Hydrocodone the Most Prescribed Drug under Medicare

As American adults get older, they become increasingly vulnerable to substance abuse and addiction. Baby boomers are quickly becoming senior citizens, making this particular population the fastest-growing group in the country[1]. For many who are crossing the bridge to senior citizenship, their changing care needs as well as their old lifestyles (drinking and casual drug use) render them easier targets for potential chemical dependency. Recent data from an analysis of Medicare’s prescription drug program[2] reveals further vulnerability, as it is reported that hydrocodone acetaminophen (the generic form of Vicodin) was the most commonly prescribed drug to Medicare recipients in 2013.

The Go-To Drug

These findings clearly illustrate that physicians have come to regard prescription opioids as a default mechanism for treating various types of pain. Rather than try to integrate less dangerous and addictive measures into their patients’ care routine, many doctors look to ease the pain and thereby disregard the potential for abuse and chemical dependency. We’ve seen considerable evidence of this in the past among young adults and the middle-aged; however the stakes for seniors may be considerably higher. A group with more complex advanced-care needs and slower recovery time, some seniors may require a lower-risk pain management alternative. More than half of the prescriptions discovered in the study came from family-practice or internal-medicine physicians.

Meanwhile: That Same Year

The Centers for Disease Control and Prevention reported that in 2013 nearly two million people were battling opioid abuse and addiction[3]. Despite these staggering numbers, it has remained standard practice to prescribe these drugs even in cases in which they might not necessarily be needed. Over eight million patients were prescribed the drug in 2013 from 691,000 care providers. The five most commonly prescribed drugs under Medicare in 2013 included: Hydrocodone-Acetaminophen, Simvastatin, Lisinopril, Omperazole and Amlodipine Besylate.

How Are Patients Getting these Drugs?

More than half of the prescriptions discovered in the study came from family-practice or internal-medicine physicians[4]. The rest of the prescriptions were broken down among nurse practitioners, orthopedic surgeons, physician assistants, emergency rooms, rehabs, anesthesiologists, pain management clinics and dentists. As of 2012, it was estimated that 336,000 seniors were misusing prescription drugs[5]. Since doctors have started prescribing hydrocodone more frequently, this number is likely to have gone up in past years. To make matters worse, many physicians are prescribing these drugs without even describing the risks and potential complications associated with their use. This dramatically increases the possibility of a reaction which can cause serious complications to the patient.

Comparative Health Risks

At any age, the period of withdrawal from prescription drugs can be a downright nightmare. The process is not unlike withdrawal from heroin and can be an extremely taxing ordeal. It’s important to remember, however, that the aging process tends to magnify every physical complication[6]. Every ache, every shiver, every bout of intestinal distress is more severely experienced in older patients, and their bodies are slower to recover. This is something every physician must keep in mind before prescribing powerful opioids to their elderly patients. Many patients fail to recover from prescription withdrawal under the best of circumstances – imagine how difficult it must be for patients of advanced years with established health issues.

What Is It All For?

Although the medical community, by and large, has placed their faith in drugs like hydrocodone to offer comprehensive pain management, the fact is that prescription opioids fall short of delivering long-term results. In over 70 percent of chronic pain cases, these drugs fail to deliver the effectiveness that they did when they were first administered[7]. The body builds up tolerance and needs higher and more frequent doses to function normally. This is not, nor has it ever been, a sustainable pain management model. It is, however, the perfect recipe for chemical dependency. In exchange for a long-term care plan that doesn’t work, the senior community is seeing a dramatic increase in ER visits and overdose fatalities.

An Unfortunate Side Effect of a Lack of Leadership

Earlier on during the development of drugs in the 20th century, there was a concerted effort to treat chronic pain by any means necessary. This philosophy is what initially gave birth to medications like OxyContin and Vicodin. Now prevention advocates and the federal government are calling for more restrictions on dispensation. The problem is, however, that even with these new recommendations in place, physicians are prescribing hydrocodone more than ever before. In the meantime, seniors throughout the country remain more exposed to addiction-related injury. As our parents and grandparents become less and less able to take an active part in their care, it may be up to many of us to help them avoid prescription abuse and addiction by stepping in to determine if such drugs are warranted.

The Need for Systemic Change

Many experts have argued that in order to truly break away from America’s dependence on prescriptions, there needs to be a dramatic shift in attitude regarding how we choose to treat chronic pain[8]. There’s little doubt that these drugs provide short-term relief from things like cancer-related and post-operative pain, but as many have become more dubious about the ability of prescription opioids to manage long-term conditions, it might be time to reassess our clinical approach, particularly given the potential consequences of long-term use. The longer seniors remain on prescription opioids like hydrocodone, the harder it will be for them to get off of them.

Addressing the Present and the Future

While general-practice physicians and the federal government iron out the extent to which prescription opioids are to be involved in pain treatment going forward, addiction treatment professionals must account for the specialized care needs of addicted seniors. Behavioral Health of the Palm Beaches offers a program targeted toward baby boomers that addresses the physical fallout of their chemical dependency as well as the psychological issues that drive it. If your aging loved one has fallen into prescription drug addiction because they were overprescribed opioids, don’t wait another second to get them help.