Dayton Daily News...
Seniors at higher risk of abusing prescriptions 
November 9, 2011 

Seniors, who often take multiple medications prescribed by different doctors, are at risk for prescription drug abuse and may be subject to overdose and interaction side effects from those medications, Ohio health officials said. 

People aged 65 and older comprise 13 percent of the U.S. population, yet account for a third of the population using prescription drugs, according to the National Institute on Drug Abuse. 

Nearly 20 percent of the 125 unintentional prescription drug deaths last year in Montgomery County were people age 55 and older, according to Center for Interventions, Treatment & Addictions Research at Wright State University’s Boonshoft School of Medicine. 

Some of those deaths were accidental but others were not so benign, said Russel Falck, a Wright State associate professor and CITAR’s associate director. 

“They have access to more drugs because they are older and they may be using them for purposes that are not always in their best medical interest,” he said. 

Between 1997 and 2008 the rate of U.S. hospital admissions for conditions related to prescription medication and illicit drug use grew by 96 percent for people ages 65 to 85, and increased 87 percent for people age 85 and older, according to the Substance Abuse and Mental Health Services Administration. 

Locally, seniors abusing controlled substances, either prescription or off the street, represent “a very small percentage of our elderly population,” said Dr. Brian Clymer, medical director of Miami Valley Hospital’s hospitalist program. 

The Dayton Daily News has been highlighting the region’s prescription drug overdose epidemic and has regularly sought answers for why the problem is so severe locally. 

Overdose deaths from prescription painkillers have skyrocketed in the past decade and are a public health epidemic, according to the Centers for Disease Control and Prevention. One in 20 people in the U.S., ages 12 and older, used prescription painkillers without a prescription or just for the “high” they cause in 2010, the CDC said. 

The use of narcotic pain relievers such as OxyContin and oxycodone has increased nearly 1,000 percent on a per capita basis since 1997, said Orman Hall, director of the Ohio Department of Alcohol and Drug Addiction Services. 

“Essentially, we are treating chronic pain with pharmaceutical-grade heroin, which we believe is a very dangerous practice,” Hall said. “Seniors, along with most people in our state, really don’t have an adequate understanding of how dangerous and addictive these types of substances are.” 

About 80 percent of seniors have at least one chronic health condition and 50 percent have at least two, according to SAMHSA. 

“Simply having two or three chronic conditions can get them a prescription list of six to 10 medications,” Clymer said. 

The use of multiple medications, or “polypharmacy,” can increase a person’s risk for bad interactions and unintended side effects, especially in older patients who metabolize drugs differently than younger people. 

“Many of those people who are using opiates at the highest level are receiving drugs from multiple physicians,” Hall said. “The degree to which services aren’t being coordinated across different practices may create a degree of risk for seniors to be in receipt of opiates and other controlled substances that might put them at risk.” 

Taking opioids for pain in conjunction with benzodiazepine drugs such as Xanax and Valium for sleep or anxiety disorders can be a dangerous combination. Nearly 60 percent of Montgomery County’s unintentional prescription drug deaths last year involved a combination of opioids and benzodiazepines, Falck said. 

People who have been prescribed narcotics or benzodiazepines to help control their symptoms “usually have a good reason to be on them and it’s not a pathological dependence,” Clymer said. 

Many area seniors are often afraid to start on those medications “because they are concerned they will get addicted,” he said. 

Addiction factors can include people increasing their dosage because of drug tolerance, as well as loneliness and depression, officials said. 

“There is literature to support the notion that people who are depressed or who have suffered some degree of trauma may be more predisposed to opiate addiction than people who don’t have those conditions,” Hall said. 

Last week, the Ohio Prescription Drug Abuse Task Force launched a work group that will focus on professional education for pain management and addiction treatment. 

“What we have to do is be careful that as we talk about the opiate and prescription drug problem that we don’t discourage the treatment of legitimate pain amongst our older population,” said Bonnie Kantor-Burman, director of the Ohio Department of Aging and work group co-chair. 

In June, the Ohio Substance Abuse Monitoring Network reported that seniors in the Youngstown, Toledo and Akron-Canton regions were being recruited by drug dealers to obtain prescription medication for “diversion” or illegal resale. 

“A higher percentage of seniors are living on fixed incomes and prescription painkillers are a pretty hot commodity,” Hall said. 

Drugs such as Percocet or Vicoden sell from $7 to $15 on the street, while in-demand opiates such as OxyContin can bring as much as $40 per pill. 

“There has been a certain percentage of seniors who have always been involved in diversion. They get a certain amount of drugs and some of them sell them to a person who then resells them,” said Maj. John Burke, commander of the Warren County Drug Task Force. 

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