It is hard to grow older, and the common expression of “never grow old” is said to the younger generations as a half-hearted warning about what’s to come. Aging can create a multitude of physical and mental challenges that many people didn’t consider when they were younger. The National Council on Aging (NCOA) writes that there are about 49 million Americans aged 65 and older.

The U.S. Census Bureau published a 2019 article that states, “In less than two decades, the graying of America will be inescapable: Older adults are projected to outnumber kids for the first time in U.S. history.”

It is projected that in 2035 (a short 14 years from now), there will be 77 million people over age 65, and children under age 18 are projected to number 76.5 million. Even more amazing is that the year 2060 projected number of people over age 65 is 94.7 million compared to 80.1 children under 18. Think about that.

We will explore how medications can be overprescribed for the elderly and how that affects their overall health and welfare and can potentially develop into drug abuse.


Senior Adults and Prescription Drugs

Senior Adults and Prescription Drugs

Older adults are prescribed more prescription medications for the medical and psychological conditions they have. Our minds might not be as sharp as before, which can lead to not remembering what drug was taken and when or which drugs we are on. Prescription medicines taken together can cause harmful interactions.

The NCOA notes the most common medical and mental issues affecting the senior population:

Chronic health conditions – About 80 percent of seniors have at least one chronic condition, and 70 percent have at least two with diabetes, heart disease, stroke, and arthritis leading the way. Chronic disease is the leading cause of death for seniors.

Falls – Older adults suffer from falls more than younger people. An older adult is treated in an emergency room every 11 seconds, and every 19 minutes, a senior dies from a fall. Hip fractures, head trauma, and death are the possible results of an older person falling.

Physical activity – Older adults should fit physical activity into their day, and that activity should be aerobic and muscle-strengthening. Yet, only 28% of adults over age 50 did not engage in physical activity other than work, as the NCOA writes.

Oral health care – We’re talking about the mouth, teeth, and gums. Nineteen percent of seniors do not have any natural teeth left, 40% have not been to the dentist in the last year. Nineteen percent of seniors with teeth had untreated tooth decay. Bad oral health not only affects how one eats but also affects the proper management of chronic conditions. Many medications should be taken with food, and with bad teeth, one is less likely to eat. Medicine taken on an empty stomach can cause stomach upset, nausea, vomiting, and dizziness, which can lead to falling and becoming injured.

Behavioral health – Behavioral health most definitely affects the elderly. One in four struggles with anxiety, depression, or substance abuse. The National Institute on Drug Abuse (NIDA) reported in 2020 that “nearly 1 million adults aged 65 and older live with a substance use disorder (SUD), as reported in 2018 data.”

As we age, so do our bodies and minds, and the likelihood of being prescribed medications for different conditions and symptoms, and some carry a higher percentage of being possibly addictive.

Prescription Medications Usually Prescribed for Seniors

Prescription Medications Usually Prescribed for Seniors

It is noted that more than 50 percent of the older population is taking more than five medications or supplements on a daily basis by NIDA. They also say that higher rates of chronic illnesses, lower metabolism, and the potentiality of drug interactions or drug misuse is possible.

Seniors may be prescribed several medications for different conditions. Some of the more common, as noted by WebMD, are:

  • Blood thinners
  • Blood pressure medication
  • Benzodiazepines
  • Opioid pain medications
  • Antidepressants
  • Antibiotics
  • Hypothyroidism medication
  • Diabetes medication
  • High cholesterol medicine
  • Acid reflux medicine
  • Opioid pain medicine

When one or more of these medicines are taken together or within a short time frame of each other, it can cause several problems, such as:

  • Dehydration
  • Dizziness
  • Excessive bleeding
  • Falls and fractures
  • Trouble conducting everyday tasks
  • Thinking and reasoning problems
  • Confusion, decreased awareness of where you are
  • Adverse side effects from the drugs
  • Hospitalization
  • Possible death

If an elderly person is not using a pill organizer and relies on their memory about which medication to take, there is a real chance that they will take the wrong medication or the wrong dose. When the treating doctor does not know what prescriptions a person is taking, they will not know what not to prescribe. It is vital to keep a list of medications and the dosages in a wallet to be referred to when needed.

Substance Use in the Elderly Population

Substance Use in the Elderly Population

elderly-man-addicted-to-pills-sadly-looks-at-pills-on-table

Older adults have a stronger potential to misuse or abuse medication than younger adults. The Substance Abuse and Mental Health Services Administration (SAMHSA) with the federal Administration on Aging wrote that about 25% of older adults use prescription psychoactive drugs for longer periods of time than younger adults. These types of drugs have a strong potential for misuse and abuse.

Medications in this class of drugs include:

  • Benzodiazepines – Xanax, Valium, Ativan, Restoril, Halcion, and others.
  • Opioid Analgesics – Tylenol #3, Robitussin A-C (codeine), Percocet (oxycodone), Vicodin (hydrocodone), Demerol (meperidine) Actiq (fentanyl), Ultram (tramadol), and others.

Extended benzodiazepine use has been associated with depression, cognitive decline, confusion, and hip fractures from falls. Extended opioid pain medication use has been associated with excessive sedation, vision impairment, attention impairment, coordination impairment, and falls, SAMHSA wrote. In addition, NIDA relays that almost one million adults over the age of 65 live with a substance use disorder. The main admission for substance use in people over age 65 was for alcohol abuse.

Marijuana is another primary substance listed at admission by older generations. Opioids are also on the top of the list, according to data NIDA published. Sedative abuse is another substance in which older adults are admitted for addiction treatment.

Data collected by SAMHSA’s Center for Behavioral Health Statistics and Quality, Treatment Episode Data Set in 2011 indicated that the primary substances people over age 65 were admitted for were:

  • Alcohol
  • Heroin and other opiates
  • Cocaine
  • Marijuana
  • Other drugs

When reviewing substance misuse or abuse data for the elderly, it is necessary to examine how drugs were ranked by emergency room visits in people over age 65.  The federal agency’s Drug Abuse Warning Network (DAWN) 2011 report indicated:

  • Prescription or non-prescription pain relievers
  • Narcotic pain relievers
  • Benzodiazepines
  • Alcohol use with other drugs
  • Antidepressants or antipsychotics
  • Cocaine
  • Heroin
  • Marijuana
  • Illegal amphetamines or methamphetamine

How to Determine Substance Abuse in the Elderly

How to Determine Substance Abuse in the Elderly

It can be challenging to determine if an elderly person has a substance use disorder since some symptoms are the same as those that an older person may be experiencing. The International Psychogeriatric Association (IPA) shares that the signs of normal aging can overlap with signs of substance use, such as:

  • Neglecting responsibilities
  • Memory issues
  • Relationship problems
  • Changes in sleep
  • Physical appearance deterioration

It states that normal aging is usually quiet and slow, with changes being subtle. However, sudden or dramatic changes are warning signs in which to pay attention. If you think an elderly person in your life may have a substance use problem, these are some of the signs to know:

  • Excessive preoccupation with having enough pills or the timing of doses
  • Sleep disturbances
  • Decline in functioning
  • Social withdrawal

 Treating the Elderly for Substance Abuse

Compassion, patience, and understanding are essential when confronting an elderly person about possible substance abuse. They may reject any such thought and chalk up their behavior to aging. Nonetheless, when an older person is prescribed several or many medications to treat their current and ongoing conditions, the possibility of misusing or abusing the medications is real.

NIDA explains that many of the behavioral therapies coupled with managed medications have been successful when treating seniors for drug abuse. Some of these include cognitive behavioral therapy, dialectical behavior therapy, rational emotive behavior therapy, and others. Also, psychoeducation group therapy and other treatment modalities are beneficial in treating the older person struggling with drug abuse.

A Final Note on Elderly Drug Abuse and Overprescribing

A Final Note on Elderly Drug Abuse and Overprescribing

We are living longer these days than in the past, which means we are taking more medications for our ailments. Each visit to a doctor, no matter where that doctor practices, can prescribe a new drug for the elderly patient, thus adding to the list of medications taken. Some physicians randomly prescribe medicines without asking what other medication the older person is currently taking. Benzodiazepines are meant to treat anxiety, stress, and sleep problems but can cause dependency in a short time. Opioid pain relievers can do the same, and when the dosage is raised, it can lead to addiction or a fatality.

If you have an elderly loved one in your life, work with them on managing their prescriptions. Overprescribing is common, but drug abuse should not be. There are many addiction treatment centers that can help get your older loved one back on the right path.

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