Prescription drug abuse is not just a problem for younger generations; it can be a problem for anyone.
In the US, 13 percent of people are over the age of 65, and this same group is responsible for over one-third of the purchased prescription drugs in the country. It is more probable for elderly patients to use prescribed medications on a long-term basis or several prescribed medications at the same time due to different medical issues. Because some older patients experience cognitive decline, it is possible for these patients to improperly administer medication to themselves. In addition, substance abuse in this demographic is also common.
Prescription drug abuse in elderly people often goes unnoticed, but it is a bigger problem than most realize. Drug abuse in this demographic is often neglected or overlooked mainly because addiction is typically considered to be a problem primarily associated with younger individuals. The thought of an elderly person purposely abusing a drug or substance seems odd to many, and misuse is usually thought to be related to forgetfulness. Any side effects as a result drug abuse in elderly people might even be confused for other health complications or just signs of aging.
Why Are Elderly People Abusing Prescription Drugs?
As a person ages, the body begins to change. The person may become more sensitive to medications; their metabolism begins to slow down; their experience of pain may increase; sleep disorders may develop; problems with memory may occur; anxiety may become more prevalent; and overall, the body does not function the same as it did in the person’s younger years. Some of these changes may trigger a prescription from a medical profession. But because of these physical changes, elderly people are at a higher risk of danger and complications when a medication is not properly administered.
Elderly people might experience extreme physical pain from various conditions and need a way to decrease or eliminate that pain. When the symptoms become stronger or intolerable, some elderly patients may take matters into their own hands by changing their dosage or finding alternatives to getting the medication they think they need.
Elderly individuals might abuse prescription drugs to address difficulty sleeping, boredom, loneliness, family issues, or financial hardship. They might experiment with altering dosage levels to deal with fear of aging or sadness from losing a loved one.
Once a person begins to abuse a prescription, they are at risk of becoming addicted as well as experiencing harmful side effects that could even lead to death.
Signs of Drug Abuse in Elderly Patients
There are signs that may suggest an elderly person is abusing prescription drugs. Some of the signs include a patient filling a prescription at multiple pharmacies, getting the same prescription(s) from multiple doctors, a constant fear of running low on medication or the need to know where their medication is at all times, mood swings, increased dosages of medication(s), frequently refilling prescriptions, forged or false prescriptions, lack of interest in social events, or changes in personality.
Some signs might go unnoticed and be confused with symptoms related to medical conditions, such as sleep problems, anxiety, memory issues, frequent falls, and depression. Since these can be mistaken for other potential medical problems possibly related to aging, doctors and family members do not always connect them to a potential substance abuse issue. These signs going unnoticed can result in the elderly patient not receiving the help or medical attention that is needed to address the substance abuse.
Elderly individuals commonly use various prescriptions that have ingredients with high potential for addiction. Two of the most frequently used drugs by elderly individuals are opioids and benzodiazepines.
Opioids are prescribed narcotic medications used to control pain in users. Popular medicines containing opioids are Percocet, Vicodin, and OxyContin. Opioids are highly addictive and should be administered only as prescribed. Users abuse opioids by either using more than prescribed by their doctor, using someone else’s prescription, or using for a longer period than prescribed. In addition, some users may alter the method of intact, such as crushing and snorting the pills, or combine the medications with other substances like alcohol.
Abuse of opioids can lead to drug addiction or dependency, and can have severe side effects in users. Some of the side effects elderly patients may experience from abusing opioids are sedation, nausea, small pupils, slurred speech, constipation, euphoria, respiratory depression, analgesia, confusion, itchiness, and poor judgement.
Benzodiazepines are prescribed to help with anxiety, seizure control, muscle relaxation, insomnia, and/or panic attacks. Popular benzodiazepine medications are Xanax, Ativan, Valium and Klonopin. Users may believe they can only function with the help of these drugs, or they may enjoy the feelings produced by the medications, causing a dependency that can have negative effects on the user. Some known side effects of benzodiazepine drug abuse are dizziness, lack of coordination, drowsiness, weakness, blurred vision, slurred speech, and a comatose state.
Elderly patients also tend to abuse over-the-counter medications and health supplements, which may cause adverse effects to their health instead of helping them. These drugs are easier to access and may not signal any red flags to loved ones.
It is estimated that between 14 and 20 percent of elderly Americans have one or more mental health conditions or issues related to substance abuse or misuse, totaling between 5.6 million and 8 million elderly individuals. Depression-related problems and dementia-related behaviors are the most common. Patients experiencing mental health problems and depression stemming from prescription drug abuse are less likely to take other medications for medical conditions, such as medications for high blood pressure, heart disease, and diabetes, often causing patients to have repeat hospital visits or stays. Drug abuse symptoms include memory problems, dizziness, weakness, blurred vision, slurred speech, and overdose. In some cases, overdose can even lead to death.
Multiple Medical Conditions and Medications
Elderly patients are more likely to be prescribed multiple medications in the United States. According to SAMHSA, as cited by the Partnership for Drug-Free Kids, almost three out of 10 people in the 57-85 age group consumed at least five different prescription drugs regularly in 2011. During the time period of 1997-2008, the rate of hospital admissions related to use of prescription and illicit drugs rose by 96 percent in individuals aged 65-84, and for people 85 and older, the rate increased 87 percent.
It is common for elderly users who take multiple medications to abuse them, often mixing the drugs with alcohol. Drug abuse in elderly patients can stem from a number of different physical, social, or psychological factors, making them more vulnerable to drug addiction or abuse. If a medication’s effectiveness begins to plateau, they may begin taking high doses to address symptoms or even add an additional medication to the mix. It is also possible they merely confuse each medication’s dosage or mix medications that are not compatible and should not be taken together; this is still considered prescription drug abuse.
As people age, some might begin to struggle with their cognitive abilities. These abilities are related to memory, attention, language, motor skills, vision, flexibility, sequencing, decision-making, and problem-solving. If cognitive abilities are compromised, performing regular tasks, such as taking medication, can become a challenge.
It is possible for an elderly patient to become forgetful and neglect the fact that they have already taken their medication and then take a second dose. They may also take more than prescribed simply because they forgot the dosage amount. If they take more than one medication, it is possible to even confuse the dosage amount for each medication taken.
According to the National Institute on Drug abuse, prescription drug abuse is increasing in people in their 50s and early 60s. This may be partially due to the fact that this group includes baby boomers who have historically had higher rates of illicit drug use over previous generations.
Emergency departments in the United States experienced a 78 percent rise in older adults being admitted for prescription and illicit drug misusebetween 2006 and 2012. According to a study by the Hanley Center, about 63 percent of older patients blame anxiety and depression for their substance abuse. In addition, 30 percent of those participants claimed that financial stress was the primary contributing factor, and almost half of all participants said that their substances of choice were prescription drugs and alcohol.
How to Help
Medical professionals determine safe dosages for patients, and prescriptions should be strictly followed. If there is any question whether an elderly patient is abusing prescription drugs, a medical professional should be contacted immediately. It might be suggested to lower the dosage, or change medications to one that is less addictive or more effective at a lower dosage.
Family members or friends should have a list of prescribed medications and dosage amounts of each medication for elderly patients to ensure they are being properly administered. An elderly patient’s medication can be prepared in a pill organizer to prevent misuse or abuse, and to avoid repeat dosages by forgetful patients.
How to Treat Prescription Drug Abuse in Elderly Patients
Prescription drug abuse is a condition that needs focused medical attention. Users may want to quit abusing prescription drugs but don’t know how or feel that they cannot do it on their own. Suddenly quitting a drug, or going “cold turkey,” should not be attempted, as doing so can be particularly problematic and harmful to elderly patients. Elderly users should contact their doctor or a professional addiction treatment program to establish a recovery plan that includes medical detox and comprehensive treatment.