Not What the Doctor Ordered: Prescription Drug Misuse & Abuse in Older Adults INSERT YOUR NAME HERE

1. Not What the Doctor Ordered:Prescription Drug Misuse & Abuse in Older AdultsINSERT YOUR NAME HERE

2. Older Adults Take More Medicine • Consume 1/3 of all prescription meds • One in four older adults has used psychoactive meds with abuse potential • Prescription drug misuse and abuse is a growing problem • May be as high as 11% of older adult population

3. Definitions Prescription Drug Misuse • The use of a medication other than as directed • May be accidental or willful Prescription Drug Abuse • Intentionally taking medications that are not medically necessary

4. Misuse can Lead to Abuse Patient behavior Prescriber behavior Both The pathway from appropriate use, through misuse to abuse can result from

5. Prescription Drug MisusePatient Behavior • Taking more of a drug than prescribed • Missing doses • Taking the wrong drug • Using a drug for other than the prescribed reason • Sharing or borrowing drugs • Using drugs that have expired • Combining drugs with alcohol or other substances

6. Prescription Drug MisusePrescriber Behavior • Medications w/o indication • Multiple drugs from same class • Dose too high; duration too long • High risk drugs or inappropriate for elderly • Inadequate instructions for taking meds • Failure to question about use of alcohol or other drugs with abuse potential

7. Prescription Drug Misuse is UNSAFE! • Treatment failure • Increased health resource utilization • Physician visits • Laboratory tests • ER visits • Hospitalizations It might lead to prescription drug ABUSE

8. Prescription Drug MisuseRisk Factors • Number of medications • Multiple prescribers • Inappropriate prescribing • Limited English language proficiency • Low health literacy • Memory problems • Hearing/Vision impairments • Treating symptoms and not the cause

9. How Many is Too Many?

10. Prescription Drug AbuseOlder Adults • Present in nearly 15% who seek medical attention • Second only to alcohol abuse • ED visits doubled between 2004 & 2008 • 20% age 70 and older • 1/3 required hospitalization • Projected to double over two decades, to 2.7 million by 2020 • 4.4 million will need substance abuse treatment

11. Commonly Abused Medications • Opioid (narcotic) painkillers • Medicine for anxiety • Sleeping pills • Stimulants

12. Prescription Drug Abuse is UNSAFE! • Health gets worse • Higher risk of accidents • Higher risk of falls and injuries • Serious side effects • Physical dependence and addiction

13. Prescription Drug AbuseRisk Factors • Female gender • Social isolation or loss of social supports • History of mental health problems • History of substance abuse • Exposure or access to prescribed medications with abuse potential

14. Recognizing Prescription Drug AbuseCan Be Difficult • Older adult does not fit the typical drug abuser profile • No validated screening instruments to identify/diagnose drug abuse in geriatric population • Many diseases caused by substance abuse are common disorders in later life • Many symptoms of prescription drug abuse mirror common signs associated with aging

15. Warning Signs Prescription Drug Abuse • Sudden change in behavior • Withdrawal from family, friends, activities • Sleeping during day • Changes in personal grooming, hygiene • Worry about . . . Are the drugs “really working” Having enough medication on hand • Giving excuses as to why they need pills • Sneaking or hiding pills • “Doctor shopping” for several prescriptions

16. How to Help Someone with Prescription Drug Abuse? • Get them to talk to a doctor, counselor or other health professional • Encourage them to be honest about exactly how they are taking their medications • The sooner, the better!

17. Case Study Place Holder

18. STAMP Out Prescription Drug Misuse & Abuse!Tool Kit Developed by Supported by an educational grant from Purdue Pharma L.P.

19. STAMP Out Prescription Drug Misuse & Abuse! Tool Kit Contents • Backgrounder • Getting Started • Flyer • PowerPoint Presentation w/Speaker Notes • Self-Assessment • Evaluation • Handouts

20. Notes Pages: Speaker Tips, Teaching Points & Animation Hints

21. Attention Seniors:STAMPOut Prescription Drug Misuse & Abuse! Making the Best Use of Your Medicines 1c SAFE SENIORS

22. Know Your Medicine As long as I take the medication, it doesn’t matter at what time of day I take it. True or False? On days when I wake up feeling good, I don’t have to take my medication. True or False? I had the same cold last year, so I can use the antibiotics I had left over for this cold. True or False?

23. We Take More Medicine as We Get Older But, as we age, our bodies change. We handle medicine differently than when we were younger. …So, it is important to be careful with medicine. Taking medicine prescribed by your doctor is usually safe and effective.

24. OOPS! Sometimes we don’t take medicine the way the doctor prescribes . . .

25. What Are Some Ways We Take Medicine WRONG? This is PRESCRIPTION DRUG MISUSE • We take MORE • We take LESS • We take more OFTEN • We FORGET • We STOP before we are supposed to • We give OTHER people our medicine • We TAKE other people’s medicine

26. Prescription Drug Misuse is UNSAFE! What can happen if you misuse Prescription Drugs? • You might not get well • You might actually get sicker • You might have to go to the doctor or the hospital • It might lead to prescription drug ABUSE

27. What if Someone Takes Prescription Drugs Wrong on PURPOSE? This is PRESCRIPTION DRUG ABUSE If someone takes: • MORE medicine than prescribed • More often than prescribed • For no MEDICAL reason • Or mixes medicine with alcohol or illegal drugs

28. Commonly Abused Medications • Opioid (narcotic) painkillers • Medicine for anxiety • Sleeping pills Take these medicines only if YOUR doctor prescribed them for YOUand take them just as the doctor ordered!

29. Prescription Drug Abuse is UNSAFE! • Health gets worse • Higher risk of accidents • Higher risk of falls and injuries • Serious side effects • Physical dependence and addiction

30. Recognizing Prescription Drug Abuse Look for these signs . . . • Sudden change in behavior • Withdrawal from family, friends, activities • Rapid increase in the amount of medicine that is needed • Very frequent refills • “Doctor shopping” to get several prescriptions for the same medicine

31. How to Help Someone with Prescription Drug Abuse? • Get them to talk to a doctor, counselor or other health professional • Encourage them to be honest about exactly how they are taking their medications • The sooner, the better!

32. Be Part of the Solution STAMP Out Prescription Drug Misuse and Abuse by • S afely • T aking • All • M edicine • P roperly

33. How to… STAMP Out Prescription Drug Misuse & Abuse! • Keep an up-to-date list of all your medicines – prescription and over-the-counter • Take your medicine list to ALL your medical appointments: doctor, dentist, emergency room visits & hospital stays and share with your pharmacist • Take your medicine EXACTLY as prescribed • Only use the medicine for the reason it was prescribed

34. More STAMP Out Tips! If you are not sure how to take a medicine, ask your doctor or pharmacist Ask your doctor or pharmacist about side effects to watch out for and interactions with other medications Ask how the medicine will affect driving and other daily activities Talk with your doctor BEFORE you change a dose or stop taking a medicine

35. More STAMP Out Tips! • Do not crush or break pills without checking with your doctor or pharmacist • Don’t use someone else’s medicine • Don’t share your medicine with anyone else • Don’t mix your medicines with alcohol • Don’t be afraid to ask for help in organizing your medicines • Schedule a yearly “medication check-up” with your doctor and pharmacist

36. And Finally. . . If you want to help fight Prescription Drug Misuse & Abuse CLEAN OUT YOUR MEDICINE CABINET!!

37. The Medicine Cabinet can be DANGEROUS! • You may become a target for burglary, theft or scams by those looking for drugs to abuse • Accidental poisonings, abuse and misuse often occur when people store old medications in their homes • A majority of abused prescription drugs are obtained from family and friends, including from the home medicine cabinet

38. Prevent Poisonings, Misuse & Abuseand Properly dispose of unused/expired medicine DO NOT FLUSH unused medications DO NOT POUR them down a sink or drain Protect the Environment • Take advantage of community drug take-back programs that allow the public to bring unused drugs to a central location for proper disposal

39. Why don’t you start today? It’s Up to You to STAMP Out Prescription Drug Misuse & Abuse!

40. For More Information • Prescription and Illicit Drug Abuse: Information on trend among older adults, tips on prevention, treatment http://nihseniorhealth.gov/drugabuse • Substance Abuse and Mental Health Services Administration (SAMHSA) www.samhsa.gov 888-662-HELP (4357) SAMHSA • Find a Senior Care Pharmacist: Specializing in the medication needs of older adults https://www.ascp.com/find-senior-care-pharmacist

41. Medication Disposal DisposeMyMeds.org An online resource to help find medication disposal programs at the local independent community pharmacy near you Drug Take Back Network Information on permanent and regularly recurring drug take-back events www.takebacknetwork.com/local_efforts.html SMARxT Disposal http://www.smarxtdisposal.net/

43. Attention Seniors:STAMP Out Prescription Drug Misuse & Abuse! Join us for a special program on making the best use of your medicines! Date: ___________Time:_______ Location: ___________________ ___________________________ 1c SAFE SENIORS

44. Self-Assessment Quiz

45. Evaluation

46. Key Messages