Prescription drug abuse among older adults

Victoria Burke by Victoria Burke | Licensed since 2011
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This article was updated on: 09/15/2018

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Prescription drug abuse means using prescription medications in a way that’s not in line with your doctor’s instructions, according to the Mayo Clinic. It could also involve taking someone else’s medications that were not prescribed for you. Seniors can be drug abusers, even though people might associate drug abuse with the young.

Older adults are at risk for prescription drug abuse because they take more prescription medicines than other age groups. The National Institute on Drug Abuse notes that Americans 65 years of age or older make up only 13% of the U.S. population, yet they consume approximately 33% of all prescription drugs. Alcohol and prescription drug abuse affects approximately 17% of older adults according to a report from the National Center for Biotechnology Information.

Prescription Drug Abuse Risk factors

Prescription drug abuse among seniors is of special concern because it can cause cognitive and physical impairment— putting these individuals at greater risk for falls and motor vehicle accidents as well as making them generally less able to care for their daily needs. This was reported by the Public Library of Science (PLOS) in 2015.

Older adults are likely to take a range of prescription drugs, reports the National Institute on Drug Abuse; among those studied between 57 and 85 years old, more than 80% take at least one prescription drug every day. The following prescription drugs are examples of types of medicines with a high potential for addiction, according to the National Institute on Drug Abuse:

Opioids: may be used to treat pain. Common opioids include oxycodone (the active ingredient in Percocet and OxyContin), and numerous other related medicines such as morphine, codeine, and fentanyl. Opioids are a vital tool for pain management, but carry clear risks of dependence and addiction. The National Institute on Drug Abuse reports that more Americans die from overdosing on opioid painkillers than from cocaine and heroin put together.

Depressants (benzodiazepines and barbiturates): may be used to treat anxiety, panic disorders, insomnia – and can also be used to treat bipolar disorder and even epilepsy, notes the National Institutes of Health’s Medline Plus website. The class of depressants called benzodiazepines can be habit-forming, and dangerous when mixed with other sedatives, according to the Food and Drug Administration.

Stimulants: may be used to treat disorders such as narcolepsy and obesity, according to Medline Plus.

Prescription drug abuse signs and symptoms

According to the Mayo Clinic, people who abuse prescription drugs might show any of these symptoms. This is not a complete list, and showing symptoms doesn’t necessarily mean a person is abusing drugs.

  • Confusion
  • Slurred speech
  • Nausea
  • Drowsiness
  • Poor coordination

People who are abusing a prescription drug may display some of the following behaviors that may indicate a substance abuse problem. Again, this is not a complete list, and doing these things doesn’t necessarily mean a person is abusing drugs.

  • Getting a prescription for the same medicine from two different doctors
  • Forging a prescription
  • Taking more of a prescription medicine than instructed
  • “Losing” prescriptions so they’ll have to be refilled sooner than scheduled
  • Having behavior changes, such as mood swings
  • Acting agitated or sleepy, more than normal
  • Having poor judgment

Again, these symptoms and behaviors could be due to reasons other than prescription drug problems, but you might want to consult your doctor or urge your loved one to see a doctor if you think there’s a possibility of drug abuse.

Medicare coverage of prescription drug abuse treatment in the elderly

The treatment for prescription drug abuse/misuse may involve detoxification, counseling, prescription medications, or other appropriate methods, according to the National Institute on Drug Abuse.

Medicare may help pay for treatment of alcoholism and drug abuse in inpatient and/or outpatient settings if all of the following are true:

  • Services are provided from a Medicare-participating provider or facility
  • The Medicare beneficiary’s doctor states that the services are medically necessary
  • The doctor sets up plan of treatment

Medicare Part A may help pay inpatient substance abuse treatment. Out-of-pocket costs are generally the same as for any other type of hospital stay—usually 20% after the individual pays the Part A deductible. Medicare has a limit of 190 days in a psychiatric hospital for an entire lifetime, however. If you reach that limit, Medicare may cover further inpatient mental health care in a general hospital but not a psychiatric hospital.

Medicare Part B may help pay for outpatient substance abuse treatment services in a clinic or hospital outpatient department. Medicare will usually pay 80% of its approved amount for mental health services, including treatment for alcoholism and drug abuse, and you are generally responsible for the remaining 20%.

Part B covered services may include:

  • Medication management.
  • Individual and group psychotherapy
  • Partial hospitalization

In addition, Medicare may provide coverage for Structured Assessment and Brief Intervention (SBIRT) services provided in a doctor’s office or outpatient hospital department. Medicare also may cover one depression screening per year. The screening must be done in a primary care doctor’s office or primary care clinic that can provide follow-up treatment and referrals. Once you’ve paid the deductible, Part B typically covers 80% of the Medicare-allowed charge for most services. You may be able to receive certain preventive care screenings are at no cost to you.

If you’re enrolled in a Medicare Advantage plan, the plan must provide at least the same level of coverage as Medicare Part A and Part (but hospice care is still covered directly under Part A). The Medicare Advantage plan may require use of providers who participate in the Medicare Advantage network to receive full benefits. You must keep paying your Part B premium if you have a Medicare Advantage plan, as well as any premium the plan may charge.

If you’re enrolled in a stand-alone Medicare Part D Prescription Drug Plan, the plan may cover outpatient prescription drugs used in your treatment, provided these medications are on the plan’s formulary or an exception is granted by the plan to provide coverage. Furthermore, Medication Therapy Management (MTM) services might be offered at no cost if you’re eligible for these services, and enrolled in a stand-alone Medicare Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug plan.

Do you have more questions about prescription drug abuse or Medicare plan options? I’m happy to help. You can schedule a phone call or request I email you information by clicking one of the links below, or click the Compare Plans button to see a list of plan options in your area.

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