Prescription and Illicit Drug Abuse

Recognizing Substance Abuse

Signs Can Be Missed or Misread

Recognizing the signs of substance abuse or addiction (to prescription or illicit drugs) in older adults is not always easy. Some warning signs -- such as sleep problems, falls, anxiety, depression, and memory problems -- can also be signs of other health conditions. As a result, doctors and family members often do not realize that the person has a problem, and people may not get the help they need.

Behavior Change Can Be a Sign

A person’s behavior, especially changes in behavior, can signal a possible problem. In the case of prescription medications, a family member or friend may notice, for example, that an older adult seems worried about whether a medication is “really working,” or complains that a doctor refuses to write a prescription. He or she may have new problems doing everyday tasks or withdraw from family, friends, and normal activities.

Other Warning Signs

Other warning signs of a substance abuse problem or addiction, may include

  1. mood swings
  2. rapid increases in the amount of medication needed
  3. frequent requests for refills of certain medicines
  4. a person not seeming like themselves (showing a general lack of interest or being overly energetic)
  5. "doctor shopping" (moving from provider to provider in an effort to get several prescriptions for the same medication)
  6. use of more than one pharmacy
  7. false or forged prescriptions.

Questions to Ask

Asking some simple questions can also uncover a substance abuse problem. For example, the CAGE questionnaire, originally developed for alcohol, has been modified to include drug use and has been tested in older adults with some success. CAGE includes four basic questions, with the modified version asking about drinking and drug use:

  1. Have you felt you ought to cut down on your drinking or drug use?
  2. Have people annoyed you by criticizing your drinking or drug use?
  3. Have you felt bad or guilty about your drinking or drug use?
  4. Have you ever had a drink or used drugs first thing in the morning to steady your nerves, get rid of a hangover or, get the day started (as an eye-opener)?

When to Seek Help

Research suggests that answering yes to just one of these questions can identify a potential problem with substance use. If you or someone you know might have a problem with substance abuse or possible addiction, talk to a doctor, substance abuse counselor, or other health care professional. Being honest about substance abuse is a critical step toward getting needed help.