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 She seemed withdrawn and sometimes anxious.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 the medication and started increasing how much she was taking. Fearing that her doctor would stop prescribing the medication if she told him that she had increased the dosage, she kept it a secret. She did not believe that she would be able to function without the pills. She began visiting several different doctors, requesting the same medication, and using different pharmacies to fill the prescriptions. She began to change the numbers on the prescriptions so that she could get more pills with more refills. 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% of adults age 60 and over abuse prescription drugs. Narcotic pain killers, sleeping pills and tranquillizers are common medications of abuse.
When drugs come from a doctor's prescription pad, misuse is harder to identify. We assume pharmaceutical drugs are only used for treating medical conditions. But many older adults take mood-altering medications for non-medical reasons. Over time, they develop a tolerance to the drug. Achieving the same effect requires more and more of the drug.
Dr. Marvin Tark, a board certified anesthesiologist and pain management specialist, explains it like this: "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."
Seniors do not fit the picture in most people's heads of a drug abuser, so more often than not, practitioners and family members do not suspect that seniors have a problem. This makes access to prescriptions even easier for seniors. "When grandma goes to the doctor with an ache or pain, she easily gets Percocet," says Tark. "Fifteen percent of the population has a tendency towards addiction. Seniors have same propensity."
Taking more then the prescribed dose of prescription medications, or combining them with alcohol or other drugs, can have deadly consequences. An accidental overdose leading to death can occur.
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. So how does a caregiver know when their loved one crosses that line? When does the medication use stop being medically necessary and transform into an addiction?
Tarks answer: "When the person starts using the medication for non-intended purposes. If your parent is taking certain types of medication like narcotics, or even osteoarthritis meds, monitor their use. These are the most commonly abused types of medicine."
Signs of Prescription Addiction Among the Elderly
- How much are they taking? If they used to take one or two a day, and now they are taking four or six, that's a red flag. Looking at the dosing instructions on the pill bottle or container can also give you a clue whether or not they are abiding by the prescibed amounts.
- 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 or pocket supply" in case of 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 Get Help for Prescription Addiction
- Stay as connected as you can and make sure you know what medications your they are taking and why.
- Check that they are following the prescribed dosage.
- Encourage them to use painkillers and sedatives only when absolutely necessary and to taper off as soon as they can.
- Control access to their medications.
- Look for alternatives. 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 suspect addiction, consult with their prescribing physician.
- Ask medical professionals about psychological tests to check for mood or behavior disorders.
- Check into treatment facilities that treat addiction. Ask about programs specifically for seniors. Many insurance plans cover stays at in-patient addiction programs.