Prescription drug abuse data suggest that the face of this issue is young and likely between the ages of 18 to 25. In fact, the National Institute on Drug Abuse (NIDA) states that in 2014, the non-medical use of prescription drugs was the highest among young adults in that age range. Statistically, they are the biggest abusers of prescription opioid pain relievers, ADHD stimulants, and anti-anxiety medications, according to NIDA.
However, an equally compelling argument can be made that seniors represent the true face of prescription drug abuse and addiction, particularly with regard to opioid medications. Opioid painkiller addiction among seniors is growing. As Washington Post columnist Joe Davidson put it, “The face of the nation’s opioid epidemic increasingly is gray and wrinkled.”
The drugs seniors tend to misuse are prescribed — opioid medications such as oxycodone (OxyContin) and benzodiazepines like alprazolam (Xanax). Yet, due to their unique requirements and health characteristics, more and more seniors are becoming addicted and subjecting themselves to overdose and death.
Thus, seniors and the elderly require drug treatment that is not only comprehensive but specialized and nuanced to meet their unique and delicate needs.
Read on to find out more about the most commonly abused drugs by seniors and professional treatment options.
The opioid crisis — the most relentless, wide-ranging, and insidious drug scourge of our time — has claimed the lives of individuals from virtually every socioeconomic, ethnic, and demographic sector imaginable.
Members of the senior or elderly population are not immune. From 1996 to 2010, there was a ninefold increase in the number of elderly patients who received opioid prescriptions, and the rate of hospitalization for geriatric misuse of opioids has quintupled in the last 20 years.
According to a study published in the New England Journal of Medicine, about 40 percent of older adults, which includes seniors, have chronic pain that is treated with opioid medications.
What this amounts to is the fact that seniors and the elderly misuse opioids more than any other type of prescription drug.
The following is a list of the most commonly abused prescription drugs by seniors:
Opioids. These medications are typically prescribed to treat acute episodes of pain. Seniors can unknowingly become addicted to these medications by taking them for longer-than-prescribed periods or accidentally taking more than the intended dose. Examples of commonly prescribed opioids include hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), oxymorphone (Opana), morphine (Kadian, Avinza).
Benzodiazepines. These class of medicines have tranquilizer properties and work by depressing the central nervous system (CNS). They are typically prescribed to treat anxiety, insomnia, and seizures. They are also prescribed to relax the muscles. Prescription benzodiazepine medications include diazepam (Valium), clonazepam (Klonopin), alprazolam (Xanax), triazolam (Halcion), and estazolam (Prosom).
Sedatives. Non-benzodiazepine sedative hypnotics or “Z-drugs” and barbiturates produce sedative effects. The former medicines treat sleep disorders while the latter treats a variety of conditions including insomnia, seizures, and headaches. It’s worth noting that benzodiazepines have largely replaced barbiturates. Commonly prescribed non-benzodiazepine sedatives include zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata). The barbiturates that are still prescribed today include mephobarbital (Mebaral), phenobarbital (Luminal), and pentobarbital sodium (Nembutal).
There are concerns and risk factors that are unique to seniors and the elderly when it comes to drug abuse. The first concern is that many elderly Americans, ages 65 and older, live with multiple health conditions, like diabetes and high blood pressure, that require them to take multiple medications. According to the AARP Public Policy Institute, 65 percent of Americans 65 years of age or older used three or more prescription drugs over the past 30 days between 2009 and 2012.
Using multiple prescriptions can leave elderly patients prone to potentially deadly interactions and cause them to miss taking their medicines at the appropriate times. They can forget that they have already taken their medications which can cause them to exceed daily dosage amounts in an attempt to compensate.
What’s more, taking multiple prescriptions can cause seniors to develop a dependency that could escalate into an addiction.
Other risk factors for addiction and abuse in the elderly include:
In addition to those unique concerns, there are the usual characteristics of addiction that could be present, whether the subject is a teenager or senior citizen.
The American Psychiatric Association (APA) publishes The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the principal authority for psychiatric diagnoses. It details specific criteria that characterize addiction.
If someone displays two of the following symptoms over a 12-month period, that person may have an addiction:
Professional addiction treatment is available to all adults, including seniors and the elderly.
When someone decides to enroll in a professional recovery program, they access proven, evidence-based services that comprise a continuum of care, a system of recovery processes marked by four broad levels of therapy.
For seniors addicted to opioids, benzodiazepines, sedatives, or alcohol, a reputable, professional rehab program will assess their health and ensure that treatment does not negatively interact with their current medication.
With professional drug rehabilitation, you can expect to undergo the following processes: the removal of the addictive substance from your body, the restoration of your mental and physical well-being, counseling and therapy that identifies the root causes of your addiction, and life skills training and strategies to equip you against relapse.
For people battling addiction and a mental health disorder, there is a specialized treatment process called dual diagnosis, which addresses both conditions at the same time.
Professional recovery begins with medical detoxification, which is administered under acute treatment. At this stage, the addictive substance is removed from the body, and any present withdrawal symptoms are medically treated. During this process, a staff of doctors, nurses, and medical personnel will provide you with around-the-clock care and supervision in order to monitor your physical and mental well-being.
Depending on the nature of your addiction, the next step after detox is clinical stabilization services, where you will have access to an array of treatment and counseling options that address your whole being while you reside on the premises of the facility.
If you have a mild addiction, then you can access outpatient services after detox. In outpatient, you can receive therapy and counseling on a part-time basis, which allows you the flexibility to attend to the day-to-day responsibilities of your life.
After your treatment is completed, we can connect you to a supportive recovery community that can help guide you on your new journey.
Medicare is the federal health insurance program for individuals who are age 65 and older.
Alcohol and drug addiction treatment can be covered by Medicare under certain conditions, according to Medicare Interactive, an organization that helps clients understand this government program. Those conditions include the following:
Substance use disorders (SUDs) are covered under particular Medicare parts that cover various services, which ultimately comprise a complete addiction treatment program.
Part A: Covers the cost of hospitalization. In the context of addiction treatment, this section covers you if you are hospitalized due to an overdose or you require supervision during detox. Psychiatric hospital stays are covered for a total of 190 days. The first 60 days of hospitalization are covered at no cost to coinsurance. Days 61 to 90 are about $335 in coinsurance per day. Days 91 and over are $670 in coinsurance per day. There is a 20 percent reduction in cost for associated counseling or mental health services received during your hospitalization.
Part B: Outpatient rehabilitation for drugs or alcohol is considered part of mental health coverage. This is because it is based on counseling and therapy. Part B covers outpatient mental and behavioral health treatment with a 20 percent coinsurance if you meet your deductible.
What’s more, Part B may also provide reference care through Screening, Brief Intervention, and Referral to Treatment (SBIRT), which focuses on people who abuse drugs but are not chemically dependent by screening for potential addiction problems. It provides physician or counselor intervention and refers them to treatment programs that can help.
Partial hospitalization is also covered under Part B, but not Part A, because much of partial hospitalization for substance abuse allows for the subject to live at home while they receive treatment. Part B also covers these screenings and treatments:
Part D: This covers prescription medications including drugs like buprenorphine, which is utilized to help patients manage withdrawal symptoms from opioid addictions. However, Part D does not cover methadone treatment, which can only be dispensed at approved clinics. Part D solely covers medications that are dispensed at pharmacies. Medicare does cover Suboxone, which has largely replaced methadone as the preferred treatment for opioid addiction.
There are different Medicare Advantage Plans, often referred to as Part C or MA plans, that are offered to Medicare-eligible individuals and approved by Medicare but created by private insurance companies.
These plans can provide additional coverage for services that are uncovered under the Medicare program. With these plans, seniors can access the gamut of evidence-based services offered through professional addiction treatment.
Dean, O. (2017, August 01). Prescription Drug Abuse among Older Adults. Retrieved from https://www.aarp.org/ppi/info-2017/prescription-drug-abuse-among-older-adults.html
Delphi Behavioral Health Group. (2018, December 03). Addiction Treatment With Medicare Insurance Coverage. Retrieved from https://delphihealthgroup.com/medicare-options/
National Institute on Drug Abuse. (n.d.). Prescription Opioids. Retrieved from https://www.drugabuse.gov/publications/drugfacts/prescription-opioids
National Institute on Drug Abuse. (2018, March 06). Prescription CNS Depressants. Retrieved from https://www.drugabuse.gov/publications/drugfacts/prescription-cns-depressants
Opioid Abuse in Chronic Pain – Misconceptions and Mitigation Strategies | NEJM. (n.d.). Retrieved from https://www.nejm.org/doi/10.1056/NEJMra1507771
Outpatient Mental Health Coverage. (n.d.). Retrieved from https://www.medicare.gov/coverage/mental-health-care-outpatient
Serenity at Summit. (2018, November 09). Substance Abuse And The Elderly. Retrieved from https://www.serenityatsummit.com/addiction/substance-abuse-and-the-elderly/
What Part A covers. (n.d.). Retrieved from https://www.medicare.gov/what-medicare-covers/what-part-a-covers