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UCSD Researchers Find Older Adults With Impairments Linked To Drug Use, Misuse

UC San Diego's School of Medicine is shown in this undated photo.

Photo by Milan Kovacevic

Above: UC San Diego's School of Medicine is shown in this undated photo.

Researchers at UC San Diego's School of Medicine found "functional impairments" among adults 50 and older are associated with a higher risk of medical cannabis use and prescription opioid and tranquilizer/sedative use and misuse, according to a report published Thursday.

In a study published in Thursday's online edition of the American Journal of Preventive Medicine, the UCSD researchers looked at rates of drug use among the 22% of older adults in the United States who suffer from a functional impairment — defined as difficulties performing daily activities, such as bathing or getting dressed, or problems with concentration or decision- making affected by physical, mental or emotional conditions.

"Our study implies that there may be a link between functional impairments and use and misuse of these prescribed drugs," said Dr. Benjamin Han, first author of the study and a clinician-researcher in the Division of Geriatrics, Gerontology and Palliative Care in the Department of Medicine at UCSD. "It is important to recognize that any psychoactive substance may be risky for this vulnerable population.

"Many older adults use these substances due to chronic pain, insomnia or anxiety — conditions that can affect daily functioning," Han continued. "These symptoms can be challenging to manage, especially in the setting of multiple chronic conditions and other prescribed medications."

The study analyzed data from participants age 50 and older from the 2015-2019 National Survey on Drug Use and Health. Through a computer-assisted interview process, participants were asked about use of cannabis and prescription opioids and tranquilizers/sedatives in the past year, as well as the presence of any functional impairments.

Those reporting cannabis use were asked if it had been recommended by a doctor, and those reporting opioid or tranquilizer/sedative use were asked about misuse — defined as using prescription drugs in any way not directed by a doctor, including use without a prescription or use in greater amounts or longer than prescribed.

The study found adults age 50 and older reporting medical cannabis use, prescription opioid use and misuse, or prescription tranquilizer/sedative use and misuse were more likely to report having an impairment.

"Our findings suggest the symptoms of this patient population are not always being fully addressed or that something else is going on, such as a substance use disorder or a mental health issue like depression and anxiety," Han said. "As health care providers, we need to take a closer look at chronic symptoms among older patients with functional impairments. Managing these conditions often requires a multidisciplinary approach."

Han said patients should work with their health care providers to develop appropriate treatment plans with realistic expectations.

"It is also vital to communicate the risks of medications with older adults with functional impairments and the importance of balancing these risks with the potential benefits," he said.

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