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Prescription Drug Misuse & Abuse in Older Adults INSERT YOUR NAME HERE. Older Adults Take More Medicine . Consume 1/3 of all prescription meds One in four older adults has used psychoactive meds with abuse potential Prescription drug misuse and abuse is a growing problem - PowerPoint PPT Presentation
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Prescription Drug Misuse & Abuse in Older Adults
INSERT YOUR NAME HERE
Older Adults Take More Medicine
Consume 1/3 of all prescription meds One in four older adults has used
psychoactive meds with abuse potential Prescription drug misuse and abuse
is a growing problem May be as high as 11% of
older adult population
Definitions
Prescription Drug Misuse The use of a medication other than as
directed– May be accidental or willful
Prescription Drug Abuse Intentionally taking medications that are
not medically necessary
Misuse can Lead to Abuse
Patient behaviorPrescriber behaviorBoth
The pathway from appropriate use, through misuse to abuse can result from
Prescription Drug MisusePatient Behavior
Taking more of a drug than prescribed Missing doses Taking the wrong drug Using a drug for other
than the prescribed reason Sharing or borrowing drugs Using drugs that have expired Combining drugs with alcohol or other
substances
Prescription Drug MisusePrescriber Behavior
Medications w/o indication Multiple drugs from same class Dose too high; duration too long High risk drugs or inappropriate for elderly Inadequate instructions for taking meds Failure to question about use
of alcohol or other drugs with abuse potential
Prescription Drug Misuse is UNSAFE!
Treatment failure Increased health resource utilization
–Physician visits–Laboratory tests–ER visits–Hospitalizations
It might lead to prescription drug ABUSE
Prescription Drug MisuseRisk Factors
Number of medications Multiple prescribers Inappropriate prescribing Limited English language proficiency Low health literacy Memory problems Hearing/Vision impairments Treating symptoms and not the cause
How Many is Too Many?
Prescription Drug AbuseOlder Adults
Present in nearly 15% who seek medical attention
Second only to alcohol abuse ED visits doubled between 2004 & 2008
–20% age 70 and older–1/3 required hospitalization
Projected to double over two decades, to 2.7 million by 2020
4.4 million will need substance abuse treatment
Commonly Abused Medications
Narcotic analgesics Anxiolytics Sedative/Hypnotics Stimulants
Prescription Drug Abuse is UNSAFE!
Increased health problems Higher risk of accidents Higher risk of falls and injuries Serious side effects Physical dependence and
addiction
Prescription Drug AbuseRisk Factors
Female gender Social isolation or loss of social supports History of mental health problems History of substance abuse Exposure or access to prescribed
medications with abuse potential
Recognizing Prescription Drug Abuse
Can Be Difficult Older adult does not fit the typical drug abuser
profile No validated screening instruments to
identify/diagnose drug abuse in geriatric population
Many diseases caused by substance abuse are common disorders in later life
Many symptoms of prescription drug abuse mirror common signs associated with aging
Warning Signs Prescription Drug Abuse
Sudden change in behavior Withdrawal from family, friends, activities Sleeping during day Changes in personal grooming, hygiene Worry about . . . Are the drugs “really working”
Having enough medication on hand Giving excuses as to why they need pills Sneaking or hiding pills “Doctor shopping” for several prescriptions
Identifying Prescription Drug Abuse
Modified CAGE questionnaire1. Have you felt you ought to cut down on your
drinking or drug use?2. Have people annoyed you by criticizing your
drinking or drug use?3. Have you felt bad or guilty about your drinking or
drug use?4. Have you ever had a drink or used drugs first thing
in the morning to steady your nerves, get rid of a hangover or get the day started (as an eye-opener)?
Prevention Tactics Improving medication adherence. Making sure that older adults understand how
to take medications and what to avoid when taking a prescription medication.
Encouraging older adults to share concerns and ask questions about their medication.
Encouraging older adults to inform health care providers of all medications they take regularly.
Encouraging older adults to keep a current medication list.
Prevention Tactics Provide medication aids Address communication barriers Community informational and
intervention support programs Educate prescribers Adequate treatment of underlying
conditions Standardized screening Transitional care and medication review
Help fight Prescription Drug Misuse & Abuse
CLEAN OUT THEMEDICINECABINET!!
Proper Disposal of Unused/Expired Meds
DO NOT FLUSH unused medications DO NOT POUR them down a sink or drainTake advantage of community drug take-
back programs
Case Study
Place Holder
Key Messages
STAMP Out Prescription Drug Misuse & Abuse!
Tool Kit
Developed by
Supported by an educational grant from Purdue Pharma L.P.
For More Information
Prescription and Illicit Drug Abuse: Information on trend among older adults, tips on prevention, treatment
http://nihseniorhealth.gov/drugabuse Substance Abuse and Mental Health Services
Administration (SAMHSA)www.samhsa.gov888-662-HELP (4357) SAMHSA
Find a Senior Care Pharmacist: Specializing in the medication needs of older adults
https://www.ascp.com/find-senior-care-pharmacist
Medication Disposal
DisposeMyMeds.org An online resource to help find medication disposal
programs at the local independent community pharmacy near you
Drug Take Back Network Information on permanent and regularly recurring drug
take-back events www.takebacknetwork.com/local_efforts.html
SMARxT Disposal http://www.smarxtdisposal.net/
STAMP Out Prescription Drug Misuse & Abuse!
QUESTIONS?