Prescription Drug Misuse among Older Adults

Author: David V. Flores, PhD, LMSW, MPH

Overview

Prescription drug misuse among those 65 and older is reaching epidemic proportions in the U.S. and will continue to rise over the next several decades with the aging “baby boomer” population, the cohort with the highest prevalence of substance use historically (Culberson et al., 2011; Institute of Medicine, 2012; Kalapatapu & Sullivan, 2010; Maxwell, 2011; National Institute on Aging, 2013).

Risk Factors for Prescription Drug Misuse Opioids Benzodiazepines Stimulants

 

Key Points

Increased prescription drug misuse and need for treatment is expected to rise given the aging of the baby boomer generation, the generation with the highest prevalence of substance use.

The true extent a prescription drug misuse and prescription drug diversion is unknown.

  Most commonly misused prescription drugs (Manchikanti, 2006):

 

Assessment

The Consensus Panel on the Treatment Improvement Protocol (TIP) makes the following assessment recommendations: Several instruments have been developed and can be useful in the identification of prescription drug misuse:

 

Interventions

The Center for Substance Abuse Treatment recommends the following non-pharmaceutical interventions for treating substance use disorders in older adults:

 

References

Culberson, J.W., Ticker, R.L., Burnett, J., Marcus, M.T, Pickens, S.L., & Dyer, C. B. (2011). Prescription medication use among self neglecting elderly. Journal of Addictions Nursing, 221), 63-68. 

Culberson, J.W., & Ziska, M. . (2008). Prescription drug misuse/abuse in the elderly. Geriatrics, 63(9), 22-31. 

Grohol, J. M.A. (2010). Top 25 Psychiatric Prescriptions for 2009. Retrieved September 26, 2013, from http://psychcentral.com/lib/top-25-psychiatric-prescriptions-for-2009/0003170 

Institute of Medicine. (2012a). The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? In J. Eden, K. Maslow, M. Le & D. Blazer (Eds.), Committee on the Mental Health Workforce for Geriatric Populations Board on Health Care Services, . Washington, DC: Institute of Medicine, The National Academies Press. 

Institute of Medicine. (2012b). The mental health and substance use workforce for older adults In whose hands? Washington, DC: National Academy of Sciences. 

Kalapatapu, Raj K., & Sullivan, Maria A. (2010). Prescription Use Disorders in Older Adults. American Journal on Addictions, 19(6), 515-522. doi: 10.1111/j.1521-0391.2010.00080.x 

Kan, C. C., Hilberink, S. R., & Breteler, M. H. . (2004). Determination of the main risk factors for benzodiazepine dependence using a multivariate and multidimensional approach.Comprehensive psychiatry, 45(2), 88-94. 

Laqueille, X., Dervaux, A., El Omari, F., Kanit, M., & Bayle, F.J. . (2005). Methylphenidate effective in treating amphetamine abusers with no other psychiatric disorder. European Psychiatry, 20(5-6), 456-457. 

Manchikanti, L. (2006). Prescription Drug Abuse: What is Being Done to Add ress This New Drug Epidemic? Testimony Before the Subcommittee on Criminal Justice, Drug Policy and Human Resources. Pain Physician, 9, 287-321A. 

Maxwell, Jane Carlisle. (2011). The prescription drug epidemic in the United States: A perfect storm. Drug and alcohol review, 30(3), 264-270. doi: 10.1111/j.1465-3362.2011.00291.x 

National Institute on Aging. (2013). Alcohol use in older people. Retrieved from http://www.nia.nih.gov/health/publication/alcohol-use-older-people. 

Simoni-Wastila, L., & Yang, H. K. . (2006). Psychoactive drug abuse in older adults. American Journal of Geriatric Pharmacotherapy, 4, 380-394. 

Substance Abuse and Mental Health Services Administration. (2009). National Admissions to Substance Abuse Treatment Services. Rockville, MD: Treatment Episode Data Set (TEDS). Highlights-2007 Retrieved from http://wwwdasis.samhsa.gov/teds07/tedshigh2k7.pdf. 

Wu, Li-Tzy, & Blazer, Dan G. (2011). Illicit and Nonmedical Drug Use Among Older Adults: A Review. Journal of Aging and Health, 23(3), 481-504.