Prescription Drug Abuse in the Elderly

When most people think of painkiller addiction, they usually think about the young or middle-aged adults we hear in the news dying of overdoses. However, there is also a painkiller addiction problem in the senior population, and almost no one is talking about it. In the United States, people aged 65 or older make up just 13 percent of the population but consume one-third of all prescription drugs.

It is estimated that substance abuse occurs in 17 percent of the elderly. However, it can sometimes go unnoticed because friends, family members, and even physicians may see the signs and think that they are just common signs of aging, such as confusion or forgetfulness. Elderly substance abuse can happen when seniors have trouble reading or understanding prescription instructions, or take double the dosage because they forgot they had already taken their medicine.

Seniors are at a higher risk to develop an addiction to painkillers. As the body ages, the liver cannot filter out medications from the body as efficiently, meaning these drugs stay in the system of an older person longer. This means that seniors can become addicted at much lower doses than young people. Seniors that are on opioids are at a higher risk to experience falls due to the side effects of these powerful drugs.

Two Addictive Prescription Drugs

Benzodiazepines

Benzodiazepines are a type of medication also known as tranquilizers. They are used to treat conditions like anxiety, panic attacks, insomnia, bipolar disorder, seizures, and acute stress from traumatic experiences, like a death in the family. They work by slowing brain activity, relaxing muscles and lowering anxiety levels. The more they are used, the higher a person’s tolerance to them becomes, resulting in needing higher doses to feel the same effect. Those that become addicted to these drugs can have major medical issues if they suddenly stop taking them.

Some of the drugs in this class include diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin).

Symptoms of benzodiazepine abuse or overdose include:

Memory impairment
Impaired reasoning
Confusion
Drowsiness
Dizziness
Blurred vision
Slurred speech
Lack of coordination
Difficulty breathing
Coma

Opioids

Opioids work by attaching to opioid receptors in the brain and blocking the sensation of pain. They also produce euphoria by increasing dopamine levels in the parts of the brain that are responsible for our sense of pleasure. With the effects of blocking pain and boosting pleasure, it is easy to see how people can become addicted to these types of drugs.

Opioids include oxycodone (Percocet and Oxycontin), hydrocodone (Vicodin), and other medicines like morphine, codeine, hydromorphone, and fentanyl.

Side effects of opioid use include nausea, vomiting, dizziness, sleepiness, constipation, and itching.

Opioid overdoses are characterized by three signs and symptoms known as the “opioid overdose triad.” They are:

Pinpoint pupils
Unconsciousness
Respiratory depression

How do I know if my senior has a substance abuse problem?

There are many signs that you can look for that could signal that your senior is struggling with prescription drug abuse. Some questions you should ask yourself:

How much are they taking? Has this increased? (Did they use to take 2 pills a day and now are taking 5 or 6 a day?)
Has their mood changed? Are they more anxious, irritable, withdrawn or argumentative?
Are they giving excuses as to why they need the pills?
Have they ever been treated for alcohol or drug abuse before?
Have they recently changed doctors or pharmacies?
Do they demand pills during a doctor’s visit?
Have they received the same pill from two or more doctors at the same time?
Have their pills been “lost” or “stolen” more than once?
Are they constantly requesting early refills for pills?
Are they annoyed or uncomfortable when people talk about their medication use?
Do they hide or try to sneak pills?

While these signals could also indicate other circumstances than drug abuse, if you find yourself answering yes to these questions, you should look further into your senior’s relationship with their medications.

How do I help a senior with a substance abuse problem?

Sometimes seniors will misuse drugs because they may not be able to read smaller print on the medication labels, and may be too embarrassed to ask for help. If this is the case, help make larger labels for your senior loved one. If they take many pills, consider making a list or schedule for them to make sure they take the right pills at the right time.

If you believe that your senior loved one has a drug problem, you may want to intervene. Talk to their primary health care provider and letting them know your concerns. Seniors tend to trust their doctors without question, so if their physician does an assessment and agrees, your senior is more likely to be receptive to help. If your senior requires treatment for substance abuse, make sure you choose a program that your insurance will cover.