Elder Prescription Drug Abuse

JULY 01, 2006
Cmdr John Burke

As my baby boom generation begins to receive AARP mailings more and more each year and is approaching free coffee at McDonald's, the question of prescription drug abuse rears its ugly head in the government's latest check on emergency room visits.

Inspectors found that, in 2004, almost 64,000 people 55 years of age and older visited the emergency room of local hospitals for prescription drug abuse.

This probably should not surprise most of us, since this generation grew up in the 1960s and 1970s at the start of the illegal drug trade in this country. Marijuana, LSD, heroin, and even prescription drugs were widely abused on college campuses during the baby boom era.

I was a young uniform police officer in the very early 1970s when oxycodone, hydromorphone, codeine, diazepam, pentazocine, methaqualone, and assorted amphetamines were being sold and abused regularly. It was my first exposure to pharmaceutical abuse, and I quickly learned that it could be every bit as devastating as heroin usage.

For years physicians have prescribed regular monthly dosages of propoxyphene to elderly patients for their aches and pains and diazepam for their anxiety or inability to fall asleep. Some experts have suggested that these drugs had no real purpose for the elderly and kept them dependent on steady doses of pain relievers and benzodiazepines for no sound medical reason.

A common practice years ago, and still today in urban settings, is for seniors to sell their medications every month. The drugs are prescribed for pain or anxiety, and are either free or bought with a small copay. One or more enterprising individuals in the neighborhood would approach these fixed-income folks with offers of $1 to $2 per pill. This represented a steady income for the seniors and at least double the profit for drug-dealing entrepreneurs who turn them over quickly.

These dealers were sometimes the people that appeared on the surface to be Good Samaritans taking the older generation to the doctor and then to the neighborhood pharmacy. The problem is that when they separated, the wrong person had the pills, and the senior had a few extra bucks in his or her pocket.

Once tipped off by the physician's office or pharmacy, we watched many of these transactions take place from covert locations, and made arrests accordingly. It is a hard lesson to learn for money-strapped senior citizens who then find themselves involved in felony drug-trafficking offenses.

How do you spot drug dealers or abusers by just looking at them at your pharmacy counter? The problem is that you cannot, and some of the old stereotypes that were not always accurate years ago are getting more difficult as the baby boomers consume more and more prescription drugs, with a growing percentage needing help with their dependence on or addiction to pharmaceuticals.

I am not suggesting that you aggressively interrogate the next 70-year-old patient that comes to your counter, but senior abuse of prescription drugs is growing, and it is important that pharmacy personnel recognize it when it happens. If a crime is being committed, recognizing and doing something about it may very well save that senior's life.

John Burke, commander of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 38-year veteran of law enforcement. Cmdr Burke also is the current president of the National Association of Drug Diversion Investigators. For information, he can be reached by e-mail at burke@choice.net, via the Web site www.rxdiversion.com, or by phone at 513-336-0070.