one third of outpatient spending on prescription medications. Due to the cognitive decline in elderly patients this leaves them susceptible to improper use of medications. Due to the inability to work or a fixed income status, a senior citizen may use another person’s prescription to save money. Misuse of prescription drugs is very likely with the elderly leading to prescription drug abuse in senior citizens.
As per an article on drugfree.org addiction to prescription painkillers is growing among seniors. The article talks about prescription painkiller addiction becoming more common among seniors.
“The problem is certainly ubiquitous, and often missed, to be honest,” said Dr. Joseph Garbely, Medical Director of Caron Treatment Centers. “Caretakers oftentimes miss the signs and symptoms of a substance use disorder. Doctors do too, and often aren’t asking the questions when seniors are there for their monthly checkups. An elderly person who is addicted to painkillers may appear more anxious or depressed, Garbely said. They may injure themselves and appear confused or disoriented.”
Alcohol and Prescription Drug abuse is one of the fastest growing problems in the United States
Abuse of alcohol and prescription drugs in the elderly population is growing rapidly among adults 60 and older. Yet even though the numbers are climbing, treatment for the issue is still on the back burner of understanding. Insufficient knowledge, limited research and the overlooking of healthcare professionals all contribute to this problem not being addressed. Many relatives of older individuals with substance use disorders, particularly their adult children, are also ashamed of the problem and choose not to address it. There is an unspoken but pervasive assumption that it’s not worth treating older adults for substance use disorders.
Prescription Drug Addiction in Seniors
Older patients are prescribed benzodiazepines more than any other age group, and North American studies demonstrate that 17 to 23 percent of drugs prescribed to older adults are benzodiazepines (D’Archangelo, 1993). Unfortunately, these agents, especially those with longer half-lives, often result in unwanted side effects that influence functional capacity and cognition, which place the older person at greater risk for falling and for institutionalization (Roy and Griffin, 1990)
Why seniors are at greater risk of prescription drug addiction and abuse.
Seniors have a higher risk of prescription drug addiction and other adverse effects such as overdose, falls and other accidents for several reasons. These risk factors increase if there is an issue of prescription drug abuse in senior citizens.
The aging process – older adult’s bodies age with time as does everyone else, but with seniors they start to grow tired easier and experience pain in unexpected places. Due to these experience a senior citizen can experience depression, anxiety, and other feelings of self-pity. Many doctors have a solution for this which could be defined as a prescription pad.
A tolerance – can easily develop in older adults who take prescription pain medication which loses its effectiveness making the prescribed take more than their allowed dose to kill the pain, which in turn can lead to prescription pain killer addiction. This often leads to overdose if the senior citizen doesn’t manage their intake of pain pills.
Seeing more than one doctor – is common among seniors, but many of those doctors are unaware of each other and prescribe conflicting medications which can cause a dependency problem and over prescribing issue.
Cognitive decline and forgetfulness – is common in older adults which can lead to forgetting when they took their last dose. This will lead them to taking more than prescribed leaving them susceptible to addiction or abuse of the medication they’re prescribed.
Prescription drugs create havoc – with the kidneys and digestive tract within seniors causing more problems than solutions. Some of the prescribed medications by doctors can create more problems than they’re solving.
The aging body – of seniors slows down the metabolism which in turn makes it significantly harder for the seniors body to process the medications.
Some helpful resources below to guide you in your research for the elderly…
- How to Prevent an Addiction to Pain Killers– Helpful tips on how to avoid a pain killer addiction.
- Prescription Painkiller Dependency Warning Signs– What to look for if you suspect your elderly loved one has a pain killer addiction.
- Recognizing and Preventing Prescription Drug Abuse– The National Institute on Drug Abuse provides tips on how to both prevent and recognize prescription drug abuse.
- Safe Pain Management and the Elderly– How to safely manage the pain of older adults.
It is also important to remember that your elderly loved one should only stop using anti-depressants with the recommendation of a physician and a gradual plan in place.
- Doctors Overprescribe Antidepressants to the Elderlya> – AARP investigates the overprescribing of antidepressants to older adults.
- Geriatric Depression– Information about depression among the elderly and possible treatment options.
- Going Off Antidepressants– How to safely stop using antidepressants.
- Seniors and Prescription Drug Addiction– Helpful information about seniors and prescription drug abuse.
- Using Antidepressants Successfully (PDF)– Tips for how to successfully use antidepressants without dependency or addiction.
What barriers are there in identifying older adults with substance abuse problems?
The complexity of barriers in identifying substance abuse issues in older adults is unparalleled to those in their younger counterparts.
- Lack of Awareness
- Clinical Behavior
Ageism with older adults
The term ageism was coined in the mid-1960s (Butler, 1969) to describe the tendency of society to assign negative stereotypes to older adults and to explain away their problems as a function of being old rather than looking for specific medical, social, or psychological causes. American culture embraces ageism due to the reflection of personal revulsion towards getting older due to fear of death, uselessness and powerlessness.
Lack of Awareness
Another barrier to treating substance abuse in older adults is the lack of awareness of abusive potential within their prescription drugs. This is also commonly associated with the social stigma of addiction and abuse of drugs. The stigma of addiction almost always raises barrios of the afflicted senior seeking treatment for prescription drug addiction.
The behavior of Clinicians and Service Professionals
Most healthcare professions specializing in the care of older adults and senior citizens are slow to pick up on a substance abuse problem. A clinician or a doctor may have trouble diagnosing a substance abuse or addiction problem with a senior because of the diagnostic criteria typically associated with it sometimes comes with age and is normal for the person age.
Comorbidity within Seniors
Medical and psychiatric comorbidities present yet another challenge to the effective treatment of the older substance abuser. Comorbid conditions such as medical complications, cognitive impairment, mental disorders such as major depression, sensory deficits, and lack of mobility not only can complicate a diagnosis but can sway the provider from encouraging older patients to pursue treatment for their substance abuse problems.
Other Barriers to Identification and Treatment
Other barriers to treatment in the older population are
- Transportation (may be available to go to a hospital but not to AA or aftercare or evening programs): This is especially problematic in rural communities that lack public transportation or in poor urban communities where accessing transportation can be dangerous (Fortney et al., 1995).
- Shrinking social support network: Fewer friends to support them, participate in the treatment process, or take them places.
- Time: Despite the assumption that older adults have an excess of free time, they may well have to provide 24-hour supervision to a spouse, other relative, or friend, or must care for grandchildren while the parent works.
- Lack of expertise: Few programs have specialists in geriatrics, treat many older adults, or are designed to accommodate functional disabilities such as hearing loss or ambulation problems.
- Financial: The structure of insurance policies can be a barrier to treatment. The carving out of mental health services from physical health services under managed care can prevent older adults from receiving inpatient substance abuse treatment.
If you or your family is struggling with alcoholism or addiction, please reach out and ask for help.
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About the Writer, Peter D.
Peter Dimaira is the online researcher and writer for Bright Futures Recovery Center. Peter has years of experience in journalism and joined the Bright Futures team to spread awareness about addiction, alcoholism and provide better resources on the treatment of drugs and alcohol.