Posted on February 24, 2015 by Laura Fuller
The lexicon of long standing terms such as drug addiction, abuse, dependence is constantly changing. At Origins Behavioral HealthCare, we are mindful of this evolving language in both the public and professional arenas. For the purposes of this particular article, we are utilizing the term “abuse.”
Drug abuse can be related to a variety of substances and is more often than not seen as when a person decides to continue using drugs in spite of the knowledge that his or her life has become unmanageable. It is often experienced along with negative social, physical or psychological issues.
With addiction, the substance use must be stopped all together; there is no amount that a person who is addicted can ever “safely” use or drink if that individual wants to be able to control or stop their drinking and drugging behaviors. There is an important distinction between problem drug use and addiction because not all substance users become drug addicts/alcoholics, but all alcoholics/drug addicts go through a period of substance abuse. Substance use disorders may range from mild to severe and should be treated accordingly following a professional assessment.
A professional assessment is often required in the early stages while in the late stages intervention and formal treatment may be the necessary course. In either case it is best to consult an addiction professional with long term experience and demonstrated outcomes.
In December of 2011, the National Institute of Drug Abuse (NIDA) reported that the percentage of American 50- to 59-year-olds who reported having abused illicit or prescription drugs during the past year more than doubled, from 2.7 percent to 6.2 percent, between 2002 and 2009. Not coincidentally, by the end of that period the Baby Boomer generation born between 1946 and 1964 filled that age range. Baby Boomers’ histories of illicit drug use, and their relatively tolerant attitudes toward it, along with the fact that at that time they comprised nearly 30 percent of the U.S. population, have raised the stakes on understanding and responding effectively to drug abuse among older adults.
NIDA suggested that the social and physical changes that accompany aging may well increase vulnerability to drug-related problems. The loss of loved ones, juggling of multiple roles, and retirement or other alterations in employment and income may cause some older people to use illicit drugs as self-medication for anxiety or depression, especially if they have a history of taking drugs to cope. Slowing metabolism can increase sensitivity to the effects of drugs. Furthermore, the effects of drugs of abuse in older adults may be influenced by age-related health conditions and medications. These issues become even more problematic when patients hide their drug abuse.
Older Adults and Baby Boomers respond at least as well as younger individuals to drug addiction therapies so recognizing drug problems in these patient populations is both effective and critical. Clinicians need to be aware of patterns of drug abuse among older people and alert themselves to the possibility that some physical problems of older adults, for example falls and other accidents, may stem from drug abuse.
Medical professionals can make a positive impact by assessing a patient’s risk of developing an addiction problem, advising patients on the negative health effects of substance abuse, and, if needed, arranging a referral to specialty care or a drug rehabilitation facility. Within this and every age group the goal is to help people live longer, healthier, and more productive lives.
In 2011, NIDA also reported that persons aged 65 years and older comprised only 13 percent of the population, yet accounted for more than one-third of total outpatient spending on prescription medications in the United States. Older patients are more likely to be prescribed long-term and multiple prescriptions, and some experience cognitive decline, which could lead to improper use of medications. Alternatively, those on a fixed income may abuse another person’s remaining medication to help save money.
The high rates of comorbid illnesses in older populations, age-related changes in drug metabolism, and the potential for drug interactions may make any of these practices more dangerous than in younger populations. Additionally, a large percentage of older adults use over-the-counter (OTC) medicines and dietary supplements, which further compound any adverse health consequences resulting from prescription drug abuse.
Older Adults and Baby Boomers should always monitor their consumption of all medications and share that information with their primary care physician and any specialists they visit. The combination of any drugs with alcohol, including OTC medications, can result in problems with coordination, nausea and irritability among other side effects which can be life threatening.
Addiction to prescription medications can be dangerously complicated by the use of OTC medications. If you have a serious medical condition, there are some OTC drugs that you should never take. For example, when analgesics are used in high doses, cardiovascular and renal toxicity can occur, as well as gastrointestinal hemorrhaging. Analgesics should also never be taken in conjunction with alcohol.
Baby Boomers and Older Adults should also understand that OTCs could possibly contain duplicate ingredients to their prescribed medications. Seniors with high blood pressure and other medical conditions should avoid diet pills and energy potions since some have been associated with cardiovascular problems.
Be aware that some OTCs, including cough syrups, contain alcohol and should be avoided by anyone in recovery. Drugs that combine cough suppressants with sleep-inducing properties may not mix well with other medications.
Accidental prescription pill addiction can result from confusion about a complicated prescription drug regimen. The Older Adult or Baby Boomer’s doctor may have prescribed psychotropic medications for pain, sleep or anxiety problems over a period of time, even decades. Older women take an estimated 33 percent more of these medications than men. Of course, they may be surprised and defensive to learn this has become a dependency because, after all, “the doctor has prescribed it.”
Risks of prescription drug use and abuse among seniors include memory and cognition loss, sleep problems, serious medical complications, loss of physical mobility and balance, and increased pain. In cases such as these, the person has increasingly taken more of the drug to get the same effects. Later, the individual may have purposefully sought more medications, sometimes resorting to doctor shopping, visiting “pain pill mills” or shopping online.
Aging bodies do not metabolize drugs with the same efficiency that younger ones do, so drugs can have a stronger effect. Physiological changes occur as a person ages that do not allow them to metabolize drugs with the same efficiency as they once did. Alcohol does not mix well with any prescription drugs, including over-the-counter drugs such as antihistamines.
Senior drug abuse is not limited to medication misuse but steadily includes illicit drug use. Age-sensitive rehab for Older Adults and Baby Boomers addresses specific drug use and encourages the involvement of family members in treatment.
Assessment and diagnosis of substance abuse or addiction must take into account which drugs are used in which quantity and combination and for how long. Many medical conditions are caused by drug abuse, and at least 70 percent of senior hospital admissions are related directly to alcohol, medication or other drug misuse.
Marijuana ranks as the No. 1 choice among illegal drugs for seniors. Many seniors started smoking marijuana as teens or young adults and never completely quit. Marijuana as well as alcohol and tobacco have been the gateway drugs for many who went on to experiment with hallucinogens such as LSD, MDMA and opioids such as heroin. The No. 1 choice of first-time illicit drugs used by the senior population is the central nervous system stimulant, cocaine.
Many Older Adults and Baby Boomers who enter rehab suffer from chronic pain. They have been using at least four to five prescription medications as well as over-the-counter drugs. However, their pain has not subsided but may have actually increased, because long-term use of pain pills can actually exacerbate the pain
Drug abuse can also be entirely accidental, especially when doctors prescribe addictive medications over long periods of time. Physical, emotional and mental dependence follow and, finally, the addict struggles to get through life. Relapse can also occur for many alcoholics and drug addicts in recovery when pain medications are not tapered correctly following surgery.
If you or a loved one is exhibiting signs of alcohol abuse, please contact us at any time to receive more information: 1-844-U-GET-WELL (844-843-8935).
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