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In “Take as Prescribed,” Fault Lines explores why so many elderly Americans are becoming addicted to painkillers—and what’s being done to stop it. The film premieres on Monday, Aug. 31, at 10 p.m. Eastern time/7 p.m. Pacific on Al Jazeera America. | Click here to find Al Jazeera in your area.
In early July, 70-year-old Carol Billker traveled two hours from her home in Rockledge, Florida, to Hanley Center, an in-patient substance abuse treatment facility in West Palm Beach, to attend a support group for recovering drug addicts.
With her silver hair, soft-spoken voice and sweet demeanor, she looked out of place in a circle that included former alcoholics and drug abusers, many of whom were in their 20s and 30s. As she addressed the group, Carol described the impact that being hooked on powerful opioid painkillers had on her life.
“You never realize how foggy you are until you go through the recovery and get off the drugs,” she said.
Three years ago, Billker came to Hanley to seek treatment for her addiction. She had been taking opioids—drugs like hydrocodone and oxycodone—to treat pain she experienced from frequent migraine headaches. She was on a pain regimen involving the drugs Percocet and Demerol.
“I think back and I realize how much my husband wanted to do, and I would say, ‘Oh no, not tonight. Not today. I don't want to go to the movies today. I have a headache and I've taken medication,’” she said in an interview with “Fault Lines.” “We missed going out to a lot of activities and fun things because I had a headache and I had taken medication. My neighbors hardly knew me because I didn't leave the house very much. I stayed at home. I slept a lot.”
In treating her migraines, Billker became one of a growing number of elderly Americans addicted to opioids. More than 16,000 Americans die each year after overdosing on opioid painkillers, according to the Centers for Disease Control and Prevention—a number that exceeds those who die from cocaine and heroin overdoses combined.
While the image of the typical opioid addict is still that of a young or middle-aged drug abuser, that perception is slowly changing.
“When you look at the groups that have had the greatest increase in problems associated with prescription opioids—for example, visits to hospital emergency rooms because of opioid misuse—it’s Americans over 65,” said Andrew Kolodny, the executive director of Physicians for Responsible Opioid Prescribing.
A 'hidden epidemic'
Kolodny and other physicians have dubbed painkiller addiction among the elderly a “hidden epidemic.” There’s reason to believe there may be a “massive undercount” of senior citizens who have died of opioid overdoses, Kolodny explained.
It is uncommon for autopsies to be carried out on senior citizens, even those with known prescription painkiller addictions.
“Nobody wants Grandma's body to go to the medical examiner for toxicology and autopsy,” Kolodny said.
According to a 2014 USA Today analysis of data collected from IMS Health, a group that tracks drug dispensing, “the 55 million opioid prescriptions written [in 2013] for people 65 and over marked a 20 percent increase over five years—nearly double the growth of the senior population” itself.
The number of elderly patients on opioids continues to balloon, despite the fact that the class of drugs has more severe effects on older bodies.
John Dyben, the director of older adult treatment at Hanley, said elderly patients are not able to metabolize the medication as easily as younger ones.
“If I am taking the same amount of opioids at age 70 as a 40-year-old, those opioids are having a much more powerful effect on me,” he said, adding that addiction could be difficult to detect among seniors because the signs, such as constipation and confusion, often mimic those of aging.
No one knows exactly how many senior citizens are addicted to prescription painkillers, Dyben said, but it could be as many as “2 to 5 million."
“We think that someone with the white hair and the long beard, the grandpa, Santa Claus-looking person, is less likely to be addicted to drugs.”
He explained that cultural assumptions about addiction contribute to a lack of knowledge about the problem.
“We think that someone with the white hair and the long beard, the grandpa, Santa Claus-looking person, is less likely to be addicted to drugs,” said Dyben. “If you assume that the symptoms you see are just from aging, then you’re not going to look for the problem. And if you don't look for the problem of addiction, you're not going to find it.”
Larry Moore, 67, attended Hanley’s recovery program in 2009, after his family held an intervention to urge him to get treatment for his opioid addiction. At the time, his wife, Dinah, even threatened to leave him because she did not like the side effects of his medication: anger, volatility and depression.
Moore said the drugs transformed his personality, from an easy-going, reasonable person to someone who was angry, impatient and had loud, frequent outbursts.
“On the drugs,” he said, “I would confront you in a heartbeat and didn't care of the outcome. I learned that my grandchildren were afraid to be around me, which to this day breaks my heart.”
Moore told “Fault Lines” that he was an “accidental addict,” becoming hooked despite taking the proper dosage of medication—primarily OxyContin and hydrocodone—which he used for 10 years to treat back pain.
“It was taking exactly what the doctor prescribed, when the doctor prescribed, how the doctor prescribed," he said.
He added that he was never told that there were any alternative treatments to treating pain other than powerful narcotics. “Fault Lines” tried to contact Moore’s doctor, but she did not respond to multiple messages.
Moore said that while his pain hasn’t gone away, he’s learned to live with it.
“I took away years of time that I could have spent with [my grandchildren] and really been happy,” he said. “That’s horrid.”
Unfortunately for Carol Billker, she hasn’t been able to make up for lost time with her husband. He died before she went to rehab to kick her opioid addiction.
She said she feels that she missed out on living a full life with him. So she’s trying to stop others from ending up in the same situation she found herself in—as well as trying to be more active, as her husband always encouraged.
“I'm trying to get out in the world and help; I volunteer at the senior center,” she said. “I’ve also started an exercise program and I’m just feeling great. Really great.”