May 2010 Navy
by LCDR David M. Bradley, USN (Ret)
This may seem an unlikely subject matter for a retiree article, but an advancing number of drug abusers are addicted, not to illegal drugs, but to medically prescribed drugs. It has become such a problem that it rivals street drugs (heroin, cocaine, marijuana, etc.) in its seriousness. 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.
The Elderly Drug Abuser
Persons over the age of 65 make up only 13 percent of the population, yet they account for about one-third of all medications prescribed in the United States. As the Baby Boomer generation ages over the next 20 years, the potential for misuse of prescription drugs increases.
Older patients are more likely to be prescribed long-term and multiple prescriptions, which can lead to unintentional misuse. It can be very challenging for even the most aware person to keep track of up to 30 different pills taken in one day and all at different times and in different doses.
There are many reasons why misuse of prescription drugs can be more dangerous among the elderly than in any other demographic. Older people are more likely to take multiple prescriptions for increasing health concerns. They also use over-the-counter medicines and dietary supplements, increasing the risk of negative drug interactions.
Seniors who take benzodiazepines (Xanax, Valium, or Ativan) are likely to feel the effects of those medications in different ways or more strongly than younger people. That can lead to falls, causing hip and thigh fractures, and vehicle accidents.
Most Abused Prescription Drugs by Seniors
The National Institute on Drug Abuse identifies three classes of prescription drugs that are most often abused. You may know them best as “uppers and downers,” but the drugs are classified as opiates, depressants, and stimulants.
Opiates
Opiates are powerful drugs that have been used for centuries to relieve pain. These narcotic pain killers go by such names as OxyContin, Darvon, Vicodin, Dilaudid, Demerol, and Lomotil and are often prescribed for post-operative pain. When used as directed by a physician, opiates are safe and generally do not produce addiction. But opiates also possess very strong reinforcing properties and can quickly trigger addiction when used improperly.
Opiates act directly on the respiratory center in the brainstem, slowing down a person’s breathing. Excessive amounts of an opiate can cause the respiratory centers to shut down breathing altogether, causing death. Using needles to inject the opiates can also increase the risk of transmitting infectious diseases like HIV when abusers use unsterile or shared needles.
There is a high risk of overdose with non-medically supervised use of opiates. Most recently, emergency room physicians discovered that new “slow release” versions of the drug have led abusers to crush the pills and inject or inhale the powder, creating a much higher risk of overdose.
Depressants
Central nervous system (CNS) depressants have such trade names as Nembutal, Valium, and Xanax. These drugs are used to treat anxiety, panic and sleep disorders.
These drugs are also highly addictive, and those who have taken them for long periods of time should only try to stop using them with the support of trained medical professionals because they have serious physical withdrawal symptoms.
Stimulants
Finally, there are stimulants and amphetamines like Dexedrine, Ritalin, and Adderall. These drugs are used in weight-loss treatment programs; to treat sleep disorders; and to aid those, particularly children, with Attention Deficit Hyperactivity Disorder.
The health risks of abuse of stimulants include dangerously high body temperature, seizures, and cardiovascular complications.
In addition to the risks that all of these drugs pose when used on their own, greater risks result when they are combined with other drugs or with alcohol. Self-medicators often “try out” various combinations of “uppers” and “downers” to enhance or manage their effects; but this can cause severe physical and mental problems, and even death.
Hidden Problem
Elderly drug addiction is often a hidden problem. Compounding the problem of under-diagnosed elderly drug addiction and substance abuse problems is that many family members and even medical professionals miss the warning signs of disorientation, memoryloss, and shaky hands, confusing them as normal signs of aging. Some elderly drug addiction goes unnoticed because in their advanced stage of life, these individuals are less often subject to common detection mechanisms such as: driving under the influence, having poor performance in school or work, or increased absenteeism in work or social settings.
Next month, I’ll address prevention strategies, safeguards, disposal, and how to keep your children safe (many of these drugs found on the high school campus came from the parent’s medicine cabinet).
By this time, you’re probably wondering what my credentials are on this subject. After retiring from the Navy in 2002, I became a Diversion Investigator with the federal Drug Enforcement Agency and recently retired. I’ve dealt with many cases of this nature and seen it grow all too fast.