#41 Are the Drugs You Take Helpful?

Things to Keep in Mind.

Chances are that most people take prescription drugs, supplements, over-the-counter drugs (OTCs), or illegal ones to manage medical problems, physical pain, and emotions that arise as they get older. My concern, and a concern for anyone who wishes to age well, should be whether or not the drugs they take are helpful or harmful.

As the article Aging and Drugs says:

Older people tend to take more drugs than younger people because they may have more than one chronic medical disorder, such as high blood pressure, diabetes, or arthritis. Most drugs used by older people for chronic diseases are taken for years. Other drugs may be taken for a short time for infections, types of pain, and constipation.

Nearly 90% of older adults regularly take at least 1 prescription drug, almost 80% regularly take at least 2, and 36% regularly take at least 5. When over-the-counter and dietary supplements are included, these rates are higher.

Frail or hospitalized older people take the most drugs, and nursing home residents are regularly prescribed multiple medications.

I have taken prescription drugs, but none were that helpful. Shots for migraine headaches worked temporarily, but the dosage was soon ineffective. Tranquilizers for anxiety and pain killers for a broken arm had side effects. Hormone replacement therapy was taken off the shelf. Anesthesia and prescribed medications negatively impacted my husband’s life.

Today, at age 83, I take no prescription or illegal drugs. I use supplements and Tylenol, even though they may be problematic if misused. 

Medication can help maintain health and well-being, but studies repeatedly show that many older adults suffer from problems related to the drugs they take. The Better Health While Aging website discusses effects on the brain, and the article Conscientious Use discusses side effects, habituation, and side effects.

The following headline re-ignited my worries, and I wanted to share the information with people who wish to age well.

This article discusses the possible effects of drug misuse. Misuse can cause overdose deaths, substance abuse, and addiction.

Overdose Deaths

According to the American Society on Aging,

Due to the physiological changes of aging and a higher prevalence of chronic medical diseases, older adults are particularly vulnerable to drug-related overdose deaths and hospitalizations. The number of drug overdose deaths among adults ages 65 and older in the United States increased from 528 in 1999 to 3,281 in 2019—a 521 percent relative increase.

The Center for Disease Control says

Before the pandemic, drug use by older adults was increasing nationally due to higher rates of substance use by the baby boomer generation (now ages 57 to 75) compared to any preceding generation. During the pandemic, the number of drug overdoses in its first six months was 27 percent higher than the number of predicted deaths just 12 months prior. Monthly deaths between February to May 2020 grew by 50 percent, to more than 9,000 overdose deaths.

Another sobering issue was discussed in this CBS newscast. Take a look.

This is information we need to know.

Substance Abuse

Substance abuse is defined as “the use of illegal drugs, prescription, over-the-counter drugs, or alcohol for purposes other than those for which they are meant to be used, or in excessive amounts.” It can lead to social, physical, emotional, and job-related problems.

Listen to motivational speaker Scott McFadden as he shares his journey with substance abuse and addiction:

The U.N. News website says

As the world grows older, drug use among people over 65 has also grown. The International Control Board report found increased use of pain relievers, tranquilizers, and sedatives among this demographic. Older people with substance use problems also face unique age-related issues, including isolation or physical challenges. 

Aging can lead to social and physical changes that increase vulnerability to substance misuse. Older adults are more likely to experience mood disorders, lung and heart problems, or memory issues. Drugs can worsen those conditions and add to health issues.

Furthermore, the effect of certain drugs—like impaired judgment, coordination, or reaction time—can result in accidents and falls. These injuries may pose a greater risk to health for older adults and may coincide with a longer recovery time.

Benzodiazepines, the drug used to treat anxiety, pain, or insomnia, can be dangerous for seniors. They are generously prescribed and highly addictive. The rate of senior citizens addicted to them has increased every year.  

For an in-depth discussion regarding the Dangers of Substance Abuse, take some time to watch this video.

Addiction

Addiction among senior citizens can be divided into two categories: those who abused substances for many years and those who form dependence later in life. 

Potential causes of drug or alcohol addiction in the elderly include retirement, the death of loved ones, financial strain, loss of purpose, being in a nursing home, family conflict, and mental or physical health decline such as depression, memory loss, and major surgery.

Addiction remains a hidden problem in older adults for two reasons: lack of primary care screening and available assessment guidelines.

It’s also common for care providers, specialists, and emergency physicians to prescribe opioids and benzodiazepines on a long-term basis. This can lead to dependence or harmful cognitive effects.

Addiction Treatment

Regardless of age, treatment options are available to help a person return to a healthy lifestyle. According to the Indian Journal of Psychological Medicine, a literature review was undertaken using several electronic databases.

The evidence base consists of findings from individual studies and the meta-analyses of studies that were primarily randomized controlled trials. Individuals exposed to these psycho-social interventions had significantly better substance use outcomes either at the end of the treatment phase or at follow-up.

Consensus exists that several psycho-social treatments or interventions for substance use disorders are “evidence-based.” These include cognitive-behavioral therapy (CBT) (including relapse prevention (RP)), contingency management (CM), motivational enhancement/motivational interviewing (MI), and brief interventions (BIs) for alcohol and tobacco.

Older adults don’t always get the treatment they need for various reasons.

One is that alcohol and drug abuse can be hard to detect in older persons. The symptoms are mistaken for signs of aging, physicians receive very little education on substance dependence, and misdiagnosis is frequent.

A second is that addicted elderly people are often isolated from loved ones and hide their use. The use is viewed as "one of their few pleasures in life" or a symptom of aging.

Finally, the person typically has multiple health care providers and multiple medications, which makes identifying an addiction difficult.

There is little doubt that drugs can ease medical conditions and pain. Sometimes it boils down to knowing what is taken, weighing the risks and benefits, and making a conscientious decision.

I am not advocating “just say no to drugs.” I do suggest that people wishing to age well ask themselves if the drugs they take are necessary and are being used prudently.