Published November 8, 2018 (current as of December 30, 2024)
Drug abuse affects people from all walks of life. But when you hear about drug abuse, you tend to think of teens or young adults, not older adults. Unfortunately, drug abuse in older adults is also a serious problem. It occurs most often when the elderly misuse or abuse their own prescription medicines or when they intentionally take medicines prescribed for other people.
For example, people may take their prescription medicines with alcohol or other drugs to enhance their effects. Or, they may take more medicine than prescribed or continue to take it when they no longer need it. In a 2018 survey of older adults between the ages of 50 and 80, only half reported switching from a powerful opioid pain medicine to an over-the-counter (OTC) pain medicine as soon as possible.1 About 1 in 20 participants admitted to taking an opioid pain medicine more often and in higher doses than prescribed. Most of the older adults said they kept leftover opioid pain medicine in case they needed it later. Unused opioid pain medicines that linger in homes are one of the primary causes of prescription drug abuse and dependence.1
The Causes
Age-related physical and emotional changes are linked to the most common reasons an older adult may abuse prescription medicines (or alcohol). These age-related changes may lead to boredom, anxiety, depression, a fear of getting old, financial loss, health concerns, and chronic pain.2 More than 100 million Americans live with daily pain.1 Health problems that result in pain, such as arthritis, nerve damage, or cancer, are more common as people age. Older adults are also more likely to have mobility issues, sleep pattern disturbances, and to undergo painful surgical procedures, such as joint replacements.1,2 They may experience loneliness, social isolation, and anxiety from a life event such as loss of employment or family problems, and are prone to grief and depression because of the loss of a spouse. As these age-related changes occur, doctors often prescribe medicines intended to improve the elderly person’s quality of life. However, these medicines can also be the source of prescription drug abuse in older adults.
Medicines Most Likely to Be Abused
Older adult prescription drug abuse usually involves a “controlled substance.”3 Controlled substances are a category of addictive medicines whose possession and use is restricted by law. Examples include opioids and benzodiazepines.
Opioids are used to treat moderate to severe pain. Some examples include the following:
Benzodiazepines (tranquilizers) are used to treat anxiety, panic attacks, and sleep disorders. Some examples include the following:
Long-term use of opioids or benzodiazepines can result in several problems. The person may develop a tolerance for the drug, meaning they gradually need to increase the amount they take to control their pain, anxiety, or other symptoms. They may also find that the drug makes them feel happy, euphoric, sedated, or numb.3 To maintain or increase this effect, they may start to abuse the drug—by continuing to take it when they no longer need it or by taking it in larger doses than prescribed. Ultimately, they may become addicted, and then fear stopping the drug because withdrawal symptoms are severe.
Signs and Symptoms
It can be very difficult to identify prescription drug abuse in older adults. We are more familiar with identifying drug abuse in younger people when they are unable to fulfill their work and family commitments. Older adults may have fewer of those commitments, making it harder to identify the signs of drug abuse.2 Also, some of the more noticeable symptoms of drug abuse in older adults are changes in appearance, behavior, or health that mimic symptoms of other problems that are commonly associated with aging4:
Other behavioral clues of prescription drug abuse are more closely linked to how the medicines are obtained and taken2-4:
Here’s what you can do: Learning to recognize the physical and behavioral signs of prescription drug abuse can help prevent the problem from progressing further and causing serious harm. If you suspect an older family member or friend is abusing a prescription medicine, contact his or her doctor to discuss your concerns. The doctor can help determine if there is a problem and help to establish a treatment plan. Treatment may include counseling, detoxification, and careful monitoring of prescription medicines.
It is also important to help older family members or friends manage their medicines by5:
References