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Accidental Addicts -- 5% of Seniors Abuse Drugs

From: "Bottom Line's Daily Health News"


Drug abuse isn't just a young people's problem -- and it doesn't just involve recreational drugs. In fact, chances are good that you know someone who is secretly a drug abuser -- most likely someone over age 50 who is addicted to prescription drugs. The problem can be hard to spot unless you know the signs.

In fact, according to a new government report, about 4.3 million Americans over age 50 are drug abusers, and this number is expected to double by 2020. While it is true that many are ex-hippies who never stopped smoking pot or using other illicit drugs, many other middle-aged and senior drug abusers slid into their habits unwittingly. And for a variety of reasons, these "accidental addicts" may be in even greater danger than the aging groovesters, in part because they might not even realize that they are addicted... nor be aware of the very serious risks.

Just Say No?

The older we get, the more sensitive our bodies are to drugs, notes Ihsan M. Salloum, MD, a professor at the University of Miami Miller School of Medicine and chief of its division of alcohol and drug abuse. So as you age, it's better to completely avoid potentially addictive drugs such as certain pain killers, sleeping pills and antianxiety medications. If you must take them to recover from surgery or to get through a stressful period, keep it short-term -- meaning take as low a dose as you can for the least time possible.

Dr. Salloum and I chatted about the special challenges drug abuse poses in an aging population. Prescription drug abuse often begins when a doctor prescribes an antianxiety benzodiazepine (such as alprazolam/Xanax) to help a patient relax or an opioid pain medication (such as oxycodone/OxyContin) following major surgery, such as a hip or knee replacement. Use of such drugs over long periods can develop into tolerance (when your body adapts to a drug and you need larger and larger doses to achieve the same effect) or addiction -- especially in those with a genetic predisposition or personal history of substance abuse.

Serious Risks

Dr. Salloum warns that older people in particular face a variety of increased risks from drugs, whether they are illicit or prescribed...

Older people metabolize drugs differently -- the kidneys and liver don't function as effectively, so the drugs remain in the system longer. Other age-related changes (such as lower levels of lean body mass) mean that drugs affect older people differently across the board, making them more sensitive to the effects of drugs.
Drug-to-drug interactions are more common in older people. If you have multiple chronic diseases, you likely take multiple medicines. The more drugs you take, the greater the chance of dangerous interactions.
More prone to falls already, older people are more likely to be dangerously injured when they tumble. If age has already left you a bit unsteady, side effects of drugs may easily worsen balance and cause a fall.
Older people are more likely to have heart attacks or strokes caused by medications. Stimulants, in particular, are more likely to cause heart attacks or strokes in older people.
Recognizing and Coping with a Problem

The line between use and abuse can be a fine one, but generally speaking, addiction is what you call it when you lose control over the use of a substance and/or it begins to interfere with daily life. Signs to watch for in yourself or someone close to you include ...

Missing professional, financial or social obligations.
Changes in personality or behavior.
Neglecting personal hygiene or appearance.
Irritability and restlessness.
Driving under the influence or getting into accidents.
Preoccupation with getting and using a drug, and inability to stop using it.
Feeling that you need the drug to deal with your problems.
If you suspect that you have become dependent on any drug, visit your primary care doctor and share your concern -- he/she can help you evaluate the problem and assess what can and should be done from a medical perspective. You can also learn more, for yourself or to help a friend or loved one, by visiting Web sites such as...

The Partnership for a Drug-Free America at
Drug and Alcohol Addiction Support Groups at
Hazelden Foundation at
Mayo Clinic at


Ihsan M. Salloum, MD, MPH, professor, department of psychiatry and behavioral sciences, chief, Division of Alcohol and Drug Abuse: Treatment and Research, and director, Addiction Psychiatry and Psychiatric Comorbidity Programs, University of Miami Miller School of Medicine, Miami, Florida.

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