There is no question that opioids are valuable in pain management. They are also prescribed frequently, with about one in three Americans being prescribed a prescription opioid painkiller in 2015. That is some 92 million adults.
While many people are able to use and stop using them as their doctor prescribes, a significant percentage of people end up misusing opioids, not out of weakness or lack of character, but because addiction is an illness and opioids are highly addictive.
There is good news, however. From 2002 to 2014, misuse of opioids among younger adults dropped from 11.5 percent to 8.1 percent. Unfortunately, during that same time period, opioid misuse among adults over age 50 increased from 1.1 percent to 2.0 percent. American adults over age 65 represent only 13 percent of the population, yet they represent one-third of outpatient spending on prescription medications, including opioids. As a result, more older adults are unintentionally becoming addicted to painkillers.
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Why Older People Are at Higher Risk of Danger from Opioid Use
You likely have read tragic news stories about young people dying from opioid addiction, but opioid misuse can be particularly dangerous for older adults. For one thing, older adults are likelier to be prescribed multiple medications, and it is not always possible for doctors, specialists, and pharmacists to keep up with them all. Drug interactions, which can be dangerous, are more likely among older adults.
Older people are also more likely to be dealing with the types of ailments for which doctors prescribe opioids. They undergo surgery more frequently and have higher rates of arthritis and other illnesses that are painful. An estimated 5.6 million to 8 million older adults have a mental health or substance use disorder, and the number of people over age 65 will nearly double by the year 2030. Addiction among this population could have a devastating effect.
Effects of Drug Misuse in the Older Population
Drug tolerance and metabolism change with age, and older adults tend not to be able to consume medications in the same quantities and at the same frequencies as younger adults. In addition to drugs generally taking longer to metabolize in older adults, co-occurring health conditions like diabetes, dementia, and high blood pressure can make the effects of drug abuse more pronounced.
Like younger adults, older people may attempt to self-medicate due to symptoms of anxiety or depression. Drugs and alcohol, other than those prescribed expressly for treating mental illnesses, only mask symptoms. Over the long term, misuse of them can accelerate cognitive decline as people get older.
Community Strategies for Prevention and Addiction Treatment
The United States Department of Health and Human Services has created a five-pronged strategy to deal with the opioid problem in the US, and it applies just as readily to older Americans as it does to younger ones. Specific strategies they recommend include:
- Expanding access to drug addiction treatment and recovery services, including access to medication-assisted treatment where appropriate.
- Increasing targeted availability and distribution of drugs like Narcan that can reverse opioid overdoses.
- Ensuring public health data and reporting of drug misuse are as comprehensive and accurate as possible.
- Supporting leading edge research on pain management and addiction.
- Promoting better medical approaches to pain management.
In other words, there is no easy answer to addiction treatment in older people, just as there is not for younger people. Addiction is a disease with effects that are often specific to the person with the addiction, and these effects vary with many factors, including age. Awareness of the risk of opioid addiction among older people is the first step toward recognizing it early and encouraging addiction treatment and recovery.
The American population as a whole is aging, with the Baby Boom generation reaching retirement age in growing numbers. The illicit substances these older adults may have had access to when they were in their twenties were not nearly as potent as some of the substances causing addictions today. Combined with increased co-occurring disorders with age, more health conditions requiring pain management, and more prescription- and nonprescription medication use with age, the dangers of opioid addiction are magnified even more.
Addiction treatment works. There is no reason a person of any age cannot pursue addiction treatment and recover from addiction. Help is readily available, and if you have any questions about drug misuse, abuse, or addiction, we invite you to contact us at any time.
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