In a recent study published in JAMA Internal Medicine, researchers found lonely, older adults are nearly twice as likely to use opioids to ease pain and two-and-a-half times more likely to use sedatives and anti-anxiety medications.
This puts them at risk for drug dependency, impaired attention, falls and other accidents, and further cognitive impairment.
The researchers found that just over half of 6,000 respondents in a nationally representative survey of seniors living independently were not lonely, while 40% were moderately lonely, and 7% were highly lonely.
The proportion of seniors in each group who had prescriptions for opioids and anti-anxiety medications and sedatives, which included drugs like Valium, Xanax, BuSpar and Ambien, correlated with their degree of loneliness.
The study is from UC San Francisco. One author is Ashwin Kotwal, MD.
In the study, the team used data from the National Social Life, Health and Aging Project, and checked each participant’s medications if they were used on a regular schedule. The participants’ average age was 73.
They found that 6% of the non-lonely group used prescription opioids, versus 8% for the moderately lonely group and 11% for the highly lonely group.
For anti-anxiety medications and sedatives—which include anti-cholinergic drugs, like Valium, Unisom and tricyclic antidepressants, which have been linked to a higher risk for dementia—9% of the non-lonely group used them, versus 13% for the moderately lonely group and 23% for the highly lonely group.
Similar patterns were found with antidepressants and NSAIDs, prescription and over-the-counter painkillers that may cause ulcers and bleeding in long-term use by older adults.
The highly lonely group was also more likely to be on five or more medications—58% versus 46% for the non-lonely participants.
The team advocates for fewer prescriptions of psychotropic drugs for older adults who are lonely, and in its place “social prescribing” to local resources in the community.
This can be done by “link workers,” based in primary care practices or within the community, with connections to amenities like senior centers, exercise classes, grief groups or volunteer programs.
The team notes that the pandemic has taken the stigma out of loneliness, giving older adults an opportunity to discuss their feelings in the clinic.
Asking patients what might help can be a good first step to referring them to programs that might fit their needs.
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