Aging Well: Medications — Blurring line between helpful and harmful

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■ Colorado West Regional Mental Health Centers offer mental health and substance abuse treatment on an outpatient basis. Payment is on a sliding fee scale (based on income and other factors). For more information, call Steamboat Mental Health, 970-879-2141 or Craig Mental Health, 970-824-6541.

■ For help finding additional substance abuse treatment facilities and counselors (including those that provide payment assistance), visit www.findtreatment.samhsa.gov or call 1-800-662-HELP.

■ Alcoholics Anonymous is a support group for individuals recovering from alcoholism, and Al-Anon provides support for family and friends of alcoholics. For more information, call 970-879-4882.

■ For publications related to substance abuse, medication misuse and mental health issues in older adults, visit the Older Americans Substance Abuse and Mental Health Assistance Center at www.samhsa.gov/olderadultsTAC.

Editor’s note: This article originally was published Sept. 28, 2009. It has been updated for accuracy.

Prescription drugs and over-the-counter medications greatly can improve a person’s quality of life, but misuse quickly can blur the line between feeling better and feeling worse.

Older adults consume the most prescription and over-the-counter drugs of any age group. This, in addition to other age-related changes, make older adults particularly vulnerable to substance abuse problems, according to “Substance Abuse and Mental Health Among Older Americans,” a 2005 report by the Substance Abuse and Mental Health Services Administration.

Despite this, misuse and other medication-related problems in older adults often can be avoided.

Misuse

Substance abuse among older adults often is unintentional, stemming from misuse, which can be overuse, underuse or irregular use of a prescription or over-the-counter drug, notes the SAMHSA report.

Unsafe combinations or amounts of medications may be obtained by seeking prescriptions from multiple physicians (“doctor shopping”), by obtaining medications from family members or peers or by stockpiling medications throughout time, according to the report, “Prevention of Medication Misuse in Older Adults,” by the Older Americans Substance Abuse & Mental Health Technical Assistance Center.

Ultimately, substance abuse can prolong other health problems, increase risk of disability, lower a person’s life span and increase risk of suicide.

Erika Schmitz, substance abuse coordinator at Steamboat Mental Health, said the most prevalent substance abuse problems among older adults locally involve alcohol, prescription drugs or a combination of the two.

A common issue is the overuse of “as needed” medications that treat pain, insomnia, anxiety and other problems. Some older individuals inadvertently misuse or abuse these drugs because they did not receive enough information from their doctors about the increased likelihood of dependence, Schmitz said.

Older adults also can become inadvertently dependent on prescriptions if they can’t remember all their medications or dosages.

They may end up with overlapping prescriptions if they are seeing numerous doctors for various diagnoses or, because of complications with managed care, they do not always see the same doctor.

“On the surface, the latter may appear as ‘doctor shopping,’ but unfortunately, it is a reality that exists for many older adults who are forced to see whoever may be available at the time of need,” Schmitz said.

Patients can be proactive by asking their doctors more questions about potential problems with certain medications and also keeping organized lists of their medications and dosages to show doctors.

Recovery

In addition to chronic pain and health complications, loneliness, diminished mobility, lack of social support and even changes such as retirement can make older individuals more vulnerable to substance abuse problems.

Exploring the initial problem that led to substance abuse and learning better ways to cope is part of the recovery process, she said.

Depending on the type and extent of abuse, treatment may include detox or an inpatient program or various levels of outpatient treatment involving group or one-on-one therapy.

Financial problems should not prevent a person from seeking help. Although inpatient programs can be very expensive, outpatient programs are much more reasonable and can be adjusted in frequency to the patients’ needs.

Some substance abuse programs and counselors will work on a sliding fee scale based on a person’s income, and there are other resources to help patients pay for their treatment. Medicaid will pay for a limited number of outpatient services and detox for qualified individuals, and insurance companies slowly are beginning to join the bandwagon, Schmitz said.

If a person is worried they may be abusing medications or alcohol, they can call a certified addiction counselor or talk to any therapist to determine their next step.

Joining an Alcoholics Anon­ymous or Al-Anon meeting or simply talking to a friend also can help a person gauge their problem.

Schmitz often receives calls from people worried a family member has a substance abuse problem. Although she can provide advice about how to approach the issue, the best thing the concerned person can do is help themselves by finding a support group, such as Al-Anon or talking to a counselor.

“If you are making the call, the problem exists on your level,” she said. “If they (the person abusing substances) are not at a place to talk about it, they are not the ones needing help.”

If a person is worried a friend or family member may endanger themselves or another person as a result of substance abuse, they can seek the help of a trained interventionist.

Although individuals can be involuntarily committed to a treatment facility, the best outcome usually results from a person voluntarily seeking help, Schmitz said.

Family and friends can support someone dealing with addiction or dependency by educating themselves and not being afraid to talk to the person about their needs.

“That lets the person who’s dealing with addiction and recovery know that you actually care and want to be involved,” Schmitz said.

Tamera Manzanares writes for the Aging Well program and can be reached at tmanzanares@nwcovna.org. Aging Well is a community-based program of healthy aging for adults 50 and older. Visit www.agingwelltoday.com or call 970-871-7676.

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