Substance Abuse and the Elderly

 The Forgotten Casualties

Prescription drug abuse among our seniors has skyrocketed. What can be done about it?

By Paul Gaita

06/12/14

The prescription drug epidemic that grips the United States has shownlittle discrimination when it comes to victims. However, the Centers for Disease Control have managed to identify several subgroups within that vast demographic that would qualify as “high risk patients” and therefore more susceptible to prescription drug overdoses. Individuals who purchase controlled substances from more than one provider – known as “doctor shopping” – are most prominent on that list, followed by those who take high daily doses of pain medication.

Individuals who live in low-income areas and the mentally ill are also at risk, but a growing number of reports have indicated that people ages 65 and over comprise a substantial number of prescription medication abuse and overdose statistics. The figures show an alarming rise in the number of seniors who either abuse prescription pain medication or have succumbed to an overdose: the average number of seniors misusing prescription pain meds was an estimated 336,000 in 2012, while overdose deaths among individuals 55 and over tripled to nearly 9.4 fatalities per 100,000 people.

Why have seniors become so prone to prescription drug abuse? A number of factors come into play when elderly patients are prescribed opioids or other pain medication. Surprisingly, the physical changes that occur due to age do not play a significant factor in elderly substance abuse issues due to the great variation in how individuals age; certain seniors may even display different rates of change within their own systems. Instead, it is an array of external factors that make seniors more vulnerable to prescription drug abuse. 

Medical professionals, who should be the elderly’s first line of defense in regard to health issues, can often make slow, incorrect or discriminatory diagnoses regarding prescription drugs. The physical and emotional side effects caused by opioids – chronic fatigue and depression, among others – are often mistaken for symptoms of other medical disorders. More significantly, clinicians may not have the time or inclination to properly address a substance abuse issue with an older patient. Studies have shown that doctors give less time to office visits with patients 65 years of age or older than those who are 45 through 64. In such an abbreviated consultation, doctors may often place greater emphasis on obvious physical issues like heart problems than ones that are less evident or easily observed. 

This degree of disregard for elderly patients’ health may be echoed within their own families. Spouses, children and friends may often turn a blind eye to abuse symptoms, passing them off as the product of sadness or boredom, or refuse to address them for fear of conflict with their older relative or shame because of their behavior. More often than not, a sense of apathy or aggrieved tolerance for older relatives’ behavior motivates their thinking: elderly parents or grandparents’ lifespans are believed to be short, so devoting time and energy to their recovery can be perceived as a waste of time. Children and loved ones may also feel that the elderly will not respond to treatment in the same way as younger people, despite studies which have shown that older patients complete treatment more often than younger ones, and frequently have better rates of recovery.

All of these factors can be summed up as part of a school of thought centered on ageism that thwarts older patients from receiving the proper treatment they need in substance abuse cases. American culture’s fascination with youth culture – and general disregard for aging – has led to common mischaracterizations of the elderly as weak, ineffectual and, inevitably, doomed to eke out only a few more years of life. As a result, the elderly’s health issues – including those related to substance abuse - are often lumped into a blanket diagnosis of untreatable decline or senility, which in turn leads to many older patients refusing to seek out treatment for fear of having their needs unmet. Those that manage to get a doctor to hear their concerns are often less likely to have treatment recommended as a solution to their health problems.

As medical and law officials continue to address the rising tide of prescription drug abuse, special concern must be extended to seniors who have fallen into the dangers of addiction. Compassion and understanding – which are the cornerstones of modern medical treatment – combined with greater emphasis on treating the individual are the only lines of defense for seniors in this high risk war on the well-being of every person, regardless of age.

Paul Gaita is a Los Angeles-based writer. He has contributed to The Los Angeles Times, LA Weekly, Amazon and The Los Angeles Beat, among other publications and sites.