Prescription Drug Abuse in the Elderly

What is prescription drug abuse?

Prescription drug abuse is when a person doesn’t take his or her prescription medicine properly. Prescription drug abuse is a term usually reserved for improper use of medicine that are categorized as “controlled substances” by the Drug Enforcement Administration. Examples include many pain, anxiety, and sleep medicine. People who abuse prescription drugs may take more medicine than their doctors instructed, take medicine when it is not needed, or mix the medicine with alcohol or other drugs. This can lead to serious problems, such as addiction, drug interactions, or even overdose.
Not all prescription drugs cause addiction. Most prescription drugs are safe and effective when you follow your doctor’s directions for how to take the medicine.

Why are older adults at risk for prescription drug abuse?

Older adults are at risk for prescription drug abuse because they take more prescription medicines than other age groups. Americans 65 years of age or older make up only 13% of the U.S. population, yet they consume approximately 33% of all prescription drugs.
Older adults are also at risk for prescription drug abuse because they often take more than 1 prescription medicine each day. This increases the risk for mistakes when taking the medicines and for drug interactions.
In addition, growing older slows down your liver’s ability to filter medicines out of your body. This means that an older adult might become addicted to or have side effects from a prescription drug at a lower dose than a younger adult.

What medicines increase the risk for abuse?

A person can abuse any type of prescription drug, but elderly adults commonly take 2 types of medicines that have a high potential for addiction:

Opioids are prescription drugs used to control pain. They include medicines such as oxycodone (OxyContin), oxycodone combined with acetaminophen (Percocet), and hydrocodone combined with acetaminophen (Vicodin). A person can become addicted to opioids if he or she takes an opioid for a long period of time or if he or she takes too much of the opioid.
Benzodiazepines are prescription drugs used to treat anxiety, panic attacks, or insomnia. They include medicines such as diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan). A person can become addicted to and feel like he or she needs more of these drugs if the medicine is taken for a long period of time.

Other prescription drugs used to control pain or treat sleeping problems may also cause addiction.

How do I tell if an older adult might be abusing prescription drugs?

If you care for or spend time with an older adult, pay attention to his or her medicines and behavior. A person who is addicted to a prescription drug may:

Get a prescription for the same medicine from 2 different doctors
Fill a prescription for the same medicine at 2 different pharmacies
Take more of a prescription medicine than they used to or take more than is instructed on the label
Take the medicine at different times or more often than is instructed on the label
Have behavior changes, such as becoming more withdrawn or angry
Often think or talk about a medicine
Be afraid to go without taking a medicine
Be uncomfortable or defensive when you ask about the medicine
Make excuses for why they need a medicine
Store “extra” pills in their purse or in their pocket
Sneak or hide medicine
Have been treated for alcohol, drug, or prescription drug abuse in the past

What should I do if I think an older adult is abusing prescription drugs?

If you suspect that an older adult is abusing a prescription drug, talk to the doctor who prescribed the medicine. Tell him or her about your concerns. The doctor will determine whether your loved one actually is abusing medicine or addicted and will help your loved one get treatment.

How is prescription drug abuse treated?

The treatment for prescription drug abuse depends on what drug is being abused, severity of the addiction, and risk of withdrawal symptoms. Treatment may include counseling, medicine, or both. Your loved one’s doctor will help him or her find the right treatment.