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In contemporary society, there has been an increase in the use and abuse with illicit drugs in the United States, specifically with prescription drugs. Though most statistics and attention is focused on youths, the elderly are more prone and at risk to abuse their opioid medication. This is due to common misconceptions about the addictive properties and dangers of prescription medications. Health insurance coverage also influences use among the elderly. It is a common misconception that prescription medications are safe. However there still is potential for abuse, overdose, serious side effects, or even death.
Additionally, opioid abuse is a gateway to more potent narcotics such as heroin. Opioid prescription drug abuse is taking an opioid medication without a doctor’s prescription or in a way that differs from the doctor’s orders. 16 million people in the United States abuses prescription medications (Ashraf). In general men abuse prescription medications more than women.
Teens from ages 12 to 17 females abuse prescription medications more than males.
Prescription drug abuse rates are highest among teens and people in their 20s however the rate is increasing among those in their 50s. Abuse of prescription medications can lead to tolerance. Tolerance is the body’s adaptation to the medication over a period of time. The body no longer produces the desired effect and a higher dose is needed in order for there be the desired effect again. Abuse can also lead to withdrawal which are the symptoms that can occur when a person stops taking the drug or reduces the dose abruptly (Ashraf, 2016).
Tolerance and withdrawal are signs of physical dependence. Opioids are the most commonly abused prescription medication. Opioids decrease a person’s ability to perceive pain. It also affects the reward center in the brain causing the person to experience a sense of euphoria. The most commonly abused opioids are Fentanyl, Hydrocodone, Oxycodone, Oxymorphone, Propoxyphene, Hydromorphone, Meperidine and Diphenoxylate (NIDA). Opioid prescription drug abuse is responsible for about 75% of overdose related deaths, which is more than any other prescription or illegal drug (Ashraf). Common symptoms of opioid abuse are drowsiness, dizziness, weakness, sweating, reduced respirations, and more. Common withdrawal symptoms include restlessness, vomiting, diarrhea, pain, and chills. Opioid abuse can also lead to coma or death (Ashraf).
Additionally, opioid prescription drug abuse is responsible for 1.4 million emergency room visits per year. People between the ages of 45 and 49 have the highest death rate from overdoses (Ashraf). Opiates and heroin were responsible for nearly 30,000 deaths in the United States in 2015 (Oliver). The reason for the high prevalence of prescription drug abuse can be attributed to ease of access (NIDA, 2016). The number of prescriptions for opioids has increased since the early 1990s. There is also misconception about the addictive properties and danger of these mediations. 54% of the time the source where the user obtained the medication was free from a friend or relative. 14.9% it was bought from or taken from a friend or relative. Only 19.7% was from a doctor [ CITATION Cen17 \l 1033 ]. While prescription drug abuse affects many American youths, however the elderly are at particularly high risk. Among the youth the rate of nonmedical use of a prescription drug is higher than marijuana, cigarette smoking, binge drinking or any other illicit drug (Ashraf). Nonmedical use of a prescription drug is highest among those ages 18 to 25 with 4.4% reported nonmedical use of a prescription drug within the past month. Between the ages of 12 and 17, 2.6% reported nonmedical use of a prescription drug within the past month (Ashraf). Youth who misuse prescription drugs are more likely to misuse other drugs as well. Medical use of prescription opioids is associated with a higher risk of future opioid abuse. 75% of heroin addicts started using prescription opioids before heroin (Oliver, 2016). Among the elderly polypharmacy, which is being prescribed multiple prescription drugs to treat a health, condition is very common. 80% of older adults between the ages of 57 and 85 are taking at least one prescription drug. 50% take at least 5 prescription drugs. There is a higher rate of pain and chronic disease among the elderly however polypharmacy puts the patient at risk of taking the drug in a way unintended by the physician, side effects, and serious drug interactions. In the elderly their bodies are not able to metabolize these medications as quickly as the youth resulting in an accumulation of the drug in their system and an increased risk for overdose and drug interaction (NIDA). This makes prescription drug abuse among the elderly particularly dangerous.
Health insurance coverage influences the rate of opioid use among the elderly. 28% of the elderly in 2011 received opioid medications for pain not associated with cancer or hospice care. 1.7 million of those patients received a dose that put them at increased risk of overdose. Health insurance coverage makes the medication more affordable and it covers the refills. Health insurance coverage makes it more available to the patient, but also likely the patient will abuse or misuse their medication. Due to the concern over the high prescription rate from doctors and concern over patients abusing their opioid prescription many doctors have recently become hesitant to write prescriptions. It is difficult to distinguish drug seeking and a genuine need. This has caused many patients to suffer needlessly. Opioids are in a lot of cases the most effective treatment for a lot of different kinds of pain (Oliver). What doctors can do to prevent opioid abuse is to screen patients for potential for drug abuse, try non-pharmacological treatments for pain first, start with the lowest dose and frequency possible to still receive the desired effect and increase the dosage or frequency slowly if need be. Opioid abuse is a rising concern among the youth and elderly.
The most common misconceptions about the addictive properties and danger of prescription medications are still prevalent today. In reality, opioids can be addictive and an addiction carries serious health consequences. Opioid abuse is also due to easy access because of high prescription rates from doctors and health insurance covering the costs. In general most users receive their medication free from a friend or relative. However with proper screening for drug abuse and proper pain management opioid abuse can be reduced and prevented.
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