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Legal But Deadly

A growing number of people 50+ are abusing prescription painkillers, sometimes with fatal consequences

spinner image Opioid prescription drug addiction
Since the late 1990s, prescription-painkiller use has experienced a dramatic rise in the United States — and with it, misuse and addiction.
Photo by Adam Voorhes

In the wake of the death of pop icon Prince, reports emerged that he was seeking help in his struggle with prescription opioid-based painkillers. In recent years, many celebrities have suffered from prescription-drug abuse, and some have died from overdoses, including Michael Jackson, Anna Nicole Smith and Heath Ledger.

But it isn't just the famous who are dying. According to the Centers for Disease Control and Prevention, more than 14,800 Americans fatally overdosed on opioid-based pain medication in 2014 — four times as many as in 1999. Of those, nearly 5,900 people were age 50 or older, which is nearly an elevenfold increase since 1999.

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How did this deadly epidemic grow so rapidly? AARP's Not As Prescribed: Recognizing and Facing Alcohol and Drug Misuse in Older Adults, adapted here, documents how the United States became so deeply dependent on harmful drugs, including powerful painkillers, and tells what to do if you think a loved one may be addicted.

FOR YEARS, DOCTORS AVOIDED, prescribing opioids to treat chronic pain for fear that patients would too easily get addicted. But in the 1980s, when legal drugs became part of American culture (and illegal drugs part of the counterculture), studies began to show that only a small percentage of people became addicted to opioid painkillers.

In the mid-1990s, physicians — acknowledging that too many people were suffering from untreated pain — underwent a paradigm shift. They added pain as the fifth vital sign. They checked your temperature, blood pressure, pulse and respiration rate, and then they asked you — on a scale of 1 to 10 — the intensity of your pain. If you were suffering from back pain, a broken bone, nerve pain, cancer or other condition and indicated that your pain level was 6 or higher, your doctor was pretty much obligated to prescribe one of the many opioid painkillers on the market.

Since the late 1990s, prescription-painkiller use has experienced a dramatic rise in the United States — and with it, misuse and addiction. Since 2002, use of prescription painkillers has doubled. From 1998 to 2008, the number of people being treated for opioid abuse increased 400 percent. These numbers reflect not just a trend but a heartbreaking epidemic that is ruining the lives of millions of people and their families.

If you suspect someone you love is struggling with drugs, you'll need to take these steps.

Be aware. Does addiction run in the family? Did Mom use drugs as a teen or young adult? How many doctors does she see? What are their names and locations? What health conditions is she being treated for? Where does she fill her prescriptions? Are the labels on her prescription medication bottles from more than one pharmacy?

Observe. When Dad doesn't use pills, does his behavior improve? How many pills is he taking? Do you see any signs of addiction such as losing interest in some of the things that used to bring him joy, not managing at home or work, or giving up important activities? Does he seem out of character — more depressed, anxious, withdrawn or secretive? Does he need to take a substance in larger amounts or for longer than he's meant to?

Monitor. If I'm not around, who can I get to monitor Grandma's behavior? How often does she go to the doctor? How much does she drink? Does she forget that she took her medication in the morning and then take it again at night?

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Record. List all medications and dosages, along with why they were prescribed. Search medicine cabinets for over-the-counter medications, herbs and supplements — everything from aspirin to calcium to ginkgo. Include alcohol and marijuana.

Ask. Casually ask your loved one questions about her drug use. How many pills is she taking? Is each of her doctors aware of what the others are prescribing? Has she been feeling OK? Does she notice a change in her behavior? Extend the conversation to others — neighbors, friends, spouses, relatives and caregivers, if appropriate.

Talk to docs. Attend doctors' appointments with your loved one, and talk to the physicians about medications and health conditions. Make sure the information is entered into their computer system so it becomes a permanent piece of the electronic health record and accessible to other physicians. Opioids are powerful, and recovery rates, although improving, are not entirely promising. If there's a concern, get help. Now.

In AARP's new book, Not As Prescribed: Recognizing and Facing Alcohol and Drug Misuse in Older Adults, Harry Haroutunian, M.D., physician director at the Betty Ford Center in Rancho Mirage, Calif., discusses warning signs, ways to approach someone you suspect has a problem, where to get help and alternatives for drug-free pain management.

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Find the book online at or in bookstores nationwide. 

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