So you thought it was just your teenagers that you had to keep away from drugs? According to addiction experts, you might need to deliver the Nancy Reagan "just say no" speech to your aging parents as well.
Abuse of mind-altering prescription drugs by Americans 50 and older is projected to triple by 2020 to 2.7 million, according to a 2005 study in the Annals of Epidemiology, with people over 65 taking more than six unique prescriptions a year on average.
Combining multiple prescriptions can be deadly: A British study published last year in the Journal of the American Geriatrics Society found combined side-effects of commonly used drugs can boost the risk of death in people over 65. The drugs involved, both prescription and over-the-counter, were used to treat allergies, depression, cardiac disease, bladder disease and pain relief.
Women are particularly at risk. An estimated 11 percent of women over 59 are addicted to prescription medications, according to a report last year in the Journal Of Mental Health Counseling. The report noted several life events that can become catalysts to substance abuse: adjusting to retirement, an empty nest, acute or chronic medical problems, inability to continue living independently, or deaths of loved ones.
How can you ensure that your mom and dad -- or even you -- aren't abusing prescription drugs?
It's important to recognize what Post-50 drug abuse looks like. Experts say that the top five signs to watch for are: frequent falls, an unkempt appearance, sleeping all day, frequently misplaced items such as keys and disinterest in activities. These signs of a drug abuse problem are often overlooked because they mimic those of other ailments associated with age.
Dr. John Harsany, an addiction expert and medical director of the Riverside County (Calif.) Substance Abuse program, notes that seniors, in general, take more drugs than the rest of population. As people age, there is a general decrease in body fat and body-water. This decreases the body's ability to process medications and makes seniors more prone to addiction from a physiological perspective, he said.
What precautions can adult children take to make sure their parents don't slip into drug abuse?
Be vigilant about what drugs are used in the hospital post-surgery.
Opiates are routinely prescribed to manage pain post-surgery. And let's face it, they not only numb the surgical pain, but they also erase Mom's arthritic aches and the pain from Dad's sciatica. But when the morphine drip stops flowing, all the aches and pains come back and that wonderful relief is gone. Mom and Dad very well may ask for more of the good stuff and be given it.
It's a good idea for adult children to review in advance with the doctors what the pain management plan is post-surgery -- and to make sure the plan is followed. With no disparity intended toward hard-working and under-staffed nurses, there is a tendency to grab the nearest on-call doctor to sign an order for more pain meds if the patient is asking for them. There are other techniques to control the pain that follows having an operation that don't lead to a dangerous drug abuse problem. Post-surgery drugs can be the opening of the door to addiction.
Need some more motivation? Harsany says that every hour, two people die from pain pills and every 12.5 minutes someone dies of a prescription drug interaction.
Question the need for pain meds that go home with the patient.
Is the pain something that can be managed with Tylenol or Motrin or is Vicodin really necessary? And if it's Vicodin, how many tablets are actually necessary for the first few days at home? Often, senior patients are released from a hospital stay with generous supplies of pain medications that make them drowsy or dizzy. They mistakenly think that if the doctor prescribed 30 pills, all should be taken. A trip out of bed to use the bathroom when they are under the influence of pain medications could wind up with a fall and broken bones, which will of course lead to the prescription of more pain meds.
Make sure that good nutrition and good hydration are part of the recovery process.
Harsany's recommendation: Try over-the-counter Melatonin products before asking for a prescription sleeping aid. And seniors should drink 8 ounces of water every three hours from 8 am to 8 p.m. Get Mom or Dad in the habit of carrying a water bottle and sipping from it. The exceptions are those at risk for renal or cardiac issues, who should check with their physicians. A primary caregiver needs to be certain that balanced meals are eaten every day. Getting meals delivered are a good thing, but if they aren't eaten, they do no one any good.
Don't assume that because a doctor prescribed it, it must be OK.
Many seniors have a medicine cabinet full of prescriptions that they take every day. In some cases, the prescriptions are written by different doctors and no one doctor knows the full roster of drugs the patient is taking. Harsany knows of a patient who came to his recovery center with 21 pill vials. Three of them were prescribed by different doctors for the same medical condition. "It was a redundancy," he said, "and one that left the patient feeling light-headed and unfocused." If you aren't alert, how do you remember whether you've even taken your pills?
Adult children should write down every medicine Mom or Dad is taking, including the strength, and ask the doctor what each one is for. Are any duplicative in purpose? Are any likely to cause drowsiness? Can any be eliminated? Are there over-the-counter or holistic treatments available instead of the prescription drug?
Medications aren't the panacea to some ills; be aware of what's going on emotionally.
Growing old can be a lonely experience. Sometimes, depression sets in following the loss of a spouse. The obstacles to pursuing things that were once pleasurable are insurmountable if you don't like to drive at night or are reluctant to travel alone. Part of caregiving is spending time with your parents and helping them figure out ways to continue to do what they enjoy. If the only attention you give them is taking them to the doctor, then being sick becomes their central activity.
CORRECTION: An earlier version of this story referenced a 2001 study in the Annals of Epidemiology that stated abuse of prescription drugs by Americans 50 and older was projected to triple by 2020 to 2.7 million. The study was published in 2005 and referred specifically to mind-altering prescription drugs.