Being Thankful for the Road to Recovery

The prevalence of opioid addiction and overdose has skyrocketed since the early 1990s. According to the National Institute on Drug Abuse (NIDA) and the Centers for Disease Control and Prevention (CDC), overdose deaths from any opioid have increased sevenfold, and overdose dusts relating to commonly prescribed opioids, including natural and semi-synthetic opioids and methadone, have more than tripled.

With the holidays around the corner, it is imperative for health and human services (HHS) organizations, post-acute care (PAC) providers and other health care professionals to understand the signs of opioid addiction, how it differs between age groups, its risk factors and dangerous dance with co-occurring conditions.

What Are the General Signs of Opioid Abuse?

The signs of opioid addiction may vary significantly and depend on the specific drug taken. However, the most common signs of general drug abuse or addiction, reports the NIDA, include the following:

• Sudden changes in weight.
• Unusual smells on the breath, body or clothing.
• Changes in mood.
• This interest or lack of interest in engaging relationships or activities.
• Bloodshot eyes and pupils that are larger or smaller than usual.
• Impaired speech and coordination.
• Changes in physical appearance.

The predominant opioids abused include heroin, narcotics, Vicodin and OxyContin.

Description drug abuse is the leading cause of heroin abuse in the U.S., so it is important for HHS, PAC and other healthcare providers to understand its short-term and long-term effects, which include the following:

• Dry mouth.
• Warm flushing of the skin.
• Nausea and vomiting.
• Severe itching.
• Impaired mental judgment.
• Slipping between consciousness and semi consciousness.
• Insomnia.
• Collapsed veins among individuals injecting heroin or other opioids.
• Damaged tissue in the nose among those snorting or sniffing the drug.
• Infection of the cardiovascular system.
• Abscesses.
• Constipation and abdominal pain.
• Liver and kidney disease.
• Pneumonia another lung problems.
• Depression and other symptoms of worsening mental disorders.
• Sexual dysfunction.
• Irregular menstrual cycles.

Any of the after mentioned signs may also allude to prescription opioid abuse and depend on ends with which it was ingested, consumed or abused.

Signs of Opioid Abuse Among Different Age Groups.

As explained by the NIDA, the high prevalence of heroin as the opioid of choice, in combination with prescription drug abuse, indicates people may not be aware of how to recognize the signs of opioid addiction among different age groups.

• Teens. Teenagers may experience unusual mood changes, stunted growth and problems with school, family or work responsibilities.
• Young Adults. In addition to the signs of opioid or heroin abuse, young adults may exhibit problems similar to teens suffering from opioid addiction. Furthermore, young adults may have repeated run-ins with law enforcement and experience trouble keeping up with typical responsibilities.
• Middle-Aged Adults. Middle-aged adults may exhibit unusual, unexplained financial stress, withdrawal from family or friends and the other signs of addiction.

Although anyone 65 and older is generally considered a “senior,” seniors fall into three primary age groups.

• Youngest Old. This age group includes seniors ages 65 to 74.
• Old. This group includes seniors aged 75 to 84.
• The Oldest Old. Seniors aged set 85 and above fall into this group.

More than 43.1 million people ages 65 and over live in the United States, and this statistic is expected to reach 20 percent of the total US population by 2020, reports the Substance Abuse and Mental Health Services Administration (SAMHSA). Among all seniors, only 25.8 percent have ever used illegal drugs. However, the same percentage also appears among seniors living with mental health disorders, like depression, schizophrenia, bipolar disorder and generalized anxiety disorder.

Among all senior age groups, the same general signs of addiction may exist. However, the signs may appear in tandem with any of the signs of addiction among younger age groups, including teens and young adults. In addition, seniors may experience unexplained, continued injuries and health problems that appear unrelated to the traditional signs of aging.

For example, someone in the “oldest old” age group experiencing a rare, blood-borne infection of the cardiovascular system, with no known route of transmission, may have previously used or injected opioids or other drugs.

Unfortunately, the signs of aging tend to overshadow signs of opioid addiction among seniors.

Opioid Abuse Among the Elderly Is Underdiagnosed.

Although the CDC recently released new prescribing guidelines for opioids, healthcare professionals may not realize elderly persons in care are suffering from opioid addiction. According to The Chicago Tribune, physicians have increasingly prescribed opioids to seniors upon discharge from hospitals. In fact, up to 42 percent of seniors discharged from hospitals continue taking opioids after three months. When released back to their place of care, hospitals and facilities do not always accurately or effectively communicate what medications seniors are prescribed. This can often lead “poly-pharmacy,” or overprescribing, which creates risk for dependency.

Even seniors who take medications as prescribed may still begin to exhibit the signs and symptoms of opioid abuse, especially when taking medications following surgical procedures. In addition, the American Geriatric Society advocated for the use of opioids for pain management among seniors in 2009, citing a belief in evidence that seniors were less likely to develop addictions.

Part of this misconception derives from the low-risk behaviors. Most seniors engage in. In other words, seniors are less likely to engage in risky behaviors, like theft or burglary, to obtain opioids. Yet, prescribers continued giving seniors opioids in the first place, and paired with the financial stability of seniors, the risk for misdiagnosis and under diagnosis of opioid abuse in these age groups grew.

What Does It Mean to Your Organization?

Thanksgiving is supposed to be a joyous time, a time for celebrating and reminiscing on the things everyone is thankful for. It’s important to be aware that the opioid epidemic is leaving many families feeling lost and saddened following the death or overdose of those suffering from opioid addiction. Approximately 91 people die every day from this epidemic, and your organization can help stop it.

Encourage non-opioid and non-pharmacologic therapies to treat and manage pain among those you serve. Share the statistics with your staff members, friends and other community outreach partners. Take an active role in identifying those at highest risk for unchecked opioid addiction, like seniors, raise awareness, and do your part to stay informed.

Start with learning how the new Opioid Commission Report effects the healthcare landscape. Watch our Opioid Commission Report Webinar with representatives of the North Carolina Department of Health and Human Services: Susan Kansagra, MD, MBA, Section Chief of the N.C. Division of Public Health, Chronic Disease and Injury Section, and Jason E. Vogler, Ph.D., CSSBB, Senior Director of the Division of Mental Health, Developmental Disabilities and Substance Abuse Services.

Remember, opioids do not discriminate; they work by impacting receptors in the brain. Addiction can and will set in among anyone using them unnecessarily.