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Drug Abuse in the
Elderly
Prescription Drug Abuse in the Elderly
How the Elderly Become Addictied to Their Medications
By Cathy Meyer, published July 18, 2005.
An advancing number of drug abusers are
addicted to, not illegal drugs, but to medically prescribed drugs.
An even more startling fact is that among those abusing prescription
medications are the elderly.
Incorrectly following the instructions on the medication bottle,
mixing medications, forgetting to take medicines, and an inhibition
to ask for assistance are all common attributes amongst elderly
people that contribute to the abuse
of prescription medications.Although this kind of abuse is common in
the elderly, it is frequently misdiagnosed by physicians and goes
unnoticed by family members.
Prescription drug abuse is present in 12% to 15% of elderly
individuals who seek medical attention. Health problems related to
substance abuse cost Medicare two hundred thirty three million
dollars per year in 1989, and probably account for much larger
expenditures today.
Although 60% of substance abuse is recognized in patients under the
age of 60, only 37% is recognized in patients over the age of 60.
Physicians often fail to recognize elderly substance abuse for many
different reasons.
1. Lack of awareness by the physician
2. Embarrassment by the physician at the idea of suggesting
that his/her elderly patient be screened for abuse.
3. Failure to perceive the importance of substance abuse in
the elderly
4. The idea that, “he is old, let him have his small
pleasure.”
Elderly substance abuse can be divided into two categories,
prescription abuse and non-prescription abuse. The elderly
population accounts for 14% of our population, they consume as much
as 25% of prescription medications taken in this country. Many drugs
are inappropriately prescribed for older people and 25% of
prescriptions lack appropriate indications for the patient and their
illness. Benzodiazepines (Valium) and narcotics (Librium) are two of
the most commonly prescribed drugs of abuse by the elderly. Over the
counter sleeping medications are the most common non-prescription
drugs abused by the elderly.
Like younger patients who abuse prescription drugs, the elder
abusers have a high rate of psychiatric problems due to the
addiction. Unlike younger addicts more likely to have physical and
neurological complications due to the addiction also. Screening for
drug abuse in the elderly can be difficult because most will deny
symptoms and usage. Surveys of elderly community based individuals
indicate from 17% to 20% are receiving psychotropic medications that
are highly addictive. Almost half indicate use beyond the prescribed
levels of these medications. Most elderly patients will try and hide
inappropriate prescription drug usage by visiting several physicians
and obtaining numerous prescriptions for Valium and narcotics.
Normally when an elderly patient goes to the doctor they are on so
many different kinds of medication that it requires the use of a
shopping bag filled with bottles. Most physicians will ask their
elderly patient to bring all medications with them on each visit,
both prescription and non-prescription.
If the physician finds redundant prescriptions for narcotics,
benzodiazepines or sedative type medications then it should be taken
for granted that the patient is probably abusing the medications.
Determining whether or not an elderly patient is abusing his/her
medications takes a bio-medical approach by the physician. It has to
be determined whether the patient has a biological disease, such as
depression that is producing the abuse or dementia or delirium.
There must be an examination of the medical complications caused by
the abuse as well as medical problems that may have been made worse
due to the abuse. Psychological distress amongst the elderly can
cause addictive behaviors but to fix the medical condition that is
causing the distress the physician will need to prescribe the same
types of medications that the patient has been abusing. Elderly
patients have a mixture of social and functional dependencies that
encourage addictive behaviors.
After a certain age, when they are unable to do the social things
they have taken for granted and then begin to have problems doing
the things we all need to do daily just to function in life, it is
easy for them to just pop a pill, any old pill, as long as it helps
them continue to live independently. This need to remain independent
plays a large role in complicating any medical plan that is put into
place when it comes to helping an elderly patient who is abusing
their medication. The long-term treatment and management of an
elderly patient who has been abusing their medication will include a
mixture of medical, psychiatric and family involvement. If the abuse
is acute it may require treatment as an inpatient at a drug rehab
facility. It will definitely require family intervention and a
willingness by family members to monitor the patient’s medications
and schedules. There will have to be continued medical assessment of
any medical complications caused by the abuse. The road back to
health can be long and filled with anxiety for elderly patients who
have found themselves addicted to prescription medications.
Combinations of proper medical treatment, counseling and family
support will make it a smoother journey back to a healthier
lifestyle. One in which they can be alert, functioning and
independent without the need to abuse prescription drugs.
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On the Front Cover is the first
part of the Unanimous Declaration
of the thirteen united States of America. In the coming months
leading up to the Elections in November, we will be printing more
of this Declaration in the hopes that it will inspire others to
remember,
or to become aware of’ the dedication and care that our Founding
Fathers put into creating this Union, and with the hope that we will
live up to their high standards and use the rights for which they so
courageously fought.
It is our right and it is our duty to actively participate in our
Government on Election Day
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