Objectives
We aimed to assess the prevalence of opioid and benzodiazepine prescription drug misuse in older adults, the risk factors associated with misuse, and age-appropriate interventions.
Methods
Following PRISMA guidelines, we conducted a literature search for reports on misuse of prescription benzodiazepines and opioids in older adults. We searched PubMed, PsycINFO, and EMBASE for peer reviewed journal articles in English through April 2014 with updates through November 2015. We reviewed relevant publications that included participants ≥ 65 years of age. We also manually searched reference lists of key identified articles and geriatric journals through April 2016. Information on the study design, sample, intervention, comparators, outcome, time frame, and risk of bias were abstracted for each article.
Results
Of 4932 reviewed reports, 15 were included in this systematic review. Thirteen studies assessed the prevalence of prescription drug misuse and included studies related to opioid shopping behavior, assessment of morbidity and mortality associated with opioid and/or benzodiazepine use, frequency and characteristics of opioid prescribing, frequency of substance use disorders and non-prescription use of pain relievers, and the health conditions and experiences of long-term benzodiazepine users. One study identified risk factors for misuse and one study described the effects of provider education and an electronic support tool as an intervention.
Discussion
There is a dearth of high quality research on prescription drug misuse in older adults. Existing studies are heterogeneous, making it difficult to draw broad conclusions. We discuss the need for further research specific to prescription drug misuse among older adults.