The pharmaceutical abuser looks like you or me … They start running out of their meds. So now, they start going to the doc to get more and more…the doc cuts them off. Then they start visiting the ER, making up injuries … Now they become our problem as law enforcement.”— Keith Kamita, State of Hawai‘i Public Safety Division Narcotics Enforcement from a documentary film that focuses public attention on prescription drug addiction and polypharmacy in the senior population.

Since last year, prescription drug abuse was responsible for more than 475,000 emergency room visits and 32,329 deaths across America. Over the past 15 years in Hawai‘i, reported fatal drug overdoses in persons 60 and over increased nearly 400 percent; a large portion of these fatalities involved prescription drug abuse.

For seniors, a critical factor is “polypharmacy,” taking several medications simultaneously and drinking alcohol. Currently, about half of people over 65 take five or more medications per week. About 12 percent take 10 or more.

Combining alcohol with some agents for hypertension, type 2 diabetes and anxiety — drugs that are all metabolized in the liver — can be deadly. Patients and their doctors have to consider how drugs interact and how they will be taken.

Alan Johnson, CEO of Hina Mauka, Hawai‘i’s largest drug and alcohol treatment center, reports that this year, 16 percent of the center’s 1,500 adult patients are over 50. This increase mirrors a 35 percent increase in fatal drug poisonings among seniors. He added, “… they’re taking pain medication. The family doesn’t know what to do. Now [grandpa] has this huge addiction and he’s becoming manipulative, he’s in denial, he can’t be managed … That’s very difficult to treat when you’re at that age.” Johnson emphasizes that the longer anyone takes powerful painkillers and anti-anxiety medications, the more they need to get relief. So what are the possible solutions? Most addiction specialists agree that physicians need more training to spot addictive patterns of misuse, abuse and dependency, as well as underlying behavioral issues. Doctors then need to refer patients to therapeutic psychologists who can help them cope with underlying issues.

Through greater public awareness we may be able to get help for patients who become addicted, reduce the number of fatalities due to drug poisoning, now our number one cause of accidental death in America.

For a copy of Unprescribed — Prescription for Addiction (58-minute film), call: 808-599-6403 or email:

“It is estimated that 2.1 million Americans are addicted to opioid pain killers which reflects the wide spread availability of these drugs. Heroin abuse in our country affects more than half a million Americans, and is driven by individuals switching from prescription opioids to heroin because it is cheaper and easier to access.”

— Nora D.Volkow, M.D., Director, National Institute for Drug Abuse, NIH