Earlier this month, Gov. Tom Wolf took an unprecedented step for Pennsylvania by signing a disaster declaration to fight the heroin and opioid crisis. In doing so he acknowledged that the epidemic is a public health emergency affecting every walk of life — at least 14 Pennsylvanians die every day from an overdose, with more than 4,600 overdose deaths in 2016 alone.
While much of the media attention has focused on younger individuals obtaining opioids illegally, older adults are more likely to be prescribed opioids than any other population, and overdoses are on the rise. Nearly 14,000 people age 45-plus died from an opioid overdose in 2015 — 42 percent of all such deaths in the U.S., according to the Centers for Disease Control and Prevention.
Substance use disorder in older adults is a hidden and silent epidemic that can be traced back to the late 1990s when older patients suffering from chronic conditions like arthritis or back issues were prescribed OxyContin, Vicodin, Percocet and other opioids to relieve pain. At one point, the American Geriatric Society encouraged physicians to use opioids to treat moderate to severe pain in older patients, citing evidence that they were less susceptible to addiction. Though those guidelines have since been revised, the myth that seniors can’t become addicted persists.
The truth is that as people age they can become more at risk for drug dependence or overdose. Symptoms of substance use disorder, such as increasing fatigue, diminishing memory, or balance problems, can be mistaken for depression or dementia. Also, older adults often take multiple medications for various reasons, and since kidney and liver function slow with age, the time drugs remain in one’s system increases, making it harder to manage opioid medication effectively.
It may come as a surprise that an AARP study found that 2.7 million Americans over the age of 50 were taking painkillers for reasons contrary to or in amounts beyond what their doctor originally prescribed. Today, the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration estimates that the number of older adults in need of treatment will increase to 4.4 million by 2020.
Fighting the disease of addiction among older Pennsylvanians will require a steadfast commitment from state government, medical professionals, and even seniors and their families.
The research is clear — opioids are a short-term solution, not a long-term fix. This means we must do everything possible to educate older Pennsylvanians and their doctors about the risks associated with using opioids, and provide alternatives for pain management. To achieve this, the Department of Aging’s prescription assistance program (PACE/PACENET) hosts educational sessions for health care practitioners to ensure they have a reliable, evidence-based, unbiased, and non-commercial source of information about the drugs they frequently prescribe. The sessions also include information on treating chronic pain with non-opioid painkillers or other non-pharmacological therapies whenever possible.
Pennsylvania has instituted new safe-prescribing guidelines for geriatric pain that will help physicians save lives. These new guidelines cover the safe and effective use of opioids and improve education for medical professionals so they are better equipped to best serve the unique needs of older Pennsylvanians.
Naturally, families also play an important role in addressing the disease of addiction in older adults. When accompanying a senior to a medical appointment, family members should ask physicians how pain will be managed and how prescription pain medications will be used. They can also keep an eye out for falls, confusion, isolation, changes in habits, and other indicators of addiction.
For those individuals and families that need additional help, the Wolf Administration has provided funding for 45 Centers of Excellence that will treat and support nearly 11,000 people statewide. If you or a loved one is in need of treatment or assistance, please call 1-800-662-HELP (4357) or contact your local Area Agency on Aging.
By increasing awareness, changing prescriber conduct, and boosting access to treatment, Pennsylvania can save lives, improve health care delivery, and ensure that seniors receive the services and support they deserve.