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Opioid Use Disorder in Older Adults

Older adults are increasingly seeking help for opioid use disorder. Like anyone, older adults may take an opioid prescription for an acute injury or chronic pain, which may become habit-forming. Many seniors choose to manage their own medications, but some may also be misusing them.

Misuse means taking more than prescribed, using other mood-altering substances such as alcohol, or obtaining them from illicit means like the internet or a drug dealer. Many older adults aren’t aware of opioid use disorder or its symptoms. They may have a different belief set about addiction and recovery. However, statistics show that age doesn’t matter so much regarding addiction. Anyone of any age can develop opioid use disorder, especially if they have been using highly potent drugs like Oxycontin or fentanyl.

According to a study from the Primary Care Companion, nearly 1 million people over the age of 65 qualify to meet the criteria of opioid use disorder (OUD).  Like any other person with addiction, treatment is necessary to help people overcome their issues.

Why Do Older Adults Misuse Opioids?

Older people with OUD often start out with a legitimate prescription but decide to misuse their medication or obtain more when they’re done. Often, they do this to increase pain relief or enjoy the relaxation and euphoria that opioids can temporarily provide. However, people of all ages can have a tolerance to the drug, meaning they need to use more of the drug to get the same effect. This is when misuse gets tricky, and addiction begins to wield its influence.

OUD in older adults can be more complex due to the needs of chronic pain patients. When a pain patient misuses an opioid, they are left with pain if they stop using it. In addition to this, they risk withdrawal syndromes that can amplify pain. Older people who use drugs often do it to mask pain syndromes and comorbidities. These same health conditions can increase the risk of overdose or dangerous side effects.

Symptoms of Opioid Use Disorder in Older People

Opioid use disorder is a brain disorder. When someone begins misusing drugs, they may undergo a personality change and other lifestyle changes. Many people who misuse opioids end up with financial problems, increased health issues, and even the danger of homelessness. When all money is diverted to getting and using opioids, there is always a chance of financial peril. Older people are more susceptible to “bad credit loans” with ridiculously high-interest rates. They may also try to leverage the equity in their home for more financial liquidity, which could lead to homelessness if they cannot pay the bills.

Older adults may exhibit different signs and symptoms of substance abuse compared to younger individuals. Their symptoms may be mistaken for normal signs of aging or other health conditions, leading to misdiagnosis or underreporting. They may feel ashamed or embarrassed about their substance abuse issues, leading to secrecy and reluctance to seek help. The stigma associated with addiction can prevent open discussions and early interventions.

Here are changes in older adults to look for:

  1. Changes in behavior: Older adults may exhibit unusual behavior such as increased irritability, mood swings, or hostility. They may also isolate themselves from family and friends.
  2. Physical symptoms: Opioid abuse can cause physical signs like drowsiness, confusion, slurred speech, unsteady gait, and coordination problems. Other symptoms may include constipation, nausea, and a general decline in hygiene.
  3. Social withdrawal: Older adults abusing opioids may withdraw from previously enjoyable social activities. They may also experience a loss of interest in hobbies, work, or personal relationships.
  4. Poor medication management: Opioid abuse can lead to difficulties in managing medications. You may notice missing or stolen prescription drugs, frequent requests for early refills, or doctor shopping to obtain multiple prescriptions.
  5. Financial problems: Opioid abuse can be costly, leading to financial strain. Older adults may experience unexplained financial difficulties, unpaid bills, or borrowing money from family and friends.
  6. Neglecting responsibilities: Individuals abusing opioids may neglect their home, work, or community responsibilities. They may have difficulty completing daily tasks or show a decline in personal care and hygiene.

The dangers of overusing opioids while taking other medications stem from the potential for drug interactions and increased risk of side effects.

Older adults are more vulnerable to cognitive impairment caused by medications. Opioids can further impair cognitive function, leading to confusion, memory problems, and difficulty making decisions. They may not remember which pills they have taken or how much.

It's important to be vigilant and compassionate when addressing substance abuse with older adults. If you suspect opioid abuse by someone you know, seeking professional help from healthcare providers or addiction specialists who can provide appropriate care and support is crucial. Medication-Assisted Treatment is considered the gold standard treatment for OUD and can be used safely under the guidance of a healthcare provider to help older adults with OUD.

If you are in need of help, please call us at: 910-295-7246 or message us.

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