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Opioid Use Disorder Increasing Among our Aging Parents
Not too long ago, younger Americans worried about their aging parents or grandparents dipping into the cooking sherry a little too often. Alcohol was the primary dependence problem troubling Americans of all ages. And in fact, serious drinking among the elderly was not all that unusual.
Today there’s a different, darker story being told about substance use disorders among the geriatric set all across the country. Prescription painkiller dependencies and addictions are on the rise – even heroin abuse, because it’s easier to get and even cheaper than the co-pay for some brand-name prescriptions.
There are roughly 40 million Americans older than 65 – less than 15% of the population. And by 2020 it’s going to increase to over 20%. These moms, dads, grandmothers and grandfathers consume more than a third of all prescribed medications.
That’s not too surprising when you consider how bodies tend to wear out and start to hurt as we get older. But what we haven’t been paying attention to is how broadly older Americans have joined the pain pill revolution to treat their aches and pains.
Time was, Americans were tougher, more stoic and resilient about living with chronic pain. They were wary about drugs of any kind. And their doctors weren’t much different. When it came to pain, it was usually “Take a couple of aspirins and let me know how that goes.”
It’s a whole new ball game
We know how much those attitudes have changed. Not only are more older Americans turning to prescription opioids today, more of them than ever are tragically getting hooked.
“As the baby boomers move into the geriatric age range, they are going to be more amenable to taking drugs to alleviate pain than their parents were,” Louis Trevisan, MD, Yale University School of Medicine, told Medscape Medical News.
According to the most recent survey by the Substance Abuse and Mental Health Administration (SAMHSA), 2.8 million seniors abused prescription drugs in the last year. This includes opioid painkillers as well as other psychoactive drugs like benzodiazepines. And SAMHSA adds that the number of American seniors abusing drugs will nearly double to 4.4 million by the year 2020.
“Baby boomers are from the ‘me-me’ generation, interested in living longer and taking care of themselves. They were also exposed to marijuana, LSD, and other drugs, and of course, alcohol has always been there, so they are much more inclined to use drugs. They have a different attitude about using substances,” Dr. Trevisan said.
For decades, feel-better drugs have been featured every night on TV. And doctors have been too easily persuaded to write prescriptions when asked. Today however, many physicians are refusing to prescribe so easily.
Micah Sobota, PharmD, BCSP, is a clinical pharmacist at Coleman Behavioral Health, in Lima, Ohio. She is one of thousands of health professionals coping with the growing legion of seniors in trouble with drugs.
From hip surgery to heroin
Sobota told Pain Medicine News recently about a patient in his 60s who became dependent on opioids following hip surgery. The patient turned to street drug dealers and wound up in the clutches of a heroin addiction after his doctors capped his prescriptions.
“He had to switch to heroin, which was a heck of a lot cheaper,” Sobota said. The man’s habit had reached $120 a day. “He was eating through his savings, eating through his retirement. He had to go back to work just to feed his addiction.”
Aging physiology can render seniors more sensitive to medications and more prone to dependence. And they hurt in ways most younger people can’t imagine.
According to a June 2016 report from the Office of Inspector General, some 30% of Medicare patients are taking “at least one commonly abused opioid, and those seniors averaged five such prescriptions,” said a report in Pain Medicine News. “With advancing age,” the magazine said, “controlled substances can be metabolized differently, might interact with other drugs, or can exacerbate medical conditions or age-related vulnerabilities, such as the risk for falling.”
Let’s put this in perspective
Over three million elderly Americans are abusing prescription drugs. In only four years, close to four-and-a-half million seniors will find themselves in that deplorable condition.
Countless thousands of retirees who should be enjoying their lives are already prowling the streets looking for heroin, illicit Xanax and Zoloft and Valium and a host of other potentially harmful pharmaceuticals.
And unless something is done about it very soon, it’s just going to get worse.
Courtenay Wilson, PharmD, BCPS, told Pain Medicine News that nearly 58% of the 709 patients in her Asheville, N.C. practice who are on long-term opioid treatment are over 60 years old. And more than half of them exceed the nationally recommended dosages.
Most seniors take other drugs as well, and alcohol too, that in combination with the painkillers can be life threatening.
“You have your cocktail and you have your Ativan to help you go to sleep, and then you take your Vicodin, and then you don’t wake up,” Dr. Wilson said.
Here at Novus we understand the dire and dangerous circumstances in which so many of our patients find themselves. We’re deeply involved in helping patients of all ages break free of their dependencies and return to drug free lives.
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