Not What the Doctor Ordered:Prescription Drug Misuse & Abuse

in Older Adults

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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

Patient behaviorPrescriber behaviorBoth

The pathway from appropriate use, through misuse to abuse can result from

Prescription Drug MisusePatient 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 MisusePrescriber 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 MisuseRisk 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 AbuseOlder 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 AbuseRisk 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

Attention Seniors:STAMP Out Prescription Drug

Misuse & Abuse

Making the Best Use of Your Medicines

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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 yourdoctor 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

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 can happen if you misuse Prescription Drugs?

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

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

Look for these signs . . .

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

SafelyTakingAllMedicineProperly

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 YOURMEDICINECABINET

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

STAMPOut 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.gov888-662-HELP (4357) SAMHSA

Find a Senior Care Pharmacist: Specializing in the medication needs of older adultshttps://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/

Attention Seniors:STAMP Out Prescription Drug

Misuse & AbuseJoin us for a special program on making the

best use of your medicines

Date: ___________________ Time:__________

Location: ______________________________________________________________________

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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

Tool Kit Available

ASCP.com/stampout

STAMP Out Prescription Drug Misuse & Abuse

STAMP Out Prescription Drug Misuse & Abuse

QUESTIONS?