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Prescription Drug Abuse in the Elderly

If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

What is prescription drug abuse?

Prescription drug abuse is when a person doesn’t take their prescription medicine properly. Prescription drug abuse is a term usually reserved for improper use of medicines that are categorized as “controlled substances” by Health Canada. Examples include many pain, anxiety, and sleep medicine. People who abuse prescription drugs may take more medicine than their healthcare providers instructed, take medicine when it is not needed, or mix the medicine with alcohol or other drugs. This can lead to serious problems, such as addiction, drug interactions, or even overdose.

Not all prescription drugs cause addiction. Most prescription drugs are safe and effective when you follow your healthcare provider’s directions for how to take the medicine.

Why are older adults at risk for prescription drug abuse?

Older adults are at risk for prescription drug abuse because they take more prescription medicines than other age groups. Of Canadians 65 years of age or older, approximately 20% take at least 10 medications per week.

Older adults are also at risk for prescription drug abuse because they often take more than 1 prescription medicine each day. This increases the risk for mistakes when taking the medicines and for drug interactions.

In addition, growing older slows down your liver’s ability to filter medicines out of your body. This means that an older adult might become addicted to or have side effects from a prescription drug at a lower dose than a younger adult.

What medicines increase the risk for abuse?

A person can abuse any type of prescription drug, but elderly adults commonly take 2 types of medicines that have a high potential for addiction:

  • Opioids are prescription drugs used to control pain. A person can become addicted to opioids if they take an opioid for a long period of time or if they take too much of the opioid. Examples of opioids include codeine, morphine, hydromorphone, and fentanyl.
  • Benzodiazepines are prescription drugs used to treat anxiety, panic attacks, or insomnia. They include medicines such as diazepam (Valium), alprazolam (Xanax), clonazepam (Rivotril), and lorazepam (Ativan). A person can become addicted to and feel like they need more of these drugs if the medicine is taken for a long period of time.

Other prescription drugs used to control pain or treat sleeping problems may also cause addiction.

How do I tell if an older adult might be abusing prescription drugs?

If you care for or spend time with an older adult, pay attention to their medicines and behavior. A person who is addicted to a prescription drug may:

  • Get a prescription for the same medicine from 2 different healthcare providers
  • Fill a prescription for the same medicine at 2 different pharmacies
  • Take more of a prescription medicine than they used to or take more than is instructed on the label
  • Take the medicine at different times or more often than is instructed on the label
  • Have behavior changes, such as becoming more withdrawn or angry
  • Often think or talk about a medicine
  • Be afraid to go without taking a medicine
  • Be uncomfortable or defensive when you ask about the medicine
  • Make excuses for why they need a medicine
  • Store “extra” pills in their purse or in their pocket
  • Sneak or hide medicine
  • Have been treated for alcohol, drug, or prescription drug abuse in the past

What should I do if I think an older adult is abusing prescription drugs?

If you suspect that an older adult is abusing a prescription drug, contact the healthcare provider who prescribed the medicine. Tell them about your concerns. The healthcare provider will determine whether your loved one actually is abusing medicine or addicted and will help your loved one get treatment.

How is prescription drug abuse treated?

The treatment for prescription drug abuse depends on what drug is being abused, severity of the addiction, and risk of withdrawal symptoms. Treatment may include counseling, medicine, or both. Your loved one’s healthcare provider will help them find the right treatment.

FOR MORE INFORMATION

Nova Scotia Addiction Services website:
https://novascotia.ca/dhw/addictions/ 

Prince Edward Island Addictions Services website:
https://www.princeedwardisland.ca/en/information/health-pei/addiction-services

Sources

Drug Abuse and the Elderly by Johns Hopkins Medicine Health Alerts (04/17/12, http://www.johnshopkinshealthalerts.com/reports/prescription_drugs/3363-1.html)

Seniors and Prescription Drug Addiction by AgingCare (04/17/12, http://www.agingcare.com/Articles/Seniors-and-Prescription-Drug-Addiction-133459.htm)

Elderly at Risk for Prescription Drug Abuse by The Partnership at DrugFree.org (04/17/12, http://www.drugfree.org/jointogether/addiction/elderly-at-risk-for-prescription-drug-abuse)

Written by familydoctor.org editorial staff.

Revised/Updated: 04-01-2014

Created: 02-01-2012

This handout provides a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information on this subject, contact your family healthcare provider.

Copyright (c) by the American Academy of Family Physicians

Permission is granted to print and photocopy this material for non-profit educational uses.

Written permission is required for all other uses, including electronic uses.

Nova Scotia Telecare, Reviewed by Clinical Services Working Group, October 2019

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