National estimates of exposure to prescription drugs with addiction potential in community-dwelling elders
Department of Medicine, Division of Geriatric Medicine; Meyers Primary Care Institute
Medical Subject Headings
Aged; *Analgesics, Opioid; *Central Nervous System Depressants; Cross-Sectional Studies; Drug Prescriptions; Drug Utilization; Female; Health Surveys; Humans; Longitudinal Studies; Male; Medicare; Risk Factors; Socioeconomic Factors; Substance-Related Disorders; United States
Health Services Research | Primary Care
The use of prescription drugs with addiction potential is an overlooked and growing problem among today's elderly. This paper provides national prevalence estimates of exposure to prescription drugs with addiction potential among community-dwelling elders and explores risk factors for such exposure. Using the Medicare Current Beneficiary Survey, a nationally-representative database of Medicare eligibles, we calculated the prevalence of abusable prescription drug use, overall, by therapeutic class, and by drug. Nearly 22% (7.22 million) of all community-dwelling Medicare elders used at least one prescription medication with addiction potential. Opioid analgesics were used most frequently (14.9%; 95% CI 14.0, 15.8%); central nervous system (CNS) depressants were used by 10.4% of the nation's elders (95% CI 9.5, 10.8%). Using logistic regression analysis, we examined the association of explanatory variables with three outcome variables: any controlled substances use, any opioid analgesic use, and any CNS depressant use. We found that females, whites, those aged 65-79, and those with non-spousal others, were significantly more likely to use one or more prescription drugs with addiction potential, controlling for health status and severity-of-illness. The significance and magnitude of several explanatory variables, including age, race, ethnicity, living arrangement, and health status, varied by therapeutic category. This paper provides an important first step in acknowledging the widespread use of abusable prescription drugs in elders, and provides a foundation for future research and practical solutions to preventing subsequent problem use of prescription drugs.
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Citation: Subst Abus. 2005 Mar;26(1):33-42. DOI: 10.1300/J465v26n01_04