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

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

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

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

Prescription Drug
Misuse
Patient 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

Prescription Drug
Misuse
Prescriber 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

Prescription Drug
Misuse is
UNSAFE
 Treatment failure
 Increased health resource utilization
– ER visits
– Hospitalizations
It might lead to prescription drug
ABUSE

Prescription Drug
Misuse
Risk 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

How Many is Too Many?

Prescription Drug
Abuse
Older Adults
 Drug misuse and abuse is present in 11% of older adults
 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

Commonly Abused
Medications
 Opioid (narcotic) painkillers
 Medicine for anxiety
 Sleeping pills
 Stimulants

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

Prescription Drug
Abuse
Risk 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

Recognizing
Prescription Drug
Abuse
Can 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

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

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

Case Study
Place Holder

STAMP
OUT Prescription
Drug Misuse & Abuse Tool Kit
Program is brought to you by The American Society of
Consultant Pharmacists (ASCP). STAMP OUT was developed by the ASCP Foundation and supported by an educational grant from Purdue Pharma L.P

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

Notes Pages:
Speaker Tips
&
Teaching Points

Attention Seniors:
STAMP
Out Prescription
Drug Misuse & Abuse
Making the Best Use of Your Medicines
1c

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?

We Take More Medicine as We Get Older
Taking medicine prescribed by your doctor is usually safe and effective.
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.

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

What Are Some Ways We
Take Medicine
WRONG
?
 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
This is PRESCRIPTION DRUG
MISUSE

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

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

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

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

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

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

Be Part of the
Solution
STAMP
Out Prescription Drug
Misuse and Abuse by
 S afely
 T aking
 A ll
 M edicine
 P roperly

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

More
STAMP
Out Tip
 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

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

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

The Medicine Cabinet can be
DANGEROUS
 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
 You may become a target for burglary, theft or scams by those looking for drugs to abuse

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

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

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

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.mnsmartdisposal.net/

1c
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: _______________________________
_______________________________________

Self-Assessment Quiz

Evaluation

Key Messages
•USE YOUR MEDICINE SAFELY
•PREVENT MEDICATION MISUSE & ABUSE!
•CLEAN OUT YOUR MEDICINE CABINET ONCE A YEAR
•DISPOSE OF EXPIRED AND OLD MEDICINE PROPERLY
•NEED MORE INFORMATION ON MEDICATION SAFETY?

STAMP
OUT Prescription
Drug Misuse & Abuse Tool Kit
Program is brought to you by The American Society of
Consultant Pharmacists (ASCP). STAMP OUT was developed by the ASCP Foundation and supported by an educational grant from Purdue Pharma L.P

STAMP
Out Prescription
Drug Misuse & Abuse
Tool Kit Available
ASCP.com/stampout

STAMP
Out Prescription
Drug Misuse & Abuse
QUESTIONS?