The Drugging of GenRx

Apr 8, 2013 | The HWN Team | Insider
The Drugging of GenRx

image by: Anna Shvets

Prescription drugs bring relief from illness and pain but they come with a price...drug dependence and even death. Can we turn it around?

Drug abuse is perceived as a lifestyle of the young.  But prescription drug addiction in the older population is real and has already reached epidemic proportions.  On top of this deaths annually from prescription drugs continue to rise surpassing deaths from motor vehicle accidents. 1

And it’s not going to go away. In Europe by the year 2050, the 65 and above age group is projected to account for one fourth of the continent’s population. By the year 2030 the number of 65+ year-olds in the U.S. is projected to reach 71 million. 2

As many as 17% of adults age 60 and over abuse prescription drugs.and  it has been estimated that the number of prescription drug abusers over the age of 50 may reach 2.7 million by the year 2020. Although many have a history of substance use in the past, the majority do not start until later in life.

One fourth of all prescription drugs sold in the U.S. were prescribed to older adults for comorbidities such as chronic pain, sleep disorders and anxiety. Unfortunately management of these diseases requires the use of some of the most addictive drugs or does it? 3,4

The prescription drugs most often abused: 5,6

  • Opioids used to treat pain
  • Central nervous system (CNS) depressants, such as benzodiazepines (e.g., Xanax, Valium, Ativan, Klonopin), used to treat anxiety and sleep disorders
  • Stimulants such as Adderall or Ritalin, used to treat attention deficit disorder and narcolepsy (a sleep disorder)

Drug Type

Lifetime prevalences for nonmedical use

Rates of abuse and/or dependence

Sedatives

4.1%

1.1%

Tranquilizers

3.4%

1.0%

Opioids

4.7%

1.4%

Amphetamines

4.7%

2.0%

 

Demographic wise, generationRx addicts are: 7

  • male
  • unmarried
  • early age of drug initiation
  • low education and income
  • unemployed due to disability
  • using alcohol and tobacco in the past year
  • having in the past year a major depressive episode
  • rarely attending religious service

So, what drives older adult addiction? 8,9

  • increased number of comorbidities and medications 
  • age-related physiological changes that increase sensitivity to effects of alcohol and drugs
  • social factors: living alone and their accommodation made them more susceptible to social isolation
  • reported stressful life experiences, divorce, death of family and friends
  • history of substance use or mental health disorder  
  • medical exposure to prescription drugs which are potentially addictive
  • socially excluded from family and friends

Here’s how we may be able to turn it around

Like most social problems involving young and old alike, an ounce of prevention is worth a pound of cure. The good news is older adults tend to be more responsive to preventive measures and treatment than the young.

Doctors need to identify patients that could be susceptible to abuse before prescribing highly addictive drugs, and anti-addiction organizations need to address people of all ages not just the young.

More emphasis needs to be placed on rehabilitation and alternative therapy with 10

  • Age-specific programs.
  • Facilities that show respect for older patients
  • A holistic approach that treats mental, physical, emotional and social issues
  • A flexible program that can be customized to elderly needs

And we need to do our part by recognizing the tell-tale signs of addiction: 11

  • Getting prescriptions for the same medication from different doctors
  • Getting prescriptions for the same medication filled by different pharmacies
  • Stealing, selling, or forging prescriptions in order to obtain prescription drugs
  • “Losing” prescriptions, resulting in requests for additional prescriptions
  • Taking higher doses of prescription medications than prescribed
  • Exhibiting poor decision-making behavior
  • Appearing to be high, unusually energetic or excessively sedated

The Bottom Line

Aging and addicted – this is a segment of our society that is poorly understood, under researched and underserved.  While government agencies and non-profit organizations commit significant resources to tackling teenage drug addiction, addiction in the older population is left on the sidelines, neglected.

At the very least, doctors need to think twice before commiting their patients to the world of drug addiction through painkillers. And where is alternative medicine when you need them?


References

  1. Deaths tied to painkillers rising in U.S, Los Angeles Times, March 30, 2013
  2. Treatment and care for older drug users 2010,  European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)
  3. Sollitto M, Seniors and Prescription Drug Addiction, AgingCare.com
  4. Botek AM, Prescription Drug Abuse Skyrocketing Among Elderly Population, AgingCare.com
  5. Prescription Drug Abuse, WebMD
  6. Huang B et al, Prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders in the United States: Results of the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2006 Jul;67(7):1062-73
  7. Han B et al, An Examination of Trends in Illicit Drug Use among Adults Aged 50 to 59 in the United States, Office of Applied Studies (OAS) Data Review, August 2009
  8. Alcohol, Tobacco, and Non-Medical Drug Use Disorders in U.S. Adults Aged 65 and Older: Data from the 2001-2002 National Epidemiologic Survey of Alcohol and Related Conditions, Am J Geriatr Psychiatry. 2011 March; 19(3): 292–299
  9. Simoni-Wastila L, Yang HK,  Psychoactive drug abuse in older adults, Am J Geriatr Pharmacother. 2006 Dec;4(4):380-94
  10. TIP 26: Substance Abuse Among Older Adults: Treatment Improvement Protocol (TIP)  USDHHS
  11. Addiction and Treatment for the Elderly, rehabinfo

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