Opioid Addiction in the Middle-Aged and Elderly

Society has struggled with substance abuse, addiction and its consequences throughout history. Despite the fact that opioid addiction has reached crisis levels, many middle-aged and older adults who face this epidemic still go unnoticed. In fact, the rates of opioid addiction in the middle-aged and elderly have been increasing dramatically.

Millions of older Americans get painkiller prescriptions for chronic conditions such as back pain, arthritis and headaches. Many of them become addicted to opioids and are at a risk of overdose. It goes without saying that prescribed pain medication can do just as much harm as the heroin peddled on our streets.

Opioids and the Middle-Aged and Elderly

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The Agency for Healthcare Research and Quality reported a sharper increase in hospitalizations from prescription drug overuse among Americans aged 45 to 85 and beyond. According to the Center for Disease control and Prevention, the highest death rates from opioid drug overdose were recorded in middle-aged adults between 45 and 54.

This startling epidemic has left no age group unaffected, and the problem is getting worse. One study found that about 20 percent of people over the age of 65 take painkillers several times per week. The rate of addiction among patients with chronic pain is at an alarming level of 18 percent.

Dr. Andrew Kolodny is the chief medical officer of the Phoenix House Foundation. He is also the Executive Director of Physicians for Responsible Opioid Prescribing. He says that the highest rates of overdose deaths are in patients who appeared to have legitimate prescriptions for managing their chronic pain problems.

Dr. Kolodny goes on to clarify that some of the older patients have severe pain. He says that they are able to find doctors to prescribe them with more than enough opioids. He also points out the high risk of addiction that comes with the unmanaged or improper use of opioids. For someone taking several daily doses, physical dependence can set in within just as few as five days.

Opioid Addiction from Painkillers

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A patient under pain medication is less likely to notice the onset of addiction. In most cases, it’s the caregivers and member of family who are the first to notice addiction-related changes in behavior. It’s not uncommon for older patients who are addicted to opioids to injure themselves and seem more confused or disoriented at times. After looking into the problem, relatives are surprised to find out that the pain medication is the cause of addiction. And this is the pain medication that is meant to solve the problem.

Seniors on opioids are at a higher risk of falling, which significantly raises the risk of potentially devastating fractures. For instance, when someone with a mild cognitive impairment gets an opioid product, it increases the risk of falls, confusion and other risky events.

Because many seniors take several medications at the same time, the potential for harmful drug interactions is also very high. An opioid could interact with another drug such as sleeping medication and increase the risk of respiratory depression and sedation. Healthcare providers need to take up the responsibility of asking patients about drug abuse. They also need to consider regular screen tests to identify those at risk of substance abuse. The enhanced effects of opioids when combined with alcohol make it even more critical for healthcare practitioners to ask about alcohol abuse. Nonetheless, one doesn’t have to be a drinker to have problems with opioids.

A Way Forward

The opioid epidemic is only getting worse. So clear and strategic steps are necessary. The elephant in the room for lawmakers and healthcare workers moving forward will be to strike a balance between the benefits of pain management and the risk of addiction. Restrictions on opioid prescriptions by doctors may have adverse effects on patients who genuinely need them. However, doctors should be conservative when prescribing opioid painkillers to older patients as they are more sensitive to the harmful effects of these drugs.

The medical fraternity and other stakeholders have put forward various measures to lower the risk of addiction to opioid painkillers. Medical schools and residencies have begun to better educate physicians with some establishments offering mandatory training around the prescription of opioid analgesics.

Other recommendations put forward include the encouragement of better discussion between prescribers and patients. This includes education on the proper disposal and dangers of opioid abuse, as well as methods of improving services for those suffering from opioid addiction. There should be discussions regarding the creation of prescribing limits for opioids. Authorities must also do more to impose sanctions on anyone found guilty of wrongfully prescribing, dispensing, manufacturing and or distributing controlled substances.

About 50 percent of people over the age of 65 deal with chronic pain. While it is crucial to adequately treat the symptoms of conditions that cause pain such as diabetes and arthritis, it’s also important for doctors to avoid prescribing opioid drugs to patients who would be better off with less habit-forming treatment options. A journal review found that short-term opioid treatment in older patients who don’t have cancer is safer than long-term opioid treatment. The chances of addiction lower as a patient becomes older. However, doctors should carefully look at each individual case. Addiction is always a possibility with opioids.

Alternative Pain Treatment Options

Thanks to medical research, there are plenty of alternative treatment options that can be used to address pain. Physical therapy is particularly helpful in relieving pain through exercises meant to repair damaged tissues and improve mobility. Many chronic pain sufferers also find that combining their physical therapy with massage therapy helps reduce pain while improving mobility. Other helpful pain management approaches include meditation, yoga and cognitive behavioral therapy among other holistic treatment options.

The statistics surrounding opioid addiction among the middle-aged and elderly are devastating, but even more distressing is the overall effect of dependency which has a trickle-down effect on friends, relatives, neighbors and the community as a whole. Substance abuse and addiction touch people of all races and backgrounds: poor and rich; man or woman; young, middle-aged and elderly. It affects all of us.

As members of society, we cannot afford to sit back and do nothing about this epidemic that threatens the lives of many. We have a duty to expose the incidence of addiction and its negative impact on families and individuals.