The Growing Problem of Prescription Drug Addiction in Seniors


Susan was noticing changes in her 71-year-old mother, Florence. She seemed withdrawn and sometimes anxious. Susan often ran errands for Florence, and after a few trips to the pharmacy, she noticed her mother had prescriptions for Percocet from several different doctors. When asked about it, Florence’s answers were vague, even secretive. Further probing caused her to become confrontational.

Eventually, the full story came out. Florence had built up a tolerance to her pain medication and started increasing how much she was taking. She kept it a secret out of fear that her doctor would pull the prescription if she told him she had increased the dosage. Florence didn’t think she would be able to function without the pills, so she began visiting several different doctors, requesting the same medication and using different pharmacies to fill the prescriptions. Florence had become addicted to Percocet.

When you think of drug addiction, seniors are not the first age group that comes to mind. However, 40 percent of the prescription drugs sold in the United States are used by the elderly, often for problems such as chronic pain, insomnia and anxiety. According to the National Clearinghouse for Alcohol and Drug Information, as many as 17 percent of adults age 60 and over abuse prescription drugs. Narcotic pain killers, sleeping pills and tranquillizers are the most commonly abused medication types.

When drugs come from a doctor’s prescription pad, misuse is harder to identify. We assume that pharmaceutical drugs are only used for treating legitimate medical conditions, and this is typically how seniors begin using these drugs. Doctors often prescribe older patients medications to help them cope with age-related physical and mental changes, such as depression, limited or painful mobility, and shorter, more irregular sleep cycles. Over time, seniors may develop a tolerance to a drug, so achieving the same “coping” effect requires larger and/or more frequent doses. The result is an inadvertent addiction to a specific medication.

Dr. Marvin Tark, a board-certified anesthesiologist and pain management specialist, explains that addiction is a genetic trait. “Prescription drug addiction is no different from alcoholism or an addiction to any other substance. If a person has a history of alcoholism or substance abuse, there is a higher chance that they will abuse prescription medication,” Says Dr. Tark.

Since seniors do not fit the stereotypical picture of a drug abuser, most medical practitioners and families do not suspect that their patients and family members have a problem. This makes gaining access to addictive medications even easier for seniors. “When Grandma goes to the doctor with an ache or pain, she easily gets Percocet,” says Dr. Tark. “Fifteen percent of the population has a tendency towards addiction. Seniors have same propensity.”

Most seniors today take a dizzying number of prescription medications. In most cases, these drugs improve their lives by doing everything from lowering blood pressure to easing chronic pain. But, taking more than the prescribed dose of prescription medications, or combining them with alcohol or other drugs, can have deadly consequences, even when misuse and abuse aren’t a factor. An accidental overdose leading to death can occur.

So how does a caregiver know when their loved one crosses that dangerous line with their medications? According to Tark, a caregiver or family member has a right to be concerned when a person starts using a medication for non-intended purposes.” If an aging loved one is taking certain types of medication like narcotics, or even osteoarthritis meds, Dr. Tark advises monitoring their use. “These are the most commonly abused types of medicine,” he says.

Questions to Ask if You Suspect Prescription Misuse or Abuse

  • How much are they taking? If Mom used to take one or two pills a day, but now she is taking four or six, that’s a red flag. Looking at the dosing instructions on the pill bottle or container can give you a clue whether they are abiding by the prescriber’s instructions.
  • Has their behavior or mood changed? Are they argumentative, sullen, withdrawn, secretive or anxious?
  • Are they giving excuses as to why they need their medication?
  • Do they ever express remorse or concern about taking their medicine?
  • Do they have a “purse supply” or “pocket supply” in case of an emergency?
  • Have they ever been treated by a physician or hospital for substance abuse?
  • Have they recently changed doctors or drug stores?
  • Have they received the same prescription from two or more physicians or pharmacists at approximately the same time?
  • Do they become annoyed or uncomfortable when others talk about their use of medications?
  • Do they ever sneak or hide their meds?

How to Help a Loved One Manage Their Prescriptions Responsibly

  • Stay as connected as you can and make sure you know what medications your loved one is taking and why.
  • Check that they are following the prescribed dosage(s).
  • Encourage them to use painkillers and sedatives only when necessary and to taper off as soon as they can.
  • Look for alternative treatments. If a senior has an ongoing problem with pain, for example, a pain management specialist may be able to suggest strategies for controlling it without drugs.
  • Remind them to always avoid alcohol when taking painkillers or sedatives.
  • Encourage them to bring all their medications to their doctor when they go for their annual checkups, so the physician has an up-to-date record of exactly what they are taking.
  • If you must, control access to their medications.

If you suspect your loved one may be misusing or abusing their medications, consult with their prescribing physician to devise a solution. It may be useful to inquire about psychological tests to check for mood or behavior disorders and research treatment facilities that specialize in programs specifically for seniors. Many insurance plans cover stays at in-patient addiction centers.

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Our society has placed a high moral value on not being "addicted" to opiate pain relievers & alcohol. For centuries, people have used not only these substances, but other substances such as marijuana to ease their pain, be it physical or mental. The fundamental problem is that many physicians fail to be able to recognize this pain in their patients and if they do, are often either reluctant or unable to pharmacologically address this pain. So they talk about "addiction" & instill fear and secretive feelings into the very vulnerable elderly patient. Physicians fail to recognize that we all die and that dying without fear and pain is really far superior to dying "unaddicted" to pain relieving medications. We must recognize that alcohol, while being a depressant, is also a pain reliever and the care giver to a person who is in a chronic physical and/or mental pain condition may actually require higher and higher doses of medications (including alcohol) to down regulate the patient's pain. Pain relief ( psychological OR physical) must be addressed without the moral judgements that is so entrenched in all aspects of our society - including legal, medical & religious viewpoints.
This is an excellent article. I've written about recognizing alcoholism in elders, and this is one more - perhaps even harder to detect - problem, for some. Please remember compassion may get more cooperation than confrontation, with many elders. They don't ask to have this problem.

I am in disagreement with most of the authors thoughts on why some seniors build up reserves of pain pills. The new regulations are exactly why many seniors build reserves of pain medication and not because they are addicts. I am 77 years old and have had many diagnosed back problems diagnosed since my mid 40's. Initially I was prescribed anti- inflammatory medicine which was wonderful as it allowed me to continue jogging, playing golf and going to the gym as well as running my business.
After 10 years it was discovered that I had lost 30% of my kidney functioning due to the medication that I had been described. Since then every doctor that I went to described mixtures of pain medication. I have always taken less medication than what was described. Basically, I am not an addictive personality and also, I don't like the feeling of being woozy and disconnected. This is my story until the DEA passed the new regulations. What is happening as a result of the regulations will end up with more problems than it will ever solve. In New York, patient must get their prescriptions refilled by their doctor in person every 30 days. These days the doctors' office are filled with elderly people with walkers, wheel chairs and their personal attendants. Most of them get their by taxi, at considerable expense, and have to wait 1-2 hours. Imagine, this is now going on as a result of the DEA. It seems that there was not any more thought put into this than the sign-up to the Health Care Bill. I live in Florida 7-8 months and had my prescriptions filled by my family physician there for many years. The medications were prescribed by pain medication doctors in NY based on MRI's and Cat Scans. Last week I went to my doctor in Florida and got refills to drop off at the pharmacy. You see, my wife and I are going on a trip next week and will be gone for 3 weeks. Today I was informed that are not allowed to fill them. I must now find a pain medication doctor and who will need to do an MRI and maybe a CAT- SCAN and hopefully get the prescriptions before my existing pills run out in 3 days. For people who have never had a pain level of 9-10, I can tell you that the country will end up with more suicides due to unrelenting pain than overdoses. I am speaking about the elderly, not youngsters who take drugs to get high. The regulations should have been written to address a real problem which exists among younger people.