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Thursday, June 22, 2017

Elderly Substance Abuse Issues

 

nurse with clipboard checking - like a family caregiver - to see if a loved one needs more helpSeniors are often prescribed medications appropriately for pain or anxiety.  Sometimes, for various reasons, individuals will become addicted to the medication and begin mis-using it. 

Abuse of these types of drugs is caused primarily by the fact that some drugs are habit forming for anyone. For seniors, they can become even more habit forming if there are common emotional issues like isolation, depression and/or lonliness or chronic physical pain.

Types of Substance Abuse

The two most common types of drugs being abused are tranquilizers and pain killers.

Tranquilizers have a general effect of sedation or sleepiness and are often prescribed because they reduce anxiety and then abused because they are highly addictive. The largest type of tranquilizer is a group of medicines called “benzodiazepines.”

Since these drugs also are central nervous system depressants, they reduce heart and breathing rate which can have serious consequences when combined with heart medications or an underlying heart disorder. In addition, dangerous interactions can occur if these drugs are combined with alcohol or over-the-counter sleeping drugs. Other side effects of tranquilizers are memory loss, inability to concentrate, a “floating” sensation, and disorientation - all of which logically could lead to falls - which are of particular concern for seniors taking these medications.

While not usually life-threatening, the withdrawal (or discontinuing) from benzodiazepines can be very difficult and should be done under the supervision of a doctor.

A List of Commonly Prescribed/Abused Tranquilizers:
Xanax (alprazolam)
Valium (Diazepam)
Klonopin (clonazepam)
Ativan (lorazepam)

Pain Killers are common in the medicine chests of older adults. We have more pain as we age and this is normal. However, opiate pain killers have a strong potential for addiction and abuse - often even more than tranquilizers. Side effects can include nausea and digestion problems, blurred vision, dizziness, drowsiness, and muscle weakness. Signs of addiction are:  going to different doctors to get the medication, mood and behavior changes, strong shifts in energy levels (either really low or really manic), and irritability. 

The reason these drugs are so addictive is that once they are used regularly for some period of time (even as little as one month), the body goes into a painful withdrawal when the person no longer has the drug. The withdrawal can even be physically dangerous and includes: anxiety and panic attacks, muscle spasms and pain, vomiting, and chills. In some cases, it can cause heart damage and seizures. So, it is important to not “quit” cold turkey but to seek out medical help if someone wants to stop taking these drugs. Below are commonly prescribed pain killers that can have this addictive effect:

A List of Commonly Prescribed/Abused Pain Killers (opiates):
Vicodin (hydrocodone)
Lortab (hydrocodone)
Lorcet (hydrocodene)
Oramorph (Morphine)
Avinza (Morphine)
Fiorinal (Codeine)
Tylenol with Codeine
OxyContin (oxycodone)
Percocet (oxycodone)
Percodan (oxycodone)

Alcohol Abuse Among Seniors

Many seniors do have alcohol problems, but often these issues go undiagnosed.  One reason is that family and friends may see the person's changes in behavior (like falling more, being cognitively different, or "slowing down") as normal parts of aging and not as a result of too much alcohol consumption.  Also, even if these problems with alcohol are recognized, family members may feel like it is "too late" for the person to change and so, they don't confront the aging person for fear of just causing more problems.

There are many reasons why a person who has not previously had alcohol related problems would begin having trouble later in life.  For one thing, seniors are often isolated, depressed, in physical pain and alcohol can temporarily bring relief to these problems.  Another issue is that our bodies react to alcohol differently as we age.  So, what may have been "normal" consumption in someone's forties may be very intoxicated at age 72.  The body tends to metabolize alcohol more slowly and the effects of alcohol remain in the body longer.

One last issue to consider as you think about someone you love is whether alcohol will negatively interact with any of the medications being taken.  Seniors are much more likely to be on multiple medications than any other age group.  Alcohol may make some of those medications just not work properly or it can have dangerous and even fatal interactive effects.

The National Institute on Alcohol Abuse and Alcoholism recommends that "healthy men and women over age 65 should not drink more than three drinks a day or a total of seven drinks a week." 

Concern - Treatment

Seek out the advice of your doctor if you think you or a loved one may have an addictive use of these drugs.  Again, withdrawal can be dangerous if the drugs are discontinued abruptly, so do not simply remove the pills from someone.  If you are worried about confronting someone in your family, you may want to talk it over with others who also care about your elderly relative or a counselor or religious counselor.  Most communities have local drug and alcohol resources found in your phone book to help you find the help that would be best for you locally.  Addiction is difficult to change - but it is done every day by millions of people - leading to healthier and longer lives. 


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