Prescription drug abuse and misuse among older adults can sometimes be difficult for families and doctors to identify. Signs of addiction may be overlooked as a normal part of aging or mistaken for symptoms of a medical or mental health disorder such as diabetes, dementia, or depression. Those with substance abuse issues may be reluctant to seek treatment on their own due to the stigma or they may not be aware they are abusing. Because prescription drug abuse often goes undiagnosed or untreated, the true prevalence of substance abuse among older adults remains unknown. However, an analysis by AARP’s Public Policy Institute found that the overall number of older adults who misuse and abuse prescription drugs will likely increase as the size of the population continues to grow. With over 80% of 57- to 85-year-olds taking at least one prescription medication on a daily basis, it is important to recognize the signs of prescription drug abuse to help end what’s being called the “invisible epidemic.”

General Signs of Prescription Drug Abuse

  • Acting irritable, angry, abusive, withdrawn, sad, and/or depressed
  • Exhibiting feelings of anxiety, paranoia, and/or delusions
  • Sudden mood swings or personality changes without an obvious cause
  • Not telling the truth, being deceitful, and/or avoiding eye contact
  • Memory loss, forgetfulness, confusion, not thinking clearly, impaired judgment
  • Lacking coordination, clumsiness
  • Decreased attention span
  • Slowed reflexes, slurred speech
  • Repetitive behaviors
  • Skipping and losing interest in regular activities that were once enjoyed
  • Major changes in eating habits; eating much less or more than usual
  • Filling the same prescription from two different doctors or pharmacies
  • Taking more medicine than normal or taking more than prescribed
  • Being afraid to go somewhere without taking medicine
  • Becoming defensive when asked about a medicine
  • Making excuses for why a medicine is needed
  • Talking often about a medicine
  • Storing “extra” pills in a purse or pocket
  • Sneaking or hiding medicine
  • Unusual physical symptoms such as dry mouth, dry skin, itching, skin infections, dilated pupils, or watery eyes
  • Previously treated for alcohol, drug, or prescription drug abuse
  • Wanting to be alone often
  • Losing touch with loved ones
  • Changes in sleeping habits, including sleep deprivation or “nodding”
  • Losing interest in personal appearance and failing to bathe or groom regularly
  • Unexplained chronic pain

When to See a Doctor

If you suspect that you or a loved one is exhibiting signs of prescription drug abuse, contact a doctor immediately about your concerns. The doctor can diagnose whether the problem is prescription drug abuse and help determine treatment which may include counseling, medicine, or both.

Medicare Coverage for Substance Abuse

Substance abuse services are covered by Medicare when reasonable and necessary. This includes early intervention services called “Screening, Brief Intervention, and Referral to Treatment (SBIRT)” which aims to help individuals before more extensive or specialized treatment is needed. Medicare Part A may cover inpatient treatment in a hospital, and Medicare Part B may cover outpatient treatment through a Partial Hospitalization Program (PHP), including psychotherapy, occupational therapy, counseling, and other services. In addition, Medicare Part D sponsors must include coverage for Part D drugs when medically necessary for the treatment of opioid dependence.