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Substance Abuse and Seniors

Substance Abuse and SeniorsTreatment for pain, anxiety, or a mood disorder often includes medications that are both effective and highly addictive. And while many caregivers are aware of potential misuse or abuse of prescription drugs, they may not factor in the problems that alcohol and illicit drugs present, especially in older adults.

But substance abuse is a serious health problem among older adults, with serious consequences:

  1. Drugs—even prescription ones and socially acceptable ones like alcohol—become more difficult to metabolize as we age. Older adults may feel effects faster and the effects may last longer, and smaller amounts pack a bigger punch than they once did.
  2. Older adults often have health problems that can be aggravated by abuse. Cocaine, for example, can cause heart problems in young adults, so the risks for those with existing heart disease should be clear. But even marijuana can increase heart rate, and the risk of heart attack, in older adults. Chronic drug and alcohol use can lead to accidents caused by compromised judgment and slowed reactions, and may increase exposure to diseases, including HIV/AIDS.
  3. Just as with prescription drugs, combining recreational drugs can cause interactions that are extremely dangerous. Physicians and pharmacists may not think to warn older patients of these interactions.
  4. Diagnosing substance abuse can be difficult. Drug use may cause or mimic ailments like dementia, insomnia, or problems with balance. In addition:
  • Family caregivers and healthcare professionals may not associate drug use with older adults.
  • Users may downplay the amount they consume, or may not offer the information, to their doctors or providers.

Pain Medications

Whether you are recovering from surgery or injury, or suffer from migraines or chronic pain, “painkillers” can provide temporary relief from pain and discomfort. The most common prescription pain medications are opioids, also called narcotics, which are either naturally derived from opium (such as morphine and codeine) or synthetically produced, such as Demerol (pethidine), Duragesic (fentanyl), Lorcet, Lortab (hydrocodone), Methadone, OxyContin (oxycodone), Percocet, Percodan, and Vicodin.

When the body begins to develop a tolerance to these drugs, dependence occurs. People must take higher doses to get the pain-relieving effect and to avoid the symptoms of withdrawal. Addiction can occur when users start to abuse the drugs, taking them for reasons other than pain relief. The National Institute on Drug Abuse estimates that more than 4.7 million Americans are dependent on prescription painkillers.

According to the Mayo Clinic, symptoms of opioid addiction include:

  • Constipation
  • Low blood pressure
  • Decreased breathing rate
  • Confusion
  • Sweating
  • Poor coordination
  • Depression
  • Taking higher doses than prescribed
  • Excessive mood swings or hostility
  • Changes in sleep (increase or decrease)
  • Poor decision making

Sedatives and Anti-Anxiety Medications

Anti-anxiety drugs work by depressing the central nervous system and are known as sedatives. They can reduce feelings of tension and may be prescribed to help sleep. The most commonly prescribed anti-anxiety drugs are called benzodiazepines—in fact, these are the most widely prescribed drugs in the United States. They include Ativan, Halcion, Klonopin, Librium, Valium, and Xanax.

These drugs can quickly cause physical dependence so they are generally used on a short-term basis. According to the Substance Abuse and Mental Health Services Administration, admission for treatment of benzodiazepines nearly tripled in the United States between 1998 and 2008.

Signs of benzodiazepine abuse can include:

  • Drowsiness
  • Unsteadiness while walking or moving
  • Blurred vision
  • Poor coordination
  • Amnesia
  • Hostility or irritability
  • Disturbing dreams
  • Reduced inhibition
  • Impaired judgment

Recreational Drugs

According to the National Institutes of Health, the number of illegal drug users between the ages of 50 and 59 more than tripled between 2002 and 2012. This may be because the number of adults in that age group increased, or because baby boomers are more familiar with drugs such as marijuana and cocaine. They may use recreational drugs or alcohol to self-medicate. Be aware of risk factors such as:

  • Personal or family history of alcoholism or drug abuse
  • Living alone
  • Stress (due to retirement, loss of spouse, injury)
  • Chronic pain or depression
  • Boredom

Watch for specific symptoms and warning signs of abuse:

  • Difficulty falling or staying asleep
  • Memory loss or mood swings
  • Neglecting personal hygiene
  • Unsteadiness or falling, or unexplained bruises
  • Loss of interest in hobbies or friends
  • Slurred speech
  • Hiding garbage (empty liquor bottles) or forgetting to hide drug paraphernalia

Getting Help

The best safeguard is to pay attention. Keep the lines of communication open and be on the lookout for new or unexpected behaviors. If you see or suspect dependence or abuse of any of these drugs, contact a physician. Dealing with the problem early can prevent some of the more serious issues associated with addiction from taking root. And remember: Success rates for substance abuse treatment for older adults are as good as or better than those of younger people. Getting professional assistance does help!

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