Aging symptoms might be drug abuse, study suggests

January 03, 1995|By Linda Carroll | Linda Carroll,Medical Tribune News Service

Could Grandma's forgetfulness actually be a sign of drug addiction? Perhaps, according to a new study that found that sleeping pills and pain-killers are among a handful of prescription drugs that may be abused by the elderly.

Among older people, women and those suffering from depression or anxiety disorders are more likely to become addicted, researchers reported in the December issue of Mayo Clinic Proceedings.

"It's important for people to know that it is possible to become addicted to certain medications that are prescribed by doctors," said lead author Dr. Richard E. Finlayson, a psychiatrist and medical director of the Inpatient Addiction Program at the Mayo Clinic in Rochester, Minn.

Drug dependence in the elderly can be difficult to diagnose, according to Dr. Finlayson. Symptoms of the addiction may be misinterpreted simply as signs of aging.

"These medications can cause memory problems and cause a person to be more likely to fall and injure themselves," Dr. Finlayson cautioned. "Symptoms in an older person shouldn't automatically be written off by saying he or she is old or senile."

Other experts disagreed on whether addiction is a big problem among seniors.

Dr. Steffie Woolhandler said that doctors may be misprescribing medications to their patients.

"Often drug dependence is caused by the physician rather than the patient," said Dr. Woolhandler, an associate professor of medicine at Harvard Medical School in Boston. "When a patient comes in really suffering from insomnia, the physician thinks he is helping by prescribing sleeping pills. But often the pills are prescribed for too long and the patient becomes dependent on them."

Dr. Robert Vestal said sleeping pills should be avoided entirely by the elderly.

"You have to explain to the patients that it's not uncommon for older people to have trouble sleeping and that patterns of sleep change with age," said Dr. Vestal, chief of the clinical pharmacology and gerontology research unit at the Department of Veteran Affairs Medical Center in Boise, Idaho, and professor of medicine at the University of Washington School of Medicine in Seattle. Taking a sleeping aid or other drug is not the solution, he said.

Another expert on the elderly said she agrees that depression can lead to prescription drug addiction. But the Mayo Clinic study doesn't prove that drug dependence among the elderly has become a major problem, said Dr. Judith Ahronheim.

"They only found 100 patients over 20 years," said Dr. Ahronheim, an associate professor of geriatrics and an associate professor of medicine at the Mount Sinai School of Medicine in New York City.

Dr. Ahronheim said she is concerned that this study might scare patients with chronic pain away from drugs that might give them relief.

"Addiction is extremely uncommon when we use these drugs to treat patients with terminal cancer," she said. "We need these drugs to keep patients free of pain and to improve their quality of life."

Dr. Finlayson studied 100 elderly patients who had been admitted to the Mayo Clinic's Inpatient Addiction Program. Most -- about 70 percent -- were women, he noted.

Almost half of the patients were addicted to narcotics, while 80 percent were addicted to sedative-hypnotics -- sleeping pills.

More than a third of the patients suffered from some sort of mood disorder, such as depression, while another third suffered from a personality disorder.

Dr. Finlayson said he suspects that many patients have been prescribed tranquilizers to combat sleeping problems and anxiety, when they really need anti-depressants or psychotherapy.

"If they're only given tranquilizers they may sleep better and their anxiety levels may diminish -- but these symptoms may only be secondary to a major depression," he said.

If the depression itself isn't treated, a patient may continue to take the drugs for short-term relief. As time goes on, the patient may become addicted, according to Dr. Finlayson.

Patients who have lost someone dear to them often need help in dealing with their grief, Dr. Finlayson said.

"Often bereaved patients don't receive the psychological help they need and are instead given sleeping pills," he said.

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