Since being established in 2008, the Falmouth Prevention Partnership has focused on strategies to help prevent substance abuse among our local teens and kids. One key strategy has been to focus on the role of parents and grandparents as the most important people who influence a teen’s decision to abuse alcohol and drugs. Parents and grandparents can provide correct information about drug and alcohol use; provide support and guidance for kids struggling to make appropriate choices; and, act as role models.
Kids who are exposed to parents or grandparents who drink excessively, use recreational street drugs, or misuse or abuse prescription medication (especially opioid painkillers) are more likely to develop a substance use problem. Also, older adults tend to use more prescription medication, especially painkillers. Having these medications around in a cabinet, on a kitchen counter, in a pillbox or a purse provides easy access to a family member or friend who might want to either sell or use the drugs. Research studies have documented that more than 60 percent of teens who start to abuse prescription opioids get the drugs from a family member.
During the past several years the partnership has sponsored several programs to educate the community about this issue. The programs include:
Lock Your Meds presentations to inform seniors and others about how to safely secure and dispose of medications;
Drug disposal kiosk in the lobby of the Falmouth Police Department and twice yearly Drug Take-Back Days;
Freckle-Face Girl ads in The Falmouth Enterprise showing a teenage girl getting painkillers from her grandmother;
Ongoing educational content in The Falmouth Enterprise and the Falmouth Prevention Partnership website (www.falmouthprevention.org).
The population of Falmouth is aging. According to the 2014 report Aging in Falmouth, in 2010 people ages 60 to 79 made up 27 percent of the town’s population and an additional 8 percent of residents were ages 80 and older. This trend is expected to continue with the aging of the baby boomer population and the increasing numbers of retirees moving to Falmouth.
Seniors And Addiction: A Not-So Silent Epidemic
More of us are living longer and more of us are abusing drugs and alcohol in our later years. Substance abuse (including misuse of prescription drugs) affects about 17 percent of the senior population. By 2020, the number of seniors with a substance abuse problem is expected to double. Much of this increase is being fueled by aging baby boomers with an estimated 10,000 turning 65 in the US per day—there are 50 million people over age 65 in the nation, and people over 70 are in the fastest growing group.
According to Dr. David Oslin, a behavioral health expert at the University of Pennsylvania, “Baby boomers appear to be carrying their substance abuse habits with them as they age.” When younger, boomers used drugs at the highest rate of any generation, and in the midst of widespread abuse of opioid painkillers, some are turning to drugs as they face the challenges of aging.
Binge drinking and prescription drug misuse are of concern in this population. Dr. Oslin noted that currently, 4 million older adults need substance use treatment, including 0.4 million needing treatment for illicit drugs, 3.2 million needing treatment for alcohol, and 0.4 million needing treatment for both. By some estimates, the proportion of older adults seeking treatment for opioid addiction will increase dramatically in the coming decade.
When we think of drug addiction, seniors are not the first age group that comes to mind; our perceptions are molded by media reports of young people overdosing. In 2012, approximately 442,000 adults ages 65 or older reported having misused a prescription drug within the past month. And, according to the Centers For Disease Control, in 2013, more than 12,000 boomers died of an accidental drug overdose—more than the number who died in car accidents or from influenza and pneumonia.
According to a study reported at a recent meeting of the Gerontological Society of America, emergency departments in the US saw a 78 percent increase in the number of visits made by older adults due to the misuse of prescription or illicit drugs between 2006 and 2012. Nearly half of the visits occurred among people ages 75 and older. And, in 2012 more than 100,000 people ages 65 and older were hospitalized for an opioid overuse problem.
The misuse of prescription drugs among older adults is related to their increased risk of experiencing chronic pain—both physical and emotional—including musculoskeletal disorders (such as arthritis, low back pain, and fibromyalgia), physical trauma (as the result of falls), anxiety, depression, loss of family members, and social isolation. Often, opioid painkillers are prescribed long-term for seniors for a chronic condition, and the use of these prescriptions may not be sufficiently monitored. Recent medical evidence suggests that long-term use of prescription painkillers is not the best way to manage chronic pain. Most seniors who develop an opioid use disorder become addicted through medical treatment of a chronic pain condition.
Taking too many painkillers, especially in combination with anti-anxiety medications, can cause forgetfulness and increase the likelihood of an overdose or a serious injury. For example, your mother or grandmother may be taking OxyContin for pain, plus be having a glass or two of wine in the afternoon and, when no one is around, she falls and breaks her hip.
Some Medication Advice For Seniors
Before starting an opioid medication, work with your healthcare provider to find alternative medications or treatments for your pain. Due to side effects and interaction with other medications and alcohol, prescription painkillers are especially risky for seniors.
If you are currently taking or have recently been given a prescription for an opioid medication, here are some tips to keep you safe and to make sure that you are managing your pain effectively:
Start with a low dose and go slow. Talk to your physician about using the lowest dose of medication to see how it works and if you experience any side effects.
Tell your physician about other medications you take. One of the biggest risk factors for overdose and death from prescription painkillers is mixing them with alcohol or other medications. The combination of benzodiazepines (sometimes prescribed for anxiety or insomnia) and opioids is especially dangerous.
Follow up frequently. To monitor your condition, your physician may need to see you frequently, in some cases monthly.
Be realistic! Don’t expect any pain medication to be a magic bullet; most only ease pain, and all of them have risks. Prescription painkillers work best for acute pain and may not be as effective overtime for chronic pain.
Keep medications safe. The misuse of prescription pain medications is a serious national problem and locally is tied to the heroin epidemic. It is important that you store your medications in a locked cabinet or lockbox and keep track of how many you’ve taken. When you no longer need treatment, bring the unused medication to the drug kiosk in the lobby of the Falmouth Police Department for proper disposal.
Taking care of yourself and appropriately managing your medications is an important way to help your kids and teens to stay safe and healthy. A healthy senior population in Falmouth helps to keep the community viable for all residents.
Dr. Bihari is a pediatrician, a member of the Falmouth Prevention Partnership, and a member of the Falmouth Public School Health Advisory Committee.