Transcript Not What the Doctor Ordered: Prescription Drug Misuse & Abuse in

Not What the Doctor Ordered:
Prescription Drug
Misuse & Abuse
in Older Adults
INSERT YOUR NAME HERE
Older Adults Take More
Medicine
 Consume 1/3 of all prescription meds
 One in four older adults has used
psychoactive meds with abuse potential
 Prescription drug misuse and abuse
is a growing problem
 May be as high as 11% of
older adult population
Definitions
Prescription Drug Misuse
 The use of a medication other than as
directed
– May be accidental or willful
Prescription Drug Abuse
 Intentionally taking medications that are
not medically necessary
Misuse can Lead to Abuse
The pathway from appropriate use,
through misuse to abuse can result from
 Patient behavior
 Prescriber behavior
 Both
Prescription Drug Misuse







Patient Behavior
Taking more of a drug than prescribed
Missing doses
Taking the wrong drug
Using a drug for other than the prescribed
reason
Sharing or borrowing drugs
Using drugs that have expired
Combining drugs with alcohol or other
substances
Prescription Drug Misuse
Prescriber Behavior






Medications w/o indication
Multiple drugs from same class
Dose too high; duration too long
High risk drugs or inappropriate for elderly
Inadequate instructions for taking meds
Failure to question about use of alcohol or
other drugs with abuse potential
Prescription Drug
Misuse is UNSAFE
 Treatment failure
 Increased health resource utilization
– ER visits
– Hospitalizations
It might lead to prescription drug ABUSE
Prescription Drug Misuse
Risk Factors








Number of medications
Multiple prescribers
Inappropriate prescribing
Limited English language proficiency
Low health literacy
Memory problems
Hearing/Vision impairments
Treating symptoms and not the cause
How Many is Too Many?
Prescription Drug Abuse
Older Adults
 Drug misuse and abuse is present in 11%
of older adults
 Second only to alcohol abuse
 ED visits doubled between 2004 & 2008
– 20% age 70 and older
– 1/3 required hospitalization
 Projected to double over two decades, to
2.7 million by 2020
 4.4 million will need substance abuse
treatment
Commonly Abused
Medications




Opioid (narcotic) painkillers
Medicine for anxiety
Sleeping pills
Stimulants
Prescription Drug Abuse
is UNSAFE





Health gets worse
Higher risk of accidents
Higher risk of falls and injuries
Serious side effects
Physical dependence and addiction
Prescription Drug Abuse
Risk Factors





Female gender
Social isolation or loss of social supports
History of mental health problems
History of substance abuse
Exposure or access to prescribed
medications with abuse potential
Recognizing
Prescription Drug Abuse
Can Be Difficult
 Older adult does not fit the typical drug abuser
profile
 No validated screening instruments to
identify/diagnose drug abuse in geriatric
population
 Many diseases caused by substance abuse
are common disorders in later life
 Many symptoms of prescription drug abuse
mirror common signs associated with aging
Warning Signs
Prescription Drug Abuse





Sudden change in behavior
Withdrawal from family, friends, activities
Sleeping during day
Changes in personal grooming, hygiene
Worry about . . . Are the drugs “really working”
Having enough medication on hand
 Giving excuses as to why they need pills
 Sneaking or hiding pills
 “Doctor shopping” for several prescriptions
How to Help Someone with
Prescription Drug Abuse?
 Get them to talk to a doctor, counselor or
other health professional
 Encourage them to be honest about
exactly how they are taking their
medications
 The sooner, the better
Case Study
Place Holder
STAMP OUT Prescription
Drug Misuse & Abuse Tool Kit
Program is brought to you by The American Society of
Consultant Pharmacists (ASCP). STAMP OUT was developed
by the ASCP Foundation and supported by an educational
grant from Purdue Pharma L.P
STAMP Out Prescription
Drug Misuse & Abuse
Tool Kit Contents







Backgrounder
Getting Started
Flyer
PowerPoint Presentation w/Speaker Notes
Self-Assessment
Evaluation
Handouts
Notes Pages:
Speaker Tips
&
Teaching Points
1c
Attention Seniors:
STAMP Out Prescription
Drug Misuse & Abuse
Making the Best Use of Your Medicines
Know Your Medicine
As long as I take the medication, it doesn’t
matter at what time of day I take it.
True or False?
On days when I wake up feeling good, I
don’t have to take my medication.
True or False?
I had the same cold last year, so I can use
the antibiotics I had left over for this cold.
True or False?
We Take More Medicine
as We Get Older
Taking medicine prescribed by your
doctor is usually safe and effective.
But, as we age, our bodies change.
We handle medicine differently than
when we were younger.
…So, it is important to be careful with medicine.
OOPS
Sometimes we don’t take medicine the
way the doctor prescribes . . .
What Are Some Ways We
Take Medicine WRONG?







We take MORE
We take LESS
We take more OFTEN
We FORGET
We STOP before we are supposed to
We give OTHER people our medicine
We TAKE other people’s medicine
This is PRESCRIPTION DRUG MISUSE
Prescription Drug Misuse
is UNSAFE
What can happen if you misuse
Prescription Drugs?
 You might not get well
 You might actually get sicker
 You might have to go to the doctor or the
hospital
 It might lead to prescription drug ABUSE
What if Someone Takes
Prescription Drugs
Wrong on PURPOSE?
If someone takes:
 MORE medicine than prescribed
 More often than prescribed
 For no MEDICAL reason
 Or mixes medicine with alcohol or illegal
drugs
This is PRESCRIPTION DRUG ABUSE
Commonly Abused
Medications
 Opioid (narcotic) painkillers
 Medicine for anxiety
 Sleeping pills
Take these medicines only if YOUR
doctor prescribed them for YOU and
take them just as the doctor ordered!
Prescription Drug Abuse
is UNSAFE





Health gets worse
Higher risk of accidents
Higher risk of falls and injuries
Serious side effects
Physical dependence and addiction
Recognizing Prescription
Drug Abuse
Look for these signs . . .
 Sudden change in behavior
 Withdrawal from family, friends, activities
 Rapid increase in the amount of
medicine that is needed
 Very frequent refills
 “Doctor shopping” to get several
prescriptions for the same medicine
How to Help Someone with
Prescription Drug Abuse?
 Get them to talk to a doctor, counselor or
other health professional
 Encourage them to be honest about
exactly how they are taking their
medications
 The sooner, the better
Be Part of the Solution
STAMP Out Prescription Drug
Misuse and Abuse by
Safely
Taking
All
Medicine
Properly
How to…
STAMP Out Prescription
Drug Misuse & Abuse
 Keep an up-to-date list of all your medicines –
prescription and over-the-counter
 Take your medicine list to ALL your medical
appointments: doctor, dentist, emergency
room visits & hospital stays and share with
your pharmacist
 Take your medicine EXACTLY as prescribed
 Only use the medicine for the reason it was
prescribed
More STAMP Out Tip
 If you are not sure how to take a medicine, ask
your doctor or pharmacist
 Ask your doctor or pharmacist about side
effects to watch out for and interactions with
other medications
 Ask how the medicine will affect driving and
other daily activities
 Talk with your doctor BEFORE you change a
dose or stop taking a medicine
More STAMP Out Tips
 Do not crush or break pills without checking
with your doctor or pharmacist
 Don’t use someone else’s medicine
 Don’t share your medicine with anyone else
 Don’t mix your medicines with alcohol
 Don’t be afraid to ask for help in organizing
your medicines
 Schedule a yearly “medication check-up” with
your doctor and pharmacist
And Finally. . .
If you want to help fight
Prescription Drug Misuse & Abuse
CLEAN OUT YOUR
MEDICINE
CABINET
The Medicine Cabinet
can be DANGEROUS
 Accidental poisonings, abuse and misuse often
occur when people store old medications in
their homes
 A majority of abused prescription drugs are
obtained from family and friends, including from
the home medicine cabinet
 You may become a target for burglary, theft or
scams by those looking for drugs to abuse
Prevent Poisonings,
Misuse & Abuse and
Protect the Environment
Properly dispose of unused/expired medicine
 DO NOT FLUSH unused medications
 DO NOT POUR them down a sink or drain
 Take advantage of community drug take-back
programs that allow the public to bring unused
drugs to a central location for proper disposal
It’s Up to You to
STAMP
Out Prescription
Drug Misuse & Abuse
Why don’t you start today?
For More Information

Prescription and Illicit Drug Abuse: Information on
trend among older adults, tips on prevention, treatment
http://nihseniorhealth.gov/drugabuse

Substance Abuse and Mental Health Services
Administration (SAMHSA)
www.samhsa.gov
888-662-HELP (4357) SAMHSA

Find a Senior Care Pharmacist: Specializing in the
medication needs of older adults
https://www.ascp.com/find-senior-care-pharmacist
Medication Disposal
DisposeMyMeds.org

An online resource to help find medication disposal
programs at the local independent community
pharmacy near you
Drug Take Back Network

Information on permanent and regularly recurring drug
take-back events
www.takebacknetwork.com/local_efforts.html
SMARxT Disposal

http://www.mnsmartdisposal.net/
1c
Attention Seniors:
STAMP Out Prescription Drug
Misuse & Abuse
Join us for a special program on making the
best use of your medicines
Date: ___________________ Time:__________
Location: _______________________________
_______________________________________
Self-Assessment Quiz
Evaluation
Key Messages
•USE YOUR MEDICINE SAFELY
•PREVENT MEDICATION MISUSE & ABUSE!
•CLEAN OUT YOUR MEDICINE CABINET ONCE A YEAR
•DISPOSE OF EXPIRED AND OLD MEDICINE PROPERLY
•NEED MORE INFORMATION ON MEDICATION SAFETY?
STAMP OUT Prescription
Drug Misuse & Abuse Tool Kit
Program is brought to you by The American Society of
Consultant Pharmacists (ASCP). STAMP OUT was developed
by the ASCP Foundation and supported by an educational
grant from Purdue Pharma L.P
STAMP Out Prescription
Drug Misuse & Abuse
Tool Kit Available
ASCP.com/stampout
STAMP Out Prescription
Drug Misuse & Abuse
QUESTIONS?