Tag Archives: substance abuse

New tip sheet explores substance use disorders in older adults

Photo by cottonbro via pexels.

Substance abuse among adults over 60, particularly of alcohol and prescription drugs, is one of the fastest-growing health problems in the United States. The National Center for Equitable Care for Elders (ECE) at Harvard estimates that some 5.7 million older people needed treatment for substance use disorders in 2020, about triple that in 2000.

Prescription drug abuse affects up to 17% of older adults, according to The National Institute on Alcohol Abuse and Alcoholism (NIAAA). However, this problem remains underestimated, underidentified, underdiagnosed, and undertreated, aging experts say. Substance use disorders or addictions may be mistaken for other age-related conditions or fall completely off a clinician’s radar as they manage other age-related conditions like diabetes, heart disease, frailty, or cognitive decline. Journalists may be missing out on important story coverage as states and communities readjust their health care priorities in the wake of COVID-19 budget shortfalls.

Older people are more vulnerable to substance abuse or misuse because many may take more medications than necessary to treat their conditions. Medications metabolize more slowly, and older brains may be more sensitive to drugs, according to the National Institute on Drug Abuse. For some, cognitive decline can contribute to confusion about what, when, and how much medication needs to be taken. Risk factors may vary considerably by substance and the specific clinical presentation of a patient (e.g., age, medical comorbidities, current medications, and health history), according to a 2014 study.

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New tip sheet looks at alcohol use and older adults

Photo: Casey Clough via Flickr

It’s legal. It is readily accessible and requires no prescription to purchase. It’s socially acceptable. Yet, it can cause myriad health risks for older adults, from balance problems and falls to drug interactions to death.

“It” is alcohol — a growing concern among clinical and mental health professionals caring for our older population. Continue reading

Calif. nurse rehab program full of holes

ProPublica’s Tracy Weber and Charles Ornstein follow up their investigation of California’s nursing oversight with a story about the failures of the state’s nurse rehab program (Los Angeles Times version; ProPublica version). The embattled California Board of Registered Nursing has touted the program as a safe haven where otherwise good nurses can free themselves of bad habits, but Weber and Ornstein have discovered that nurses often don’t complete the program, and sometimes continue bad behavior unabated despite the voluntary, confidential program’s required drug tests and treatment.

The team has reinforced its data-driven story with well-chosen anecdotes and observations. Program proponents argue that Weber and Ornstein are focusing on a few failures and ignoring the more numerous success stories, but the reporters show that the failures are due, at least in part, to flaws in the program. Even nurses designated as a “public risk” often aren’t investigated until more than year after earning that dubious distinction.

The reporters’ sum up the problem thus: “At the moment, the main person responsible for protecting the public from a drug-addicted nurse in California is the drug-addicted nurse. It’s a risky honor system.”