Helping Elders Overcome Prescription Drug Addiction
Colleran, Carol, Jay, Debra, Aging Today
"She can't be addicted-her doctor prescribes the pills she takes." This statement expresses one of the common myths and misconceptions about the potential for substance abuse among older people. Many medications, although they may play an important role in medical treatment, are mood-altering, addictive drugs. Doctors prescribing drugs to older patients can be influenced by ageism-prejudices and stereotypes about what it means to be old. A doctor's beliefs about aging may lead him or her to substitute medications for other therapies, such as counseling, biofeedback, relaxation techniques, behavior modification, localized electrical stimulation, exercise, diet or other drug-free ways to solve health problems.
Consider the statistics. Older women alone consume 60% of all prescription and over-the-counter medications, according to a 1998 Columbia University study. The Medical Panel Expenditure Survey in 1998 showed that 87% of adults ages 65-79 fill an average of 20 prescriptions annually, and these figures rise with advancing age. Although it is true that older adults have increased medical needs, these statistics provoke the question, "Are elders overmedicated?"
Ageism may prevent many doctors from viewing good-natured grandmothers as drug addicts, making these physicians less observant of their patients' drug-seeking behaviors. At the Hanley-- Hazelden Center in West Palm Beach, Fla., where we counsel clients, we have seen older people who can barely function at home put on quite a good appearance at a doctor's office when they are requesting prescriptions.
The first step for determining whether an older adult has a medication problem is to talk to her or him. It is important for professionals in aging to use nonthreatening language and show empathy for the older person's well-being, rather than focusing on the problem. Regarding medications, for instance, one should ask such questions as, "Do you find you need to take more sleeping pills before they begin working for you?" Stay away from blame, anger and judgment.
Sleeping aids (sedatives/hypnotics), tranquilizers (anxiolytics) and pain pills (opiates) are common medications of abuse. Seeking pleasurable effects or attempting to ease feelings of grief and loneliness, older adults often take larger doses than recommended. Over time, they build a tolerance to the drug: The same dose becomes ineffective because their nervous system has adapted. Achieving the same effect then requires larger amounts of the drug. These older people then may go to several doctors for multiple prescriptions, or they may combine medications with alcohol to boost the effeet of the drug. Studies show that older adults shouldn't take drugs like Valium and Librium (benzodiazepines) for more than four months, but misuse may lead to elders staying on such drugs for years.
Once misuse evolves into addiction, older adults usually become deceptive and secretive about their drug use. They are ashamed but also afraid of losing the drug. They put much effort into protecting their supply while covering up the problem.
When an older adult initially becomes addicted to mood-altering prescription drugs, several early symptoms emerge. The person will begin taking the next dose of the drug earlier than scheduled. Needing more of the drug to get the same effect, the individual will then double or triple the dose. The addicted elder begins to feel excited about taking the drug and looks forward to the high, or euphoric feelings. …