Addiction Isn’t Just for the Young — Neither Is Treatment

Posted on January 26th, 2016
Posted in Articles

Ninety-one-year-old Jimmy Carter’s shocking announcement in December that his cancer was gone, just months after the disturbing report that he had metastatic melanoma on his brain, is solid evidence that people of all ages can benefit from aggressive medical care.

For the former president, it was treatment for brain cancer. But for record numbers of seniors whose names aren’t known much outside their social circles, it’s an addiction to prescription painkillers that requires intensive treatment.

And what you may also find surprising is that older adults tend to fare much better in treatment for substance abuse than younger adults. That fact alone may help you persuade your mother, grandfather or friend to get help. Research also shows that older adults can experience substantial benefits from treatment.

That’s welcome news because older adults are now one of the biggest groups of prescription drug addicts in the United States. In a new study, one of the few to examine the problem among older adults, researchers at New York University found that they are the largest age group in New York City seeking treatment for addiction to opioid painkillers, the most common of which are oxycodone and hydrocodone (sold under the brand names OxyContin and Vicodin, respectively) and heroin and say the trend is likely to continue over the next decade.

The research, published in the Journal of Substance Use & Misuse, reveals that adults aged 50 to 59 accounted for 36% of patients seeking opioid treatment in 2012, up from just 8% in 1996.

“These increases are especially striking, considering there was about a 7.6% decrease in the total patient population over that period of time,” said Dr. Benjamin Han, an instructor at the NYU School of Medicine and the study’s lead author, “and suggests that we are facing a never before seen epidemic of older adults with substance use disorders and increasing numbers of older adults in substance abuse treatment.”

Bill in Congress Would End Doctor Shopping for Medicare Enrollees

As a result of this heavy use of opioids, many seniors are winding up in emergency rooms across the U.S., which saw a 78% increase in the number of visits from older adults who had misused prescription or illicit drugs between 2006 and 2012. Many seniors, however, weren’t fortunate enough to make it to the ER. In just one year, from 2013 to 2014, there was a nearly 8% increase in overdose deaths among Medicare beneficiaries due to prescription drug abuse.

The problem is disturbing enough to have gotten the attention of Congress. In August 2015, Sen. Sherrod Brown (D-OH) unveiled legislation to help prevent prescription drug abuse by cracking down on doctor shopping. Called the “Stopping Medication Abuse and Protecting Seniors Act of 2015,” the law would require that older adults with a history of opioid abuse who receive Medicare be limited to one doctor and one pharmacy. (According to a government analysis of 2012 prescription drug data, 87% of Medicare Part D beneficiaries visited four or more doctors and filled their scripts at three or more pharmacies.) The bill has now been assigned to a congressional committee, which will consider it before possibly sending it to the House or Senate.

Senior Prescription Addiction Presents Unique Challenges

Hundreds of thousands of the nation’s seniors are getting into trouble with their prescription medications not only because more drugs are prescribed to them, but also because they are more sensitive to medication, have a slower metabolism and often have some degree of memory loss that can make keeping track of their dosages difficult. And despite the common occurrence of addictive disorders in those 50 and older, healthcare providers often write off the symptoms of substance abuse as those of depression or dementia. The gap in the number of older adults who are referred for treatment or who receive treatment for addictive disorders is also exacerbated by the fact that seniors are more likely to hide their drug and alcohol misuse and their adult children, often embarrassed by the problem, choose not to address it.

“We know that addiction treatment is highly effective for older adults,” said Dr. Jason Powers, chief medical officer at Promises Austin drug rehab center and The Right Step network of substance abuse treatment programs in Texas. “But the key is to find the right facility. Detox and treatment should take into account age-related psychological, social and health issues.” The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that age-specific and sometimes gender-specific settings have been shown to improve outcomes and compliance among older adults.

Recognizing Substance Abuse in Older Adults

The number of people 50 and older with a substance use disorder is projected to more than double from 2.8 million in 2002 to 5.7 million in 2020. Here are some warning signs that might indicate your loved one has a problem:

  • Mood swings or sudden changes in behavior
  • Withdrawal from family, friends and activities
  • Rapid increase in the amount of medicine that is needed
  • Requesting early refills
  • Paying for medications out of pocket rather than using insurance
  • Apparent doctor shopping
  • New onset irritability or agitation

How to Get Help for an Older Adult With a Drug Problem

If you believe an older family member or friend has become addicted to prescription painkillers or any drug, you should intervene. The first step may be to let your loved one’s physician know about your concern. Treatment typically involves a combination of medication, individual and family counseling, and behavioral therapy. Older adults are more likely to need inpatient treatment for opioid withdrawal than younger people because they are more likely to experience dangerous complications during detoxification. And because older people who “self-medicate” with prescription drugs or alcohol are more likely to characterize themselves as lonely, it is important for treating professionals to help senior patients in building a more robust social network. This can begin with familiarizing them with the senior center in their area and transportation options, facilitating communication with adult children or other family members, or introducing them to social media networks that can instantly connect them with friends and family. Having a strong social network also helps to ward off relapse.

Getting older shouldn’t mean getting addicted to prescription medications. Through evidence-based drug and alcohol treatment programs tailored to meet their needs, older adults can overcome addiction and regain active, vibrant lives.

“It’s not too late to reach out for help,” Dr. Powers said. “I believe if there is breath, there is hope.”

By Laura Nott

Sources

NYU Study Finds Adults Aged 50-59 Now Largest Age Group in Opioid Treatment Programs //nyu.edu/about/news-publications/news/2015/11/23/

In ‘Hidden Epidemic,’ Senior Citizens Getting Hooked on Painkillers //america.aljazeera.com/watch/shows/fault-lines/articles/2015/8/30/

Increases in Drug and Opioid Overdose Deaths — United States, 2000–2014

//cdc.gov/mmwr/preview/mmwrhtml/mm64e1218a1.htm

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