Drug Use Pattern Of The Elderly

Opioid addiction is so prevalent in the healthcare system because of the countless number of hospital patients being treated for chronic pain. While opioid analgesics have beneficial painkilling properties, they also yield detrimental dependence and addiction. There is a legitimate need for the health care system to provide powerful medications because prolonged pain limits activities of daily living, work productivity, quality of life, etc. (Taylor, 2015). Patients need to receive appropriate pain treatment, however, opioids need to be prescribed after careful consideration of the benefits and risks.

The purpose of this paper is to determine the level of substance abuse in the elderly community. There is concern that as the population ages in the United States, there will be a significant increase in the number of older adults being treated for substance abuse problems. This paper seeks to understand the issues and concerns that are consequently involved with substance abuse among the elderly.

In today's society people are quick to find easy and fast ways to make them feel better or reduce stress leading to long term health problems. Medication is designed to ease someone or somethings pain, but overusing a drug can result in side effects that can force someone to need more drugs to get better. Siri Carpenter believes that the use of multiple and unnecessary medication is escalating and frightening. “The use of multiple, often unnecessary medications — especially among older people — is an entrenched, escalating, frightening, and mostly unexamined problem in modern healthcare care,” (Carpenter 1). People find it easy to take

Mike Alstott knows first-hand how opioids, when used correctly, can play an important role in managing pain and helping people to function, but he is also keenly aware of the growing crisis of opioid misuse and overdose. More American adults are dying from misusing prescription narcotics than ever before. An estimated 35 people die every day in the U.S. from accidental prescription painkiller overdoses resulting from things like not taking a medication as directed or not understanding how multiple

Considerable cautions have been obtained throughout the United States to decrease the misuse of prescription opioids and helps to minimize opioid overdoses and related complications. Even though the pain medications have a significant part in the treatment of acute and chronic pain situations, it sometimes happen that the high dose prescription or the prescribed medications, without having enough monitoring, can create bad outcomes. It is always a dilemma for the providers to find who is really in need of pain medications and to identify those who are questionably misusing opioids.

According to the Department of Health and Human services, over 650,000 opioid prescriptions are dispensed in one day. This translates to around 230 million prescriptions each year. This amount just barely falls short of being high enough to give every adult in the United States their own bottle of opioid pills. The loose prescribing habits of medical professionals are to blame for these absurdly high numbers. Current doctors will prescribe an opiate-based painkiller for anything from a backache, toothache, to even headaches. To give patients “highly addictive” drugs for low scale chronic pain over the three-days recommended max incurs high risk for tolerance, dependence, and potential addiction to opioids. Some would argue that doctors are simply doing their job by solving their patient’s pain problem and that people should not intrude upon a medical professional’s expertise. However, while doctors should be unbiased pillars of medical advice and treatment, they should also take into account the risks involved with their treatment for their patient’s sake. Particularly for opioid prescriptions, doctors should have to abide by dosing criteria, receive guidance on when to seek consultation, and know how to use their state’s prescription drug monitoring program (Alexander et al., 2015). According to Alexander et al., (2015) Prescription Drug Monitoring Programs (PDMPs) are underutilized by 81% of all prescribers.

Opioids, otherwise known as prescription pain medication, are used to treat acute and chronic pain. They are the most powerful pain relievers known. When taken as directed they can be safe and effective at managing pain, however, opioids can be highly addictive. Ease of access helps people get pain medications through their physician or by having friends and family get the medication for them. With their ease of access and being highly addictive the use and misuse of opioids have become a growing epidemic. Patients should be well educated on the affects opioid use can have. More importantly instead of the use of opioids, physicians should look into alternative solutions for pain management. While pain medication is helpful with chronic pain, it is also highly addictive, doctors should be more stringent to whom and how often they prescribe pain medication.

Statistics for the growing prescription opioid abuse problem are alarming. Prescription analgesics are the second highest dispensed drug in the healthcare system. (Younger, et al., 2011). In 1991, approximately 76 million prescriptions were written for opioids. By 2011, that number had grown to 219 million (Jamison & Mao, 2015). Around 63 million people in the U.S. have used nonmedical prescription

Doctors and other medical professional specialize in providing quality medical care for their patients, are now fighting to control pain without the risk of misuse and abuse of prescribed medications by their patients. One disadvantage of quality care is providing opioid medications to help control extreme pain for some patients. Many patients have become dependent on opioid—highly addicted painkillers such as fentanyl, hydrocodone, morphine, oxycodone, propoxyphene, and methadone. According to 21 Health Organizations and the Drug Enforcement Agency (DEA) cited by ACPM, “effective pain management is an integral and important aspect of quality medical care, and pain should be treated aggressively” (the American College of Preventive Medicine, 2011). Aggressively fighting patients’ pain with opioid medications have led to an increase rate of addictions to the level in which it is known as uncontrollable epidemic in today’s society.

Chronic pain is an important public health problem that negatively impacts the quality of life of affected individuals and exacts a tremendous cost in both healthcare costs and lost productivity. The Institute of Medicine (IOM) in its landmark report on relieving pain in American estimated that 100 million individuals suffer from chronic pain at a socio-economic cost of between $560 and $635 billion annually [IOM, 2011]. Opioids have been increasingly prescribed for the management of chronic pain, and along with this increase in use has come an increase in opioid misuse and abuse. Of the opioids that are abused, 60% are obtained directly or indirectly through a physician’s prescription.

In order to find an adequate number of articles, there were various Boolean terms searched. Originally the PICO(T) question was: does an increase in opioid usage correlate with an increase in falls in the elderly compared to non-opioid medication usage? Locating articles, for the original PICO(T), was an issue in trying to find relevant information for the clinical case. Databases such as CINHAL, EBSCO, Medline, ProQuest, etc. were used for research, however, there was little luck in finding articles that were useful. Restrictions were placed on the PICO(T) search to the current research question which yielded more valid articles relevant to the clinical issue. The proposed research question is: does the use of benzodiazepines or opioids increase the risk of falls in elderly patients compared to non-opioid medications like NSAIDS over the course of a year? With this search, over two thousand articles were provided. The search was narrowed by limiting to specific age groups (65 years and older), English language, within the past five years (2012-2016), and human relations. The Boolean terms, OR benzodiazepines and opioids OR falls OR 65 years old, was also used to further narrow the results down to under twenty.

Opioid medications are frequently prescribed for severe pain. Opioids includes the pain medications like oxycodone, hydrocodone, morphine, and fentanyl as well as the illegal drug heroin (American Society of Addiction Medication, 2016). Many people rely on these drugs to relieve their pain from surgery, active cancer, chronic pain and end of life care (WebMD, 2017). Studies from the 2012 National Health Interview show that over 11% of adults report having chronic pain (Dowell, Haegerich & Chou, 2016). The opioid epidemic is a significant issue for nursing on the main respect that there is currently a problem with over- prescribing of narcotics and the millions of people addicted to opioid medications

The issue of substance misuse and abuse among the elderly population is complex. The elderly rarely use alcohol or drugs to get high rather drug or alcohol use that begins after age 60 appears fundamentally different (Culberson & Ziska 2008). The elderly sometimes turn to alcohol and drugs to alleviate the physical and psychological pain from the onslaught of medical and psychiatric illness, the loss of loved ones or social isolation (Culberson & Ziska 2008). Elderly patients have a combination of and functional and social habits that support substance use. As adults age, they are often unable to do the social things they have been accustomed to. This is when many elderly persons begin to display problems doing the tasks of daily life. The option of taking a pill with the promise that it will aid in living independently is often a viable option for the elderly. This desire to remain independent is an important part in the complex treatment plan that is established when it comes to assisting an elderly patient who is abusing his or her medication.

We have witnessed enormous advances in western medicine and with it we’ve seen greater longevity among America’s elder population. The number of Americans age 65 or older are living longer, in more comfort and in better health than ever before. However, not all American elders are living in good health. As our aging baby boomers live longer, a substantial and growing percentage of older adults misuse alcohol, prescription drugs, or other substances (Bartel, Blow, Brockmann, 2005). In turn, substance abuse among the elder is generating major health concerns and a rapid need for prevention methods. Substance abuse among the elderly is a concealed epidemic in the United States. Alcohol and substance abuse often go unnoticed, unreported, and therefore, untreated in the elderly (Wagenaar, Mickus, & Wilson, 2001). It is estimated that substance abuse issues among America’s elder population will dramatically increase, because while the nation’s population will increase 18%, the proportion of the population 65 and older will increase 78% by the year 2030 (Johnson & Sung, 2009).

A couple of issues related to seniors and substance abuse is that there seems to be lack of knowledge, limited research, and hurried Dr. Office visits therefore healthcare providers often overlook substance abuse and misuse in the older adults. Diagnosis of substance abuse is difficult because symptoms of substance abuse in the elder will mimic the same symptoms of other medical and behavioral issues like diabetes, dementia, and depression (Center for Substance Abuse Treatment, 1998). Oftentimes new medications are not tested on older subjects so they have no way of recognizing an adverse reaction or psychoactive effect in this group. The other reasons there’s lack of attention to substance abuse the older adult is the shame about use and misuse of substances, often times family member of the affected adult also choose not to address it because they are ashamed. They consider this to me a personal private matter and are reluctant to discuss it with anyone. The family can also become enablers to the substance abuse problem because they think that’s what makes them happy “cocktails”, and it shouldn’t matter because they are not going to be around much longer anyways (Center for Substance Abuse Treatment, 1998). Alcohol abuse in this generation is complicated by the use of prescription and over-the-counter (OTC) medications. The elderly spend over $500 million yearly on medications. Combining medications and alcohol frequently result in significant adverse reactions (FYI Elderly Alcohol and Substance Abuse).