Drug Use, Misuse and Abuse


Prescription drug abuse is defined as the use  of a medication that is not prescribed for the individual or taken in a way other than what the doctor had prescribed.  The fact that a drug is ordered does not make it safe when taken in an altered manner and can have the same

consequence as street drugs. The most common categories of abuse are opioids, including pain medication, stimulants and sedatives. The abuse of prescription drugs is illegal even when obtained through friends or family.  A report from The Florida Medical Examiners Commission provided the following information:  in 2010, 5,643 people in Florida died with one or more prescription drugs in their system.  That is an increase of more that 7% over the previous year. More than 2,710 deaths in our state during 2010 were found to be caused by prescription drugs which were identified in the system of the deceased.  This is a 9 % increase from the previous year.

Abuse of pain medication is very common in the elderly.  It is interesting to note that the perception of pain is frequently in direct proportion to the individual’s support system.  In other words those that live alone and in isolation perceive pain differently than those who live with others whether friends, family or a community setting.  The more limited a person’s world the more self absorbed they become which in turn blurs their perception of physical and psychological pain.  The abuse of pain medication and sedatives is used as anesthesia in those who choose not

to deal with their feelings in an appropriate manner. What starts as a behavior quickly becomes a habit until the individual no longer “feels” and certainly doesn’t recognize that they are compromising their own health and well being.

Caregivers need to assess and screen for misuse of drugs by simply asking the individual about their past history and then current habits.  This needs to be done in a non-judgmental manner which allows the individual to feel safe in answering the question.  This approach is applicable when working in a professional capacity or with family.  The significance of listening cannot be over emphasized.  Learn to be comfortable with silence and listen to verbiage and note body behaviors.  Avoid assuming that you “know” what the individual means or feels.  Ask for clarification if you don’t understand the message and don’t be tempted to finish another’s thoughts. Understanding how the individual copes with stressors will enable you to encourage the appropriate intervention which usually starts with the persons own physician.  Listening and caring along with an appropriate intervention can and does save lives.  

Editor’s Note: This article was submitted by Sandra Buxton RN BSN MA, Accu Care Nursing Service COO/CNO.