Q: I have been watching the TV series “Dopesick” about opioid addiction. How do I talk to my mom‘s doctor about whether or not the medication she is on needs to be adjusted as she ages?
A: This is a relevant question for any family. As adults age, social and physical changes occur which may increase vulnerability to substance misuse. As reported from 2018 Substance Abuse and Mental Health Services Administration data, 1 million adults age 65 and older live with a substance use disorder. While the total number of substance abuse disorder admissions to treatment facilities between 2000 and 2012 differed slightly, the proportion of admissions of older adults increased from 3.4% to 7.0% during this time. That means that while the abuse of prescription or illicit drugs in older adults is much lower than among other adults, it is currently increasing.
Older adults are more susceptible to the effects of drugs because as their body ages, it often cannot absorb and break down drugs as easily as it once did. Misuse can often be unintentional, as forgetfulness, or taking medication too often, or taking the incorrect amount can occur.
Events such as retirement, personal loss, declining health, or a change in living situation may cause older adults to take medication or consume alcohol in order to cope with big life changes.
Questions to your providers can give you the expertise to aid your mother. It’s always best to talk to your family member first to express your concerns before discussing with their doctor. These inquiries can then get you started in a conversation with the medication prescriber to find out what’s necessary for the current health situation.
- Are they taking medications that have a potential for interaction?
- What symptoms should I be on the lookout for that suggest potential side effects or drug misuse?
- What are the best practices for organizing medications to minimize errors?
Accidental misuse of prescription drugs and possible worsening of existing medical health issues put older adults at risk. Providers may confuse symptoms of substance use with other symptoms of aging, which could include chronic health conditions or reactions to stressful life-changing events. Additionally, marijuana use can interact with a number of prescription drugs and complicate already existing health issues and common psychological changes in older adults.
Brain health refers to the overall function across cognitive, motor, emotional and tactile areas:
Cognitive health: How well you think, learn, and remember.
Motor function: How well you make and control movements, including balance.
Emotional function: How well you interpret and respond to emotions (both pleasant and unpleasant).
Tactile function: How well you feel and respond to sensations of touch, including pressure, pain and temperature.
Brain health can be affected by age and related changes in the brain, injuries such as stroke, or a traumatic brain injury, mood disorders such as depression, substance use disorder or addiction, and diseases such as Alzheimer’s. More science is needed on the effects of substance use on the aging brain, as well as into effective models of care for older adults with substance use disorders. And, while some factors affecting brain health cannot be changed, there are many lifestyle changes that might make a difference.
Have a thorough discussion with your mother first. Then, if necessary, a conversation with her providers could be useful.
Year’s end is a good time to consider a wellness and medication review. What drugs are absolutely necessary for chronic conditions? Could healthier eating, physical activity, emotional engagement and social activities improve overall mental, physical and social health? If so, make them a priority in 2022 for a full and thriving life. Happy New Year.
Additional resources for download
“Too Many Prescription Drugs Can Be Dangerous, Especially for Older Adults” https://bit.ly/3FBxlJQ
“Talking with Your Adult Patients about Alcohol, Drug, and/or Mental Health Problems: A Discussion Guide for Primary Health Care Providers” https://bit.ly/3kWgIAQ
“Linking Older Adults With Medication, Alcohol and Mental Health Resources” https://bit.ly/3r1gRXd
“National Council on Aging, Issue Brief 2: Alcohol Misuse and Abuse Prevention” https://bit.ly/3nFyKsI
Karen Casanovas, PCC, CPCC, is a restorative coach in Anchorage. If you have a question for Karen, email her at info@karencasanovas.com.
