Seniors Care: Opioids and the Elderly | Care for the elderly

Some older adults have sold their prescription opioids to earn extra income, fueling the addiction of victims that they will never meet. Others get illegal opioids when they can no longer afford to have access to prescribed pills, such as OxyContin, Oxycodone and Hydrocodone.

An example is a 75-year-old woman who was hospitalized for heroin addiction, provided by a family member when she was no longer able to obtain an opioid prescription for her pain. chronic. This is an unintended consequence of the 2016 directive on prescription of opioids for chronic pain, published by the Center for Disease Control (CDC).

The CDC guidelines are based on three principles: "(1) Non-opioid treatment is preferable for chronic pain apart from active cancer, palliative care and end-of-life care; (2) When opioids are used, the lowest effective dosage should be prescribed to reduce the risk of opioid-related disorders and overdose; and (3) clinicians should always be cautious when prescribing opioids and closely monitoring all patients.

This recent impediment to prescription opioids for chronic pain occurs after a 20-year period when pharmaceutical companies measured their profits in billions of dollars, while opioid pills were redirected to the black market . For example, congressional hearings revealed that Miami-Luken provided, in seven years, 20.8 million opioid tablets to pharmacies in Kermit, West Virginia, a city of only 3,000 residents.

OxyContin, launched in 1995 by Purdue Pharma, has claimed the title of "safe medicine for pain relief". Purdue's strategy to promote OxyContin sales included: recruiting physicians for lavish "educational trips" to resorts; pay premiums of more than $ 40 million in 2001 to sales representatives; and give free prescriptions for a supply of 7 to 30 days, which leads some users to become addicted.

Many governments, including Cumberland, York and Dauphin counties, have sued Purdue, a private company owned primarily by the Sackler family, which in 2015 joined Forbe's list of the richest families in America. .

The US Department of Justice obtained a criminal conviction against Purdue Pharma, which included a $ 640 million fine, only a fraction of the profits of OxyContin. Rudy Giuliani was Purdue's lawyer and negotiated an agreement to avoid the imprisonment of Purdue executives or a federal ban on OxyContin sales.

Ironically, last week, Purdue received a patent to prescribe a buprenorphine patch for opioid addiction, which the CDC describes as an epidemic, having experienced a "first wave" with the increased prescription of opioids in the 1990s OxyContin . On the same day, the Colorado Attorney General announced the latest lawsuit, accusing Purdue of "willful misconduct" related to "Purdue drugs associated with their reckless marketing."

To measure the challenges, the Council of Economic Advisers estimated that the opioid crisis cost the United States $ 504 billion in 2015, or 2.8 percent of gross domestic product (GDP).

Governor Tom Wolf implemented a policy change earlier this year to make physician-assisted treatment (MAT) more accessible in Pennsylvania, a move supported by Macy's research and compatible with drug-assisted therapy. . Drugs such as Suboxone and Vivitrol, combined with psychotherapy, can help people stop using heroin or consume prescription opioids.

While some supporters of a "12-step recovery model" blame MAT for replacing one addiction with another, most experts believe that MAT is an effective way to combat opioid addiction, a killer ruthless.

According to the CDC, from 1999 to 2016, more than 630,000 Americans died from drug overdoses. To put it in perspective, the Watson Institute for Public and International Affairs at Brown University estimates that in a similar period, fewer than 395,000 people were killed directly in the wars of war in Afghanistan, Iraq and Pakistan.

The CDC says that from 1999 to 2014, more than 165,000 Americans died from overdoses related to prescription opioid medications. This is the same number of civilian casualties that the Watson Institute estimates to have occurred during the Iraq war during the same period.

This comparison with the victims of the war reminds us that after the American Civil War, America experienced an epidemic of opioid addiction among amputees and others suffering from the physical and emotional wounds of this war.

A 2017 publication entitled "Raising awareness and seeking solutions to the impact of the opioid epidemic on older adults in rural areas" found that rural Americans are almost twice as likely to take pain relievers prescribed as city dwellers. Although people over the age of 65 have an overdose death rate of about one-third that of the general population, a 2010 National Institute of Health study reported "a high and rapid rate of opioids in the general population, especially among the elderly. "

Older people also suffer collateral damage. Instead of freedom during retirement, they can raise a grandchild because of opiate addiction or the death of their own child. They hide family items to prevent them from being stolen by their children who are desperate to buy money to buy opioids.

Experts fear that the complex issues of aging baby boomers who have become dependent on opioids prescribed for workplace injuries, post-traumatic stress disorder (PTSD) and chronic pain are exhausting the future resources of organizations delivering health care .

On Wednesday, October 24, Keystone Elder Law is sponsoring a symposium for health care and long-term care professionals. He presents a talk on "The Opioid Crisis and its Impact on the Former Pennsylvanians" offered by Secretary Teresa Osborne Department of Aging and Secretary Jennifer Smith of the Department of Anti-Drug and Alcohol Programs. Information about other stakeholders, continuing education credits and registration are available on our website at https://keystoneelderlaw.com/symposium.