Opioid misuse also an issue among elders

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LA CROSSE, Wis. (WKBT) - A local agency for seniors and health experts say opioid misuse among older adults has been going on for a while, but it's now being brought to the forefront.

“I think just our society, we're finally coming to the recognition that this is an issue,” said Peggy Herbeck, supervisor at the Aging Disability Resource Center of La Crosse County.

Attorney General Brad Schimel's new task force on elder abuse targets opioid misuse among senior citizens, and according to Schimel, last year, more than 4,000 people 55 or older in Wisconsin went to the hospital for opioid dependence or poisoning.

“Boy, that was surprising to me,” Herbeck said. "In the past, we wouldn't have realized it was an opioid issue. Maybe we would've put it off to more a casual, 'Oh, the person made a mistake on their prescription.'"

Dr. Chris Eberlein of Gundersen Health system thinks that 4,000 figure doesn't tell the whole story.

"The numbers they're not catching are the elderly patient that took the opiate and fell down,” he said, adding that eldery opioid misuse is a local issue, but not necessarily in the same way it is for the younger population.

"A lot of your seniors are not purposely trying to abuse these drugs,” Eberlein said.

Instead, he said seniors may get confused on their dose, or have more exaggerated reactions to opioids because of their age or interactions with other medications.

But of course, seniors can be addicted as well.

"These are the patients we've really got to get help because they're at much higher risk of these poisonings as well,” Eberlein said.

Dr. Eberlein advises patients to make sure their doctors know of all the drugs they’re taking. He also thinks it’s a good idea for seniors to have Narcan on hand when they go home with opioid prescriptions.

"We all have to work together on this issue,” Herbeck said.

She believes it’s important for everyone to work with their physicians to make sure their prescriptions are at the right dose.

Herbeck said the increased information about opioids' potential dangers also makes a difference.

"Just this last week I had conversation with two different people, young elders, who decided not to ask for any type of a narcotic painkiller,” she said. “(They) asked their physician, isn't there something else they could be prescribed?”

According to the attorney general, a statewide prevention campaign called Dose of Reality will be providing information and resources for senior centers and elder healthcare facilities on opioid issues. More information can be found here.

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Opioid misuse also an issue among elders

Long-term use of opioid patches common among persons with Alzheimer's disease

Approximately seven per cent of persons with Alzheimer's disease use strong pain medicines, opioids, for non-cancer pain for a period longer than six months, according to a recent study conducted at the University of Eastern Finland. One third of people initiating opioid use became long-term users, and long-term use was heavily associated with transdermal opioid patches. The results were published in PAIN.

The researchers found that long-term use of opioids was approximately as common among persons with Alzheimer's disease as it was among those without it. However, long-term use of transdermal patches was twice as common among persons with Alzheimer's disease, while tablet form opioids were more common among those without Alzheimer's disease. In addition, long-term opioid use together with benzodiazepines was common, which is worrying as both medicines cause drowsiness.

The use of opioids was studied from the date of Alzheimer's disease diagnosis until death or admission into a long-term care facility. Those with active cancer treatment were excluded from the analysis.

Long-term opioid use is a problematic practice for non-cancer pain. Evidence of its benefits is limited, and the risk of adverse effects is increased compared to short-term treatment. Further, research on the benefits and adverse effects of long-term opioid use is very scarce among older adults and especially those with dementia. Changing doses and stopping medication when using patch-form opioids requires more time and thus, entails more careful monitoring. Pain, the need for analgesics, and possible adverse effects related to analgesics should be assessed regularly among persons with dementia.

The study is part of the MEDALZ cohort, which included 67,215 persons with Alzheimer's disease diagnosed during 2005-2011, of whom 13,111 initiated opioid use. Each person with the disease was matched with a comparison person without Alzheimer's disease of the same age, gender and region of residence. Data for the study were derived from Finnish nationwide registers.

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Long-term use of opioid patches common among persons with Alzheimer's disease

Lawmakers turn attention to opioid abuse

Missouri Sen. Claire McCaskill

Drug abuse in the United States has become a growing threat, and Washington has taken notice.

Only a few sentences into his State of the Union address last week, President Obama cited “battling prescription drug abuse” as one issue in which a divided Congress might find bipartisan agreement.

In Missouri, that seems to have already begun.

On Tuesday, Democratic Sen. Claire McCaskill led a field hearing in Jefferson City addressing what she termed an epidemic of opioid addiction in the United States.

Last week, Republican Sen. Roy Blunt spoke about the issue on the Senate floor, noting that the problem has especially grown among American veterans prescribed painkillers to deal with their service-related injuries.

News reports have pointed to the White House forming an interagency federal effort, headed by Agriculture Secretary Tom Vilsack, to look at the prescription drug and heroin problems in rural America.

A statistical starkness emerges from this. A Centers for Disease Control and Prevention report issued this month revealed “a 200 percent increase in the rate of overdose deaths involving opioids” between 2000 and 2014. In 2014, more than 47,000 drug overdose deaths occurred in the United States.

The CDC also pointed to 12,000 members of the Baby Boom generation dying from drug overdoses in 2013, a number that tops the deaths caused by car accidents or flu and pneumonia. The Aging Committee has taken on the issue because of the projection that, by 2020, 5.7 million Americans older than 50 will require treatment for substance abuse.

Opioids, such as Vicodin and OxyContin, serve as pain management drugs in many treatment regimens.

“Prescription drug abuse and heroin use is a major public health crisis that affects every community across this nation, and has unfortunately claimed the lives of many Americans,” McCaskill said at Tuesday’s hearing.

“Studies show that four out of five people who abused prescription opioids eventually transition to heroin as pills become too difficult or expensive to obtain. Today’s prescription opioid abuser could easily become tomorrow’s heroin user.”

Blunt, who chairs the Senate Appropriations subcommittee that deals with federal health-care programs, reinforced this, saying that the path between prescription drug abuse and heroin use has become well-traveled.

“We have made a new commitment to this issue with new programs that are targeted to combat opioid abuse ... with almost three times the investment that the country made before,” he told fellow senators. “This is truly becoming an epidemic, and we need to deal with that epidemic sooner rather than later.”

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Lawmakers turn attention to opioid abuse