{"id":2974,"date":"2018-01-20T20:37:55","date_gmt":"2018-01-21T01:37:55","guid":{"rendered":"http:\/\/www.silvercentury.org\/?p=2974"},"modified":"2018-07-19T14:50:13","modified_gmt":"2018-07-19T18:50:13","slug":"aging-and-addicted","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2018\/01\/aging-and-addicted\/","title":{"rendered":"Aging and Addicted"},"content":{"rendered":"

Jenny Gold, senior correspondent for Kaiser Health News (KHN), explores what happens to older people who become hooked on opioids after doctors prescribe them. Her story for KHN<\/a>, published in December 2016, also aired on National Public Radio.<\/em><\/p>\n

It took a lot of convincing for John Evard to go to rehab. Seven days into his stay at the Las Vegas Recovery Center, the nausea and aching muscles of opioid withdrawal were finally beginning to fade.<\/p>\n

\u201cAny sweats?\u201d a nurse asked him, as she adjusted his blood pressure cuff. \u201cLast night it was really bad, but not since I got up,\u201d replied Evard, 70, explaining that he\u2019d awakened several times with his sheets drenched.<\/p>\n

Even for him, it was hard to understand how he ended up 300 miles away from his home in Scottsdale, AZ, at this bucolic facility in the suburbs of Vegas. \u201cThis is the absolute first time I ever had anything close to addiction,\u201d he said. He prefers to use the term \u201ccomplex dependence\u201d to describe his situation: \u201cIt was, shall we say, a big surprise when it happened to me.\u201d<\/p>\n

As the nation grapples with a devastating opioid epidemic, concerns have primarily focused on young people buying drugs on the street. But America\u2019s [older people] also have a problem. Over the past several decades, physicians have increasingly prescribed pain medications for seniors to address chronic pain from arthritis, cancer, neurological diseases and other illnesses that become more common in later life.<\/p>\n

A recent study<\/a> found that in 2011, 15 percent of seniors were prescribed an opioid when they were discharged from the hospital; three months later, 42 percent were still taking the pain medicine.<\/p>\n

\u201cYou don\u2019t see people in this age group stealing a car to get their next dose.\u201d <\/strong><\/p>\n

–Dr. Bruce Ferrell<\/strong><\/p><\/blockquote>\n

One in three Americans who have taken prescription opioids for at least two months say they became addicted to or physically dependent on the medications, according to a recent Washington Post<\/em>-Kaiser Family Foundation poll. (KHN is an editorially independent program of the foundation.)<\/p>\n

It\u2019s no surprise, then, that some seniors end up addicted.<\/p>\n

Evard spent his life working as a corporate tax attorney. He\u2019s spry and white haired, with a contagious grin. A few years ago he and his wife retired to Arizona with their eyes on the golf course. The dream didn\u2019t last long. Just months later, a virus infected Evard\u2019s left ear. Overnight, he lost half his hearing and was left with chronic pain. In January, he had surgery to fix the problem.<\/p>\n

\u201cFrom the surgeon\u2019s standpoint, the operation was successful. The problem was, the pain didn\u2019t go down. It went up,\u201d he recalled.<\/p>\n

His doctors prescribed opioids, including OxyContin. \u201cThey decreased the pain, particularly at first,\u201d said Evard. \u201cAs time went on, they had less and less effect, and I had to take more and more.\u201d<\/p>\n

As the doctors increased his dosage, Evard\u2019s once active life fell apart. He was confused, depressed and still in pain. \u201cI was effectively housebound. I couldn\u2019t play golf anymore. I couldn\u2019t go to social events with my friends or my wife.\u201d<\/p>\n

He couldn\u2019t think of anything except the pills and when he could have the next one. He knew he was in trouble\u2014despite having taken them exactly as his doctor instructed.<\/p>\n

\u201cI was a rule-follower,\u201d he said. \u201cAnd I still ended up in a mess!\u201d<\/p>\n

\u2026in the past 20 years the rate of hospitalization among seniors that is related to opioid overuse has quintupled.<\/strong><\/p><\/blockquote>\n

In 2009, the American Geriatric Society came out strongly in favor of opioids, recommending<\/a> that seniors with moderate-to-severe pain be considered for opioid therapy. The panel cited evidence that seniors were less likely than others to become addicted.<\/p>\n

\u201cYou don\u2019t see people in this age group stealing a car to get their next dose,\u201d Dr. Bruce Ferrell, chairman of the panel that issued the society\u2019s guidelines, told the New York Times<\/a> at the time.<\/p>\n

Mel Pohl, medical director of the Las Vegas Recovery Center, called that conclusion a \u201chorrible misconception.\u201d<\/p>\n

\u201cThere\u2019s no factual, scientific basis for that. The drug takes over in the brain. It doesn\u2019t matter how old the brain is.\u201d<\/p>\n

The problem is that chronic pain is common as people age, and there aren\u2019t many good options to treat it. Even aspirin and ibuprofen carry bleeding risks. The 2009 AGS guidelines are no longer in use, but opioid medications remain a crucial tool to treat pain in older people. Most people are able to take opioids in small doses for short periods of time without a problem.<\/p>\n

\u201cWe really don\u2019t use opioids necessarily as the first line of treatment because we understand what the risks are. But we also don\u2019t want to see our patients suffering needlessly if we can provide them with relief,\u201d said Dr. Sharon Brangman, past president of the AGS. The trick, she said, is to try nonpharmacological options such as acupuncture first and to use the smallest effective opioid dose possible, if necessary.<\/p>\n

Still, most of the seniors at the Las Vegas Recovery Center have taken the drugs as prescribed by a willing doctor trying to address their pain, said Pohl. That pattern sets them apart from many of the younger patients, many of whom start buying drugs on the black market after being turned away by physicians.
\nNonetheless, in the past 20 years the rate of hospitalization among seniors that is related to opioid overuse has quintupled<\/a>. But relatively few of them end up in rehab. Pohl said that\u2019s due to a combination of factors.<\/p>\n

\u201cThey\u2019ve grown up in an era where drug addiction and alcoholism [were] evil, and I think that\u2019s internalized for some of the folks that I\u2019ve seen,\u201d he said, so they don\u2019t seek help, particularly from an inpatient facility. Also, some rehabs are not equipped to deal with the complex medical problems common among older people.<\/p>\n

Another problem is patients whose addictions have been misdiagnosed as dementia. \u201cWe\u2019ll have a family come [visit], three weeks into treatment, and it\u2019s like \u2018Oh my God, you\u2019re back! I haven\u2019t seen that glimmer in your eye in 20 years!’\u201d said Pohl.<\/p>\n

It took John Evard about a week to get over the vomiting and flu-like symptoms of detox, which can be particularly hard on older patients. He\u2019s speaking out now because he doesn\u2019t want other seniors to fall into the same trap.<\/p>\n

\u201cDon\u2019t just take the prescription because it\u2019s part of the checkout process from the hospital,\u201d he cautioned. \u201cIt\u2019s your body, take charge of it and push for alternatives at all costs. And if you do go on, get off them as fast as you can.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

It took a lot of convincing for John Evard to go to rehab. Seven days into his stay at the Las Vegas Recovery Center, the nausea and aching muscles of opioid withdrawal were finally beginning to fade.<\/p>\n

Read more Aging and Addicted<\/span> ›<\/span><\/a><\/div>\n

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