Aging Well: Medications blurring the line between helpful, harmful

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Resources

- Colorado West Regional Mental Health Centers offer mental health and substance abuse treatment on an outpatient basis. Payment is on a sliding fee scale (based on income and other factors). For more information, call Steamboat Mental Health at 879-2141 or Craig Mental Health, 824-6541.

- For help finding additional substance abuse treatment facilities and counselors (including those that provide payment assistance), visit www.findtreatment... or call 1-800-662-HELP.

- Alcoholics Anonymous is a support group for individuals recovering from alcoholism, and Al-Anon provides support for family and friends of alcoholics. For more information, call 879-4882.

- For publications related to substance abuse, medication misuse and mental health issues in older adults, visit the Older Americans Substance Abuse and Mental Health Assistance Center at www.samhsa.gov/ol...

Chronic pain, anxiety and depression are just a few problems that can send a person to their doctor's office for relief. Chances are, they will leave with one or more prescriptions for medications.

Although prescription drugs and over-the-counter medications can greatly improve a person's quality of life, misuse can quickly blur the line between feeling better and feeling worse.

Older adults consume the most prescription and over-the-counter drugs of any age group. This, in addition to other age-related changes, make older adults particularly vulnerable to substance abuse problems, according to "Substance Abuse and Mental Health Among Older Americans," a 2005 report by the Substance Abuse and Mental Health Services Administration.

Despite this, a growing body of research suggests misuse and other medication-related problems in older adults can be avoided.

Focusing more research and screening on potential effects of certain drugs on older individuals and spreading awareness of these issues among the medical community, patients and caregivers are among recommendations from an expert panel assembled by the nonprofit Alliance for Aging Research.

Medication misuse

Unlike younger individuals who abuse substances to "get high," substance abuse among older adults often is unintentional, stemming from misuse, which can be overuse, underuse or irregular use of a prescription or over-the-counter drug, notes the SAMHSA report.

Unsafe combinations or amounts of medications may be obtained by seeking prescriptions from multiple physicians ("doctor shopping"), by obtaining medications from family members or peers or by stockpiling medications throughout time, according to the report, "Prevention of Medication Misuse in Older Adults," by the Older Americans Substance Abuse & Mental Health Technical Assistance Center.

Ultimately, substance abuse can prolong other health problems, increase risk of disability, lower a person's life span and increase risk of suicide.

Erika Schmitz, substance abuse coordinator at Steamboat Mental Health, said the most prevalent substance abuse problems among older adults in Routt County involve alcohol, prescription drugs or a combination of the two.

A common issue is the overuse of "as needed" medications that treat pain, insomnia, anxiety and other problems. Some older individuals inadvertently misuse or abuse these drugs because they did not receive enough information from their doctors about the increased likelihood of dependence, she said.

Patients can be proactive by asking their doctors more questions about potential problems with certain medications.

Consuming alcohol while taking certain medications can interfere with the metabolism of many drugs, rendering them ineffective or causing adverse drug reactions, according to the SAMHSA report.

Recovery

In addition to chronic pain and health complications, loneliness, diminished mobility, lack of social support and even changes such as retirement can make older individuals more vulnerable to substance abuse problems.

Exploring the initial problem that led to substance abuse and learning better ways to cope is part of the recovery process, she said.

Depending on the type and extent of abuse, treatment may include detox or an inpatient program or various levels of outpatient treatment involving group or one-on-one therapy.

Financial problems should not prevent a person from seeking help. While inpatient programs can be very expensive, outpatient programs are much more reasonable and can be adjusted in frequency to the patients' needs.

Some substance abuse programs and counselors will work on a sliding fee scale based on a person's income, and there are other resources to help patients pay for their treatment. Medicaid will pay for a limited number of outpatient services and detox for qualified individuals, and insurance companies slowly are beginning to join the bandwagon, Schmitz said.

If a person is worried he or she is abusing medications or alcohol, they can call a certified addiction counselor or talk to any therapist - most are versed in substance abuse issues - to determine his or her next step.

Joining an Alcoholics Anonymous or Al-Anon meeting or simply talking to a friend also can help a person gauge their problem.

Schmitz often receives calls from people worried a family member has a substance abuse problem. Although she can provide advice about how to approach the issue, the best thing the concerned person can do is help themselves by finding a support group, such as Al-Anon or talking to a counselor.

"If you are making the call, the problem exists on your level," she said. "If (the person abusing substances) is not at a place to talk about it, they are not the ones needing help."

If a person is worried a friend or family member may endanger themselves or another person as a result of substance abuse, they can seek the help of a trained interventionist.

Although individuals can be involuntarily committed to a treatment facility, the best outcome usually results from a person voluntarily seeking help, Schmitz said.

Family and friends can support someone dealing with addiction or dependency by educating themselves and not being afraid to talk to the person about their needs.

"That lets the person who's dealing with addiction and recovery know that you actually care and want to be involved," Schmitz said.

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