Substance abuse is inclusive of drugs (both prescribed and illicit), alcohol, and tobacco. Common characteristics with any addiction are denial, rationalization, defocusing, minimization, and enabling behaviors of family members.
There are progressive stages of addiction. First learning, then seeking, dependence, to harmful dependency, finally to addiction.
According to the National Survey on Drug Use and Health, in 2004, 7.9% of the population ages 12 and older were current (30 days) illicit drug users, with and increase of lifetime prevalance in pain reliever usage such as Vicodin, Lortab, Tylox, Oxycodone, and more.
An illicit drug category of taking pain relievers for non-medical use has markedly increased. A 2005 survey shows a decrease in drug use but a continued increase of non-medical use of prescription drugs especially opioid pain killers.
Inhalant use is of great concern too. According to SAMHSA’S 2002-2004 NSDUH “an average of 598,000 youths aged 12-17 per year reported the they initiated inhalant use in the 12 months prior to being surveyed”. Prior to inhaling, 59% used cigarettes, 67.6% alcohol, 42.4% marijuana and 35.9% used all three. There appears to be a progression in use.
Other substances abused are alcohol, with 50.3% ages 12 and older being current drinkers, and 22.8% admitting to binge drinking and tobacco with 70.3 million or 29.2% of the population ages 12 and older.
I mention all this because of the possible suggestion of Kandel et al, 1986 that early use of substances may continue or reappear in the elderly.
There is 3 times the frequency of elderly using prescription drugs. Because of physiological changes they may decrease elimination or increase accumulation. Misuse maybe intentional or unintentional.
The illicit drug use among seniors has risen from 3.5% to 5% just from the previous generation. This study was from 1996 translating into 1.1 million more seniors using drugs.
A report Alcohol and the Elderly “seniors drinking mostly unreported, undiagnosed, or ignored” and “statistically in epidemic proportions”.
In our youth oriented society, seniors are not part of “mainstream society”. No one pays attention to them. If drinking wasn’t initiated in earlier years, then social isolation -depression as a result; loss, grief, or decline of health may lead many seniors to begin.
Our society focuses on prevention on the youth as it should. An ounce of prevention can save lives and alot of money over time but assessment of the elderly must begin with annual physicals, obtaining a complete medical and psychological history and verification of same, drug use history, and family history of addiction.
Perhaps if we listen to those who have experienced a lifetime, or near, of abuse we might gain wisdom on how to reach the young more effectively and prevent the obvious succession towards substance abuse.
Forensic Nursing Chronicles 