Why are so few individuals receiving treatment for opioid addiction?
An ‘addict’ can be anyone, any time – if conditions are right.
Could part of the situation be that hurried M.D’s are overlooking symptoms that would be suspicious in a younger person? Are some older adult physical symptoms being categorized and dismissed as ‘just old age’?
Subtle (and not so subtle) ageism in medical practice is something that possibly needs to be looked at more closely. Not every physical problem with older adults is ‘just old age’ and to be accepted without question. Get a 2nd and 3rd medical opinion in cases of ‘sudden decline’ and ‘sudden feebleness’.
Let’s Look at a Typical Case of Older Adult Opioid Addiction
Presenting Symptoms to Doctor: Sudden Feebleness and Sudden Decline in Overall Health
The patient is an older male, retired, age 65+. During his working life, this individual was steady and hard-working with no previous addictions or alcoholism. This individual has no particular emotional or financial stress currently; and before the hospital visit, was not taking any pain medications.
Older man goes into hospital for a procedure or surgery that requires post-procedure pain relief.
Man is prescribed pain meds after surgery, including Oxycontin.
Over time, man needs more pain medication to relieve the pain.
Tolerance has developed. He needs a higher opioid prescription dose to combat pain.
Taking higher doses relieves pain – but the man becomes rapidly feeble; trouble with balance and walking.
Man becomes bed-ridden and feeble. Former low impact exercise program is no longer pursued. An under-reported side effect of pain medication is accidental falls with serious outcomes.
Avoiding any physical activity, the man experiences a ‘sudden decline’ in overall health.
His physician, noting the man’s age and recent surgery, concludes the man is simply experiencing the effects of old age.
An M.D. 2nd opinion suggests that opioid addiction could be the cause; suggests a rehab for older men.
The man is shocked. And totally horrified.
He is not a ‘dope fiend’. Everyone knows that only the morally bankrupt become addicted to drugs. Certainly not a man taking medication as prescribed.
Yet, even as the number of older adults suffering from these disorders climbs, the situation remains under-estimated, under-identified, under-diagnosed, and under-treated. Until relatively recently, alcohol and prescription drug misuse, which affects up to 17 percent of older adults, was not discussed in substance abuse or medical literature.
Reasons Senior Adult Addiction Can Be Overlooked
Hurried medical visits. Many general practice MD’s are required to see large numbers of patients daily.
Insufficient knowledge, limited research data, preconceptions regarding ‘old age’ and hurried office visits – these are all reasons health care providers often overlook substance abuse and misuse among older adults.
Diagnosis can be difficult and more complicated in the older adult population. This is due to the symptoms of substance abuse that sometimes mimic symptoms of other medical and behavioral disorders common to senior adults.
Important for Older Adults Experiencing a ‘Sudden Decline’
Get a 2nd – and then a 3rd – Medical Opinion.
Make certain full physical and emotional workups are included.
Restlessness; not interested in previous activities.
Lack of balance and coordination; often leads to more bed rest and reduced physical activity.
Increased ‘feebleness‘: lacking physical or mental strength; difficulty to failure under pressure or stress.
Numbness (feeling no pain; or lack of feeling emotionally).
Drug Tolerance (the need to use larger amounts over time).
Withdrawal symptoms after stopping or reducing use (depressed mood, stomach upset, insomnia, and muscle aches).
Opioid Tolerance and Addiction in Older Adults
Of course, not everyone using opioids will become addicted. And some individuals need opioids to manage long term severe pain. However, anyone taking opioids over time will develop a physical tolerance.
Opioids are known to have an inverse effect on pain relief over time. In the beginning opioids are effective as prescribed for relieving pain. Over time the pain relief from opioid decreases, even at the same dose level.
This effect is known as opioid ‘tolerance’ development. Tolerance happens even if the user does not become addicted. Because of the tolerance effect, opioids will not remain effective on low doses indefinitely.
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Questions? Arrowhead Lodge Recovery Has Answers
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