When Joseph Puglisis beloved grandfather died, it naturally came as a blow. However the real shock caused the death. I lost my grandfather to opioid abuse, Puglisi says, and didnt even understand it till he was on his deathbed.
Puglisi remembers his grandfather as a sort and fun-loving man whose life changed dramatically after he was identified as having arthritis. To alleviate the pain, the patriarch and family protector considered prescription drugs and finally began self-medicating with fentanyl. The escalation didnt stop there.
He was emaciated, but I thought it had been the result of the medications, being unsure of that it had been an addiction, Puglisi explains. I knew he was an alcoholic and he sometimes smoked marijuana, but I thought he was sticking with just those vices. It wasnt until after his death that I then found out he previously started taking heroin, too.
Learning the reality made Puglisi angry. I needed answers to where he got those drugs, and just why he chose never to tell anyone about his addiction. His grandfather was pretty secretive, to state minimal even his part-time caregiver was unacquainted with the opioid abuse and Puglisi recalls feeling devastated: I knew he still had years before him, but additionally felt he was too old to be abusing drugs and really should have known better.
The finish came when, at age 65, Puglisis grandfather overdosed on a variety of fentanyl and heroin. Even then, an almost unbearable stigma remained. Everyone in his community said my grandpa was a junkie, Puglisi says.
In hiding his addiction, Puglisis grandfather endured a lonely struggle, but he was definately not alone. The National Institute on SUBSTANCE ABUSE estimates that 1 million adults 65 and older have a drug abuse disorder. In accordance with a recently available study by Northwestern University, the amount of opioid-related deaths of Americans ages 55 or more soared 1,886% between 1999 and 2019.
Researchers at Northwestern University have discovered that many seniors who overdose on opioids use drugs recreationally, a practice that began within their youth. Somerefer to it lightly as grandpa and grandma on drugs. However the rise of addiction and overdoses in older adults and the very best methods to help those at an increased risk is more technical than that suggests.
Behind the Overdose Data: Death by Despair
Even though some started taking drugs for fun back the Woodstock era, many older adults now use opioids recreationally to flee emotional pain. 1 / 2 of all suicides are overdoses its a phenomenon of death by despair, says Gary Kennedy, MD, professor of psychiatry and behavioral sciences at the Albert Einstein College of Medicine in Bronx, NY, and director of the Division of Geriatric Psychiatry at Montefiore INFIRMARY.
Kennedy sees a correlation between your rise in overdoses in this generation and the pandemic. Due to COVID, folks have experienced social isolation and economic challenges, he says. Many seniors haven’t had the chance to get healthcare and support.
Another contributing factor may be the easy option of highly addictive meds, especially those used to take care of chronic pain. Fentanyl, specifically, poses an enormous problem, says Lewei Allison Lin, MD, MS, associate professor of psychiatry and director of the Addiction Psychiatry Fellowship program at the University of Michigan and a study scientist at VA Ann Arbor Healthcare System. Whenever a person uses fentanyl, their likelihood of overdose get higher, particularly if fentanyl is blended with other drugs.
Meanwhile, many older patients take opioids plus a sedative to take care of insomnia. One particular tranquilizer, benzodiazepine, contributed to around 16% of overdose deaths in 2020. The usage of benzodiazepine in conjunction with an opioid significantly raises the chance of death, in accordance with Susan W. Lehmann, MD, director of the geriatric psychiatry hospital day program at Johns Hopkins Medicine in Baltimore and associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine. Actually, she says, once the two are taken concurrently, its four times the chance.
Another Danger Zone: Street Drugs
Even though many think it is hard to assume their grandparents getting high, an increasing number of seniors are employing illegal hard drugs and which includes heroin. Older adults could have started taking prescription opioids and be addicted, but their doctor would notprescribe them anymore, Lehmann explains. Or they might not afford them anymore. And heroin is less costly.
Needless to say, the ingredients of opioids in love with the road vary, therefore does their strength. These drugs certainly are a many more potent now, and we dont know a whole lot in what other substances could possibly be mixed into them, Lin says, adding, Whenever a drug is stronger, there are plenty more pathways that may result in overdose as soon as you take it. No matter where the drugs originated from, its needed for doctors to obtain their older patient on an opioid withdrawal regimen as quickly as possible. Methadone, the synthetic opioid most widely known as cure for heroin addiction, could be effective in treating other forms of opioid dependence.
Typically, older patients with opioid addiction dont need just as much methadone as younger ones do, Kennedy notes. By the ages of 55 to 60, many graduate from methadone, because theyve physically made all of the progress they are able to taking it. Buprenorphine, a medication that eases the consequences of withdrawal, may also be helpful, in accordance with recent research.
Supporting a mature Patient
Whats the ultimate way to help a parent or grandparent having an opioid problem? Rule one: Dont provide the hands. Addiction is truly a very treatable illness, Lin says. A big proportion of individuals who have it progress. The procedure begins with a foundation of trust and understanding, especially between patient and doctor. Its also vital that you recognize that addiction is physically doing something to your parent or grandparents brain, Lin adds. Your loved ones member is coping with a brain craving. Which means all they consider is taking the drug they’re dependent on.
Older addicts often feel too ashamed to admit they need treatment. The most crucial section of helping someone cope with opioid addiction would be to address the stigma, Lin continues, emphasizing that the caretaker must encourage not judge the individual. Have a look at the underlying factors behind opioid addiction. Your parent or grandparent may have depression or anxiety.
And express your concerns carefully. What will work best is motivational interviewing, Kennedy says. You dont become your parent or grandparents parent. You say instead, Are you currently having difficulty with opioids? In case you are let me assist you to. Ask the question, Isn’t it time to obtain help? If your parent or grandparent responds with Not now, then say, Help me know very well what is keeping you from getting help then. You might hear something you won’t ever knew.
Although older family tend to be reluctant to speak about a drug problem, stories of recovery could be inspiring. I caused a patient, a guy aged 65, who’s now living by himself and successful, Kennedy says. That patient hadnt experienced depression he was simply counting on opioids to alleviate pain and today hes taking methadone within his treatment. Says Kennedy, Its working.
Final rule: Look after yourself plus your cherished one. It took me time and energy to overcome my grandfathers death and move ahead, says Puglisi, who’s now an effective businessman in NEVADA. Based on the experts, thats perfectly OK.