An older adult as defined in our culture today is a person age 55 and older. This group is comprised of individuals we affectionately refer to as baby boomers all the way to pre-World War II era folks. These are people that have lived through war, economic crises, the civil rights movement, shifts in popular culture from music to recreational drugs and all points in between to name a few, all of which could be considered both problematic and traumatic all in the same breath. It is expected by the American Journal on Addictions that by the year 2020 all baby boomers will be age 50 and older. By 2030 they will be 65 and older, and to put this in perspective even more think about this, that 88.5 million people in the year 2050 are estimated to be comprised of older adults age 65 and older. In the equation of our adult lives there are four prevalent factors that define our behavior, that as we get older increase in difficulty and functionality they are respectively: • Cognitive Function • Biological Factors • Psychological Factors • Social Factors First, as we become older adults, basically we begin to slow down cognitively in the way we process information, very similar to the way a computer that has reached its memory space capacity. Our visual perception becomes, motor skills begin to diminish the older we get and starts effecting our response time. What took us only a matter of minutes in our 20’s and 30’s could take hours and feel like an eternity. Biologically, in the most simple of terms the body can begin to go through a process of breaking down. As a result the body of an older adult can become very sensitive to medications when used to treat various ailments, creating the perfect storm for codependency on that particular drug. Psychologically, it can be the similar to the body breaking down biologically, except there’s a mental break down instead. Everyone has their own coping mechanisms for dealing with stress, grief, pain, and so forth, however, with older adults these things can be magnified and intensely more difficult to deal with and overcome. There are tendencies for older adults to become more focused on their own mortality especially as loved ones and friends begin to pass away, causing them to look inward at feel fragile, even helpless. This vulnerability can lead to escapism and wanting to find a diversion from the reality of what’s happening in their lives. Socially, life begins to change swiftly and in some instances drastically as mentioned before about death of loved ones and friends. These changes can often be very traumatic for older adults causing some to withdraw from society and become more isolated. Not all older adults are able to work, therefore, their feeling of self-worth and identity may decrease. Case Study During my foundation year practicum, I was at a local hospital completing a field placement and a 76 year woman presented on the stroke unit with a history of one stroke and a four year habit of prescription drug abuse. I was not aware that this was more common than not until the social worker stated a lot of the elderly come in depressed from recent medical procedures and with habits. She stated a lot of hospital staff doesn’t address the issue because the patient is elderly. She stated one physician said, “Drugs use over 65 should be an option”. The patient’s family was very concerned and one of the sons felt the drugs caused the stroke and it was the physicians fault for prescribing her such an addictive drug. As I listened to one of the sons, he described his mom as a hard working single parent that suffered a stroke with paralysis two years ago. He stated rehabilitation helped very little and she had a limp that she was embarrassed of and it made her depressed. Also, he stated every time he mentioned medicine abuse to a physician they would say his mother was old enough to make her own decisions. In recent years there has been an increased awareness within the public to the health ramifications of prescription drug abuse among older. In adults as reported in an article in the Journal of Aging and Health, Illicit and Nonmedical Drug Use Among Older Adults the number of adults 50 and older with this problem was 2.8 million between 2002 and 2006, this number is projected to double to “5.7 million in 2020” (Wu and Blazer, 2011). These findings were centered on an understudied area of research focused on illicit drug use disorders and non-medical use of prescription drugs by adults age 50 and older. Results indicated that prescription drug abuse was higher among those adults age 50 - 64 versus those who were age 65 and older. A trend identified through interviews with those adults age 50 – 64 indicated a psychological pattern linked to a belief that their addiction in their minds was not wrong or viewed as a problem compared to younger adults with the same problem. This study also projected that in the coming decades that even older adults will be in more need of substance abuse care primarily those addicted to non-medical prescription drugs. Social Work Interventions Prescription abuse in older adults is a multifaceted problem. Baby boomers have been documented to having higher rates of substance abuse such as alcohol and prescription drugs, than any previous generation before them. “Treatment efforts need to provide practice skills specific to trauma and substance abuse that address the more medically compromised aging population” (Shafer 2004). Before all the baby boomers reach age 65 there is a window of opportunity to develop age appropriate interventions for the abusers. It must start with awareness of family members, professionals and the public. The initial intervention would be for the social worker or healthcare professional to do a detailed psychosocial and bio-psychosocial assessment. With both of these assessments you can find out where the older adult is cognitively and what services might be needed. In order to perform these assessments you must be able to reach out and find those older adults who may be off the radar. These are individuals who live alone and may go unnoticed for a while by family members and physicians. Older adults who live in community settings have a higher chance of being assessed quickly for any substance abuse problems. Advocating for the needs of the older adult is a second intervention that is necessary to get the help that is needed for assessment and treatment. This “requires young adults and professionals to confront their own mortality and look for meaning throughout the full life cycle” (Harper-Dorton & Lantz 2007, p. 193). Considering that depression can be the cause of an older adult to abuse their prescription drugs, cognitive-behavioral therapy (CBT) may be used with this population. “This type of therapy explores the relationship between thoughts (the cognitive sphere) and subsequent feelings and behavior” (Mc-Innis-Dittrich 2009, p.150). This type of intervention can teach the older adult to recognize the causes of their behavior and be able to change their thought process. If they can change the way they feel about something which is causing them to abuse medications, then the positive change will cause them to no longer abuse the medication. Group therapy has been very helpful when dealing with high functioning older adults. They are able to utilize the social worker and the group. In conclusion, “One of the greatest challenges to society and the profession of social work is the dramatic increase in the number of persons over age 65 in the twenty-first century” (p. 25 McInnis-Dittrich 2009). The problem of prescription abuse in older adults is a serious one realized through projections by experts that it will only increase over the next two decades. The responsibility not only fall on the shoulder of the individual dealing with the addiction but also on loved ones and health care professionals charged with treating the addiction. There has been extensive research given to this topic and there are vast resources and information available to better understand this problem and treatable solutions. Although researchers agree that defining prescription abuse within the older abuse community is problematic, this paper set out to give a general understanding and overview to the subject. Prescription drug abuse is a treatable addiction. Through family intervention in conjunction with professional counseling, older adults can find the help they so desperately need. Not to diminish in any way the illnesses or diseases associated with their need for medicine. The psychiatry community and other medical practitioners trained in this area have years of proven expertise in developing qualitative and quantitative analysis that is being used to develop practical intervention strategies to provide treatment.