Seniors and Prescription Pills
Age is no limiter when it comes to prescription drug abuse
The last time I posted about seniors and substance abuse was January 2011, when I referred to an AARP article on seniors and addiction. There was a scary statistic from SAMHSA in the article: the number of boomers with substance-abuse problems would double from 2.5 million in 1999 to 5 million in 2020.
Three years later, a series on the rising tide senior and drugs by Peter Eisler in USA Today is just as depressing. (The title of the series is Medication Generation.) The AARP article told of a 52-year-old man who was drinking to excess; writer Peter Eisler uses the example of a 68-year-old woman who was on so many medications over 20 years after back surgery that it would make your head spin: transdermal patches containing fentanyl, and bottles of hydrocodone, and Xanax, for example—a shopping bag full.
Doctors are supposed to ask patients for a medication history, but in this woman’s case, her pain doctors, orthopedists, and general practitioners must not have because they just kept prescribing meds. And so the woman became, in her own words, a zombie, sleeping through vacations, giving up driving because she was in a fog, and becoming increasingly isolated. You get the feeling there are a lot of people like this out there if they or their families have not alerted anyone to what’s going on. Eisler also mentioned a man in the article who had been a drug user in the 1960’s, and returned to it in his 60’s with the easy access to Percocet and Vicodin. He’d either buy pills illegally, steal them from his wife, or con an unsuspecting doctor into prescribing them.
Eisler presents alarming information, such as the fact that “no other segment of the population is prescribed more drugs than seniors [even though there’s a movement to try and rein in over prescribing], and none faces higher risks of complications.” He says this is due to falls, respiratory failure, cognitive problems and dementia. Another man in the article, in his 80s, was given drugs that he likely didn’t need and that were way too strong for him, and he died. His family didn’t find out why until they looked at the hospital record.
Another article in the series indicates that Medicare’s prescription drug program is paying for many of the prescriptions. Hydrocodone-acetaminophen, also sold as Lortab, Norco and Vicodin, heads the list, with Alprazolam, or Xanax, the most frequently prescribed anti-anxiety medication. Doctors who are over-prescribing are following “old teaching,” Eisler says. New guidelines are “urging prescribers to be far more judicious.”
Also, what the 68-year-old woman (and undoubtedly many other people) didn’t know is “that opioids lose their effectiveness as patients build tolerance and have little value as a long term tool for managing chronic pain.” (And indeed, the woman had less pain when she was weaned off medication after enrolling in Las Vegas Recovery Center, a pain management and addiction treatment center.) Eisler says that Valium is not effective for long-term use, either.
It’s only been in the last year or so that I’ve noticed doctors (or more accurately, their nurses) taking a history of the prescriptions I’m on. My GP has a note posted at the front desk that patients should bring in all prescriptions they’re taking, not just a list. That’s an excellent idea because then doctors can tell if patients are taking others’ medication, or have forgotten to list one, for example. That’s if patients are being truthful and aren’t hiding anything. And if they remember to bring them.