Invisible Epidemic Of Pensioner Drug Users
The older drug user is a far cry from the tabloid myth of the granny selling spare tranquillisers to young addicts to make a bit of extra cash. These are confused older people who mix up their drugs, forget when and how many to take and are often unaware of side-effects and interactions with other medicines and alcohol.
Professor Ilana Crome, professor of Addiction Psychiatry at Keele University Medical School, told delegates that at least one in ten older people - and sometimes as many as four out of 10 - took 'inappropriate' medication. This meant they had not been properly assessed and were taking the wrong drugs. At least a quarter of older people were taking psychoactive drugs, which work on the central nervous systems, such as antidepressants or sedatives. With the baby boomer generation ageing, these figures could triple by 2020, said Prof Crome.
She said there was increasing evidence that older people misused drugs that were bought, shared or hoarded for re-use. "It's not uncommon to see older people who are involved in drugs and alcohol," said Prof Crome. "They might be using old medication prescribed for a problem that no longer exists or a neighbour or friend has given them medication that worked for them. These drugs may interact with each other or with alcohol and they can become quite ill.
"Their doctor might, or might not have told them about interactions and side-effects, but if you're taking medication on a regular basis and your memory is poor, you haven't slept well, if you're in pain and you don't feel well, it's quite a demanding task to take medication correctly."
Prof Crome said older people who misused drugs and alcohol were a particularly vulnerable and neglected group. There have been only 14 randomised controlled trials on substance misuse in older people and none of the drugs used by doctors for addiction treatment were licensed for the over 65s. There was not one specialist centre in the UK for the treatment of pensioners who misused and abuse drugs and alcohol.
The symptoms of drug abuse and misuse - dementia, delirium and depression - could easily the attributed to other conditions of ageing. "Older people with drug problems are missed, overlooked, neglected and their symptoms misinterpreted," she said.
In addition, the National Service Framework for Mental Health in England makes no mention of the concept of addiction in older people and therefore ignored the potential for treatment, said Prof Crome. Benzodiazepines (tranquillisers) and painkillers were mentioned, but not alcohol or illicit drugs.
Prof Crome said she saw no reason why older people could not be targeted for treatment, as medication and cognitive behavioural therapy had proved to be effective. "Older people do as well as younger people, sometimes better. Older people are at such a disadvantage and they are subject to every kind of discrimination. Misuse of substances in older people is one of the biggest problems we've got and I don't think we can ignore it. For psychiatrists they are almost non-existent - we don't even think about them. There's a lot of discrimination."
The Royal College Of Psychiatrists' Annual Meeting
Edinburgh International Conference Centre
June 19 To 22 2007
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