Substance Abuse in the Elderly: The Boomers Change Things Again
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Steven T. Dekosky M.D.- Member, RiverMend Health Scientific Advisory Board for Addiction & Psychiatry. Professor of Neurology, Director, Alzheimer’s Disease Research Center, University of Virginia School of Medicine, Charlottesville, VA USA Dr. DeKosky addresses the RiverMend Health Scientific Advisory Board on substance abuse in older generations and the growing need for treatment. For more information visit: http://www.rivermendhealth.com/scientific-advisory-board-addiction.html
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Brain changes that occur over time with drug use challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs. This is why drug addiction is also a relapsing disease.
Relapse is the return to drug use after an attempt to stop. Relapse indicates the need for more or different treatment.
Most drugs affect the brain's reward circuit by flooding it with the chemical messenger dopamine. This overstimulation of the reward circuit causes the intensely pleasurable "high" that leads people to take a drug again and again.
Nurses Role On Substance Abuse By Philo
1) Nurses play a vital role in caring for patients experiencing substance abuse issues, including managing withdrawal symptoms and preventing relapse.
2) They meet patients' basic needs, administer substitution therapies, educate on health risks, and develop treatment plans addressing the psychological and social factors underlying substance dependence.
3) Nurses also support family members and encourage participation in rehabilitation programs to establish substance-free lifestyles and coping strategies for long-term recovery.
Drug Abuse and Misuse
The document discusses drug abuse and misuse. Drug abuse is defined as a maladaptive pattern of substance use leading to compulsive, excessive, self-damaging use of drugs for non-medical purposes. Drug misuse refers to improper use of prescription medications with abuse potential and known adverse effects. Both drug abuse and misuse can have harmful effects and involve excessive or improper use of drugs. The terms drug abuse and misuse have evolved over time and been defined differently depending on the organization.
Substance use in children and adolescent
This document provides an overview of adolescent substance abuse, including epidemiology, etiology, neurobiology, assessment, diagnosis, and treatment. Some key points:
- Substance abuse is common among adolescents, with 11.4% meeting criteria for a substance use disorder. Marijuana is the most commonly used illicit drug.
- Risk factors for adolescent substance abuse include genetics, prenatal substance exposure, childhood abuse/neglect, parenting influences, deviant peer groups, and externalizing disorders.
- Adolescents are vulnerable to substance abuse due to an imbalance between developing cognitive control systems and mature reward systems in the brain. Substance use can negatively impact brain development.
- Assessment of adolescent substance
Substance Abuse Prevention
This document summarizes substance abuse prevention. It discusses substance use on a continuum from social to dependent use. Prevention aims to foster healthy behaviors and prevent issues. Risk factors for substance abuse include genetics, mental health issues, and social influences; protective factors enhance resilience. The document provides an overview of prevention goals and strategies at various levels, from individual to community. Resources for prevention programs are also listed.
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This document discusses reasons for drug use and addiction. It provides 10 reasons why drug use is more serious today, including increased potency of drugs, younger age of experimentation, and greater availability of information. It then covers basic reasons people use drugs, the nature and costs of addiction, and risk factors. Biological and psychological explanations for drug use are presented, including the role of genetics and drugs activating the brain's reward system. Finally, signs of drug abuse and risks of different drug choices are outlined.
Drug addiction (causes and treatment)
Addiction is a biopsychosocial disorder characterized by repeated use of drugs, or repetitive engagement in a behavior such as gambling, despite harm to self and others.
intro_to_addiction_merlo
This document provides an introduction to addiction as a brain disease. It begins by defining substance use disorders and reviewing DSM-IV criteria for substance abuse and dependence. Epidemiological data on the prevalence of alcohol and drug use in the United States is presented. The neurobiology of addiction and how chronic drug use affects the brain is explained using imaging studies. The document concludes by discussing how physicians can intervene to treat addiction using screening, brief intervention, and referral to treatment methods.
Goldberg Chapter 2
This chapter discusses drug use in contemporary society. It notes that nearly every American has used a mind-altering substance such as alcohol, cigarettes, or caffeine. It provides statistics on drug use from national surveys. It discusses the health, social, and economic costs of drug use as well as patterns of drug taking and the extent of drug use according to national surveys. It also covers topics like drug use and education/employment outcomes, drug testing policies, and the large illegal drug business.
Goldberg Chapter 3 Motivations for Drug Use
This document discusses various motivations for drug use, including experimentation among youth, seeking pleasure or relief from boredom, peer influence, spiritual purposes, and rebelliousness. It also examines theories of drug addiction including personality, reinforcement, biological, genetic, social, and media influences. Finally, it covers performance-enhancing drugs used by athletes like anabolic steroids, human growth hormones, and stimulants and the risks associated with their use.
Goldberg Chapter 3
This document discusses various reasons why people use drugs, including experimentation, pleasure-seeking, peer influence, spiritual purposes, and rebelliousness. It also covers the differences between drug dependency and addiction, and discusses several theories for why drug addiction occurs, such as genetic predisposition, personality traits, reinforcement, and social/cultural factors. Finally, it examines the use of performance-enhancing drugs in sports and their associated health risks.
Psychopharmacology
This document discusses the over-medicalization and over-prescription of psychiatric medications. It notes that as diagnoses have increased in the DSM, the number of medications prescribed has also increased dramatically without corresponding decreases in rates of mental illness. Long-term use of these medications can cause drug dependency and physical changes to the brain. Alternatives to medication such as lifestyle changes are presented as better solutions to support mental health.
Psychopharmacology
This document discusses the problems with the medicalization and over-prescription of psychiatric medications. It notes that as diagnoses have increased, so too have prescriptions, yet the number of people diagnosed with mental illness has not decreased. It examines how the push for psychology to be taken seriously as a medical field led to a focus on drugs over therapy. Statistics are provided showing rising rates of diagnoses, prescriptions, and disability related to mental illness. Alternatives to medication like counseling, exercise, nutrition, and social support are proposed.
Drug Abuse
People use drugs for several reasons, including peer pressure, thrill-seeking, and to self-medicate emotional needs. Addiction is now recognized as a chronic relapsing brain disease, characterized by compulsive drug use despite negative consequences. It progresses through stages as tolerance increases and brain changes persist for years after drug use. While drugs can have medical benefits when properly used, drug abuse has significant health and social costs, including increased crime and family problems. Education and treatment aim to prevent misuse and support recovery from addiction.
drugs.ppt
This document discusses the growing problem of prescription drug abuse among teens and young adults. It notes that teens say prescription drugs are easy to get, legal, and not considered addictive. It explores where teens are getting the drugs, like from family medicine cabinets, and why they use them, such as for depression, anxiety, or fitting in. The document outlines several prescription and over-the-counter drugs that are commonly abused, like DXM in cough syrup, and notes the health risks of prolonged drug use and addiction. It also discusses warning signs of drug abuse and provides resources for parents on prevention.
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This document discusses substance use disorders and related topics. It notes that over 16.6 million Americans have an alcohol use disorder, and nearly 88,000 people die each year from alcohol-related causes. Substance abuse is difficult to determine precisely due to unreported cases. Types of substances that can be abused include alcohol, sedatives, stimulants, cannabis, opioids, hallucinogens, and inhalants. The causes of substance abuse involve biological, psychological, social, and environmental factors. Different substances cause various intoxication, withdrawal, and overdose symptoms that require medical management.
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This document discusses substance use disorders and alcohol abuse. It defines substance use disorders according to DSM-IV criteria as substance abuse or dependence. Dependence involves tolerance, withdrawal symptoms, and continued use despite problems. The document outlines short and long-term effects of alcohol, including health risks like cirrhosis and fetal alcohol syndrome. It also discusses prevalence of alcohol abuse in the US and treatments options like disulfiram and naltrexone. Stages of change and treatment are outlined from pre-contemplation to remission.
Drugs & Society Chapter 1
This document provides an introduction to a class on drugs and society. It begins with polling students to gauge their expectations and reasons for taking the class. It then outlines class policies, assignments, and expectations. The document discusses key concepts around drug use including what constitutes a drug, commonly abused drugs, and factors that influence drug use. Statistics on drug use in the United States are presented, showing high rates of alcohol, tobacco, and marijuana use. Four types of drug use and dimensions of drug abuse are defined.
Evaluation and Management of Behaviors in Persons with Cognitive Impairment
The goal of this webinar is to enable healthcare clinicians to implement a comprehensive approach to non-pharmacologic and pharmacologic management of dementia-related behaviors for the benefit of patients and their caregivers.
Teach back prescription drugs
Prescription drugs are medications prescribed by doctors to treat medical conditions. There are three main types: opioids which relieve pain, stimulants that increase energy, and depressants that cause sedation. While prescription drugs can effectively treat conditions, they also carry risks of addiction, dependency, and overdose if misused. Long term misuse can lead to health issues like increased anxiety, breathing problems, and hostility. While prescription drugs are important for healthcare, their easy accessibility and potential for abuse require responsible use to avoid harmful consequences.
Drugs & Society Chapter 1
This document provides an overview of key concepts from the first chapter of the textbook Drugs and Society. It defines what constitutes a drug and psychoactive drugs. It also outlines the major types of commonly abused drugs and discusses factors that affect drug use like biological, cultural, social, and contextual factors. Statistics on drug use in the United States are presented on alcohol, tobacco, marijuana, and other drugs. Characteristics of experimental, compulsive, and casual drug users are defined. The stages of drug dependence and criteria for substance use disorder are outlined.
Eating Disorders
The document discusses eating disorders, including signs and symptoms, contributing biological and psychosocial factors, and treatment options and their high costs. Eating disorders are complex illnesses affected by genetics and environment. They disrupt individuals' lives and are often comorbid with other issues like depression. Treatment includes inpatient programs, therapy, and medication, but access is limited due to high costs averaging $60,000-$100,000. Social workers can help educate about disorders and advocate for treatment access and coverage.
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The document discusses the use of herbal medicine in Western society. It notes that those most likely to use herbal medicine are well-educated, higher-income women. While 70% of Americans regularly use herbal medicines, most do not disclose this to their doctors due to potential drug interactions. Some of the most commonly used herbal medicines in the US include echinacea, St. John's wort, and ginkgo. The document outlines factors to consider when evaluating clinical trials of herbal medicines and criticisms of such trials, noting their quality is often superior to pharmaceutical drug trials. It stresses the importance of consulting medical professionals when using herbal supplements due to potential side effects and interactions.
Assessment of suicide risk dr essam hassan
This document provides an overview of suicide risk assessment. It begins with definitions of suicide and epidemiological data showing suicide is a leading cause of death. It then discusses risk factors like psychiatric disorders, previous attempts, and life stressors. Methods of suicide and self-harm are outlined. The assessment process involves understanding current suicidal thoughts, intent, plans and stressors, as well as protective factors. Tools like the TASR can aid evaluation. Management depends on the individual's risk level, mental state, and social support. Ongoing monitoring is important given risk can change over time.
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The document discusses several mental health issues that commonly affect college students. It provides statistics and details on eating disorders like anorexia and bulimia, which predominantly impact women. Substance abuse and its effects on individuals and society are reviewed. Post-traumatic stress disorder is explained, including what can cause it and its common signs and symptoms. Self-injury and sexual assault are also covered, outlining their emotional and psychological impacts. Treatment options discussed for various conditions include psychotherapy, medication, support groups, and self-care practices.
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- 1. Substance Abuse in the Elderly: The Boomers Change Things Again Steven T. DeKosky, MD, FAAN, FACP, FANA Professor of Neurology Director, Alzheimer’s Disease Research Center University of Virginia School of Medicine Charlottesville, VA USA Recovery Centers of America Scientific Advisory Board Meeting Malibu Beach, CA September 30, 2013
- 2. Disclosures • Consultant/Advisory Boards :Consultant/Advisory Boards : – Elan/Wyeth, Genzyme, Lilly, Janssen, Merck,Elan/Wyeth, Genzyme, Lilly, Janssen, Merck, Novartis, PfizerNovartis, Pfizer • Clinical Trials:Clinical Trials: – Baxter, Elan, Janssen, Novartis, PfizerBaxter, Elan, Janssen, Novartis, Pfizer
- 3. Signs of the Apocalypse • Cheech Marin is 67 years old • Tommy Chong is 75.
- 4. Demographics • Over the next 35 years there will be significant increases in the US elderly population as the Boomers move into late life • Substance abuse in this cohort is different from both the Greatest Generation cohort and the younger generation (Gen X) • More alcohol and prescription medication abuse in the Boomer population • Boomers have less illicit drug use, Cheech and Chong notwithstanding
- 5. Challenges • Majority of funded research has been focused on cocaine, other narcotics, and illegal stimulant drugs • Target population has been younger adult males • Less direct applicability to the elderly population • Many Boomers came of age in the 60s and early 70s and are more willing to take prescription drugs • Questions about adequacy of screening methods for elderly (most screening tests devised for younger cohorts)
- 6. Medical and Psychiatric Issues • Aging is a time of loss: friends, spouse, career, vigor, health • Higher rates of depression • Use of stimulant medications • Multiple co-morbidities: systemic diseases, increased frailty
- 7. Social Issues • In our mobile society, concerned children and social supports may not be present • Children have moved away or elderly have moved to retirement communities with loss of support systems and friends • Families reluctant to bring up substance abuse issues if they note it
- 8. Medical Disease and Predilection for Substance Abuse • Arthritis leads to chronic use/abuse of prescription pain medications • Opiates and alcohol used for mood elevation in depressed elderly • Sleep disruption due to arthritis and other pain leads to sleep medication abuse, other sedative/anxiolytic abuse • OT sleep aids frequently have anticholinergic side effects and interfere with cognition
- 9. Medical Disease and Predilection for Substance Abuse • Geriatric depression and anxiety lead to prescription for benzodiazepines • Busy physicians dealing with medical comorbidities may not be as vigilant concerning medication abuse • Slowed metabolism increases half-life of medications and increases fatigue, slowed reaction times, increased driving risk, falls
- 10. Cognition and Substance Abuse • Alcohol abuse may lead to irreversible cognitive decline • Sedative/narcotic abuse and slowed metabolism may lead to cognitive impairment/incorrect diagnosis of dementia • Amnestic mild cognitive impairment and dementia (most commonly Alzheimer disease) lead to confusion in dosing and potential overdosing of many medications
- 11. Dual Diagnoses • Geriatric depression may predispose to alcohol abuse in late life as attempt at self-medication • Both diagnoses need to be treated • Altered cognition in one or both of these disorders may lead to premature diagnosis of dementia, with decrease or cessation in therapeutic efforts • Dementia diagnosis cannot be confirmed until both are treated
- 12. Conclusions • Growing need for effective screening methods specific for geriatric population • Education programs for physicians, patients, and families regarding use of psychoactive drugs and alcohol • Research to address most effective treatment for (more frail) elderly for alcohol and drug abuse • Best practices for diagnosis and treatment with appropriate referral for the medical comorbidities