Emergency Room Doctors Can Be a Factor in Elderly Drug Abuse
Ivy Scott, M.S.W, L.S.W
February 20, 2015
February 20, 2015
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The elderly experience various life changing events--such as chronic pain, the death of friends, family, and spouse, and coping with the loss of abilities once taken for granted—that can be painful and challenging. These life events can be difficult for the elderly because they signal mortality and increase the desire for escape. Some elderly combat their challenges by abusing prescription drugs. This pain and sense of loss can lead to various behaviors such as obtaining prescriptions for the same addictive drug from two different doctors; filling re-fillable prescriptions for the same addictive drug at two or more different pharmacies; increasing the dosage of an addictive prescribed drug; and combining two or more addictive drugs. The elderly can also become angry or withdrawn, think or talk about the medicine, become defensive when you ask about the medication, and hide their pills. In addition to these warning behaviors, special care must be taken for those elderly with history of drug addiction.
Surprisingly, emergency room doctors may contribute to elderly prescription drug abuse. Because of the limited time emergency room doctors have to spend with their patients, some elderly patients are able to mislead the doctors and obtain addictive prescription drugs under false pretenses. These doctors frequently don’t have access to patients’ records, and thus, can increase the same prescriptions already prescribed by primary care doctors. Emergency room doctors may contribute to addiction by prescribing opioids (such as oxycodone and morphine) and benzodiazepines (such as valium and Xanax) to treat chronic pain, anxiety, or insomnia. When opioids or benzodiazepines are used for chronic conditions they are highly addictive; they are much less likely to cause addiction when used for acute conditions. The elderly suffer more from chronic conditions like arthritis and sleep pattern changes and have mental health issues due to life changing events. |
Emergency room doctors may contribute to addiction by prescribing opioids (such as oxycodone and morphine) and benzodiazepines (such as valium and Xanax) to treat chronic pain, anxiety, or insomnia.
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Emergency room doctors don’t know the patient. Primary care physicians, with the help of patients’ family members, need to assess behaviors that may show drug abuse before the patient arrives in emergency rooms. When possible, emergency Room doctors should ask for their help before prescribing highly addictive drugs. ER doctors need to know whether their patients have a primary care doctor and what medications they are currently being prescribed; which pharmacies their patients use; and how often their patients take their already prescribed medicines. If emergency room doctors prescribe medicines, they should prescribe the least harmful medication for the condition being treated. Similarly, doctors should be aware of what can occur if precautionary steps are neglected, and the older person becomes addicted to the prescription medication. The emergency room doctors should consult The American Geriatrics Society (AGS) Beers Criteria list of medications that are inappropriate and appropriate for the elderly.
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Mark Beers, Geriatrician
Developed the Beers List to provide guidance for physicians
prescribing to the elderly.
Developed the Beers List to provide guidance for physicians
prescribing to the elderly.
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Emergency room doctors usually aren’t around when the damage has been done - once their short-term patient leaves the emergency room. Rather, family and friends are left to deal with the problems caused by addictive prescriptive drugs. However, once prescriptive drug abuse has been identified rehabilitative steps must be taken, although the patients or their family and friends often don’t know how to deal with these drugs' effects. Primary care physicians and hospitals need to offer or, at least, be aware of educational offerings about recognizing prescription drug addiction and obtaining counseling services for the treatment of the elderly who may be addicted. Once prescriptive drug abuse has been identified, rehabilitative steps must be taken. Education seems the most appropriate method to empower patients and their family members about a healthy drug regimen for the elderly. Even when the elderly patient needs medical treatment that includes potentially addictive drugs, the elderly shouldn’t have to risk drug addiction.
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