Is Addiction an Affliction of the Young?

I wrote on Tuesday about the “Memory Wall” installed at the National Rx Drug Abuse Summit. It is a large panel containing many pictures and emotional tributes to dozens of people lost to drug abuse. It is a project provided by the NOPE Task Force. NOPE stands for Narcotics Overdose Prevention & Education.

The Memory Wall gives a plain and constant reminder of the human toll that addiction and abuse of both illicit and prescription drugs can produce.

As I stood there looking at the wall, having already penned my prior article, I could not help but notice the age of the vast majority of the people displayed there. The oldest was 55. The youngest was 13. But most are, or rather were, between 18 and 25 years of age. While taking a few minutes attempting to do the math, I was approached by a representative of the NOPE Task Force. She told me that the average age at time of death for the people on the Memory Wall was around 23. She then pointed out her son, who was on the wall. He was 14 years old at the time of his death.

From this unsettling and admittedly unscientific research project, a project by the way that used no Federal funds, we could conclude that addiction is indeed an affliction of the young. On the surface, it makes sense if you think about it. Youth is daring. Youth is adventuresome. Youth can be reckless. A song from the musical group Train contains lyrics along these lines that tell us “It's a shame when youth is wasted on the young”. It would stand to reason that the potentially fatal risk of drug addiction would claim victims earlier rather than later, and it is possible that serious drug addicts are removed in this macabre selection process early. They just don't get to live long enough to die old. Makes sense, right?

Not so fast. 

It turns out the median age of drug overdose victims is 39. That means many older folks are suffering similar fates, even if they are not visible on a Memory Wall. From a prescription addiction perspective, opioid analgesics are prescribed more to people over 40 than any other age group, with more than 60 million prescriptions going to them each year. 

That little fact should be troublesome to those of us in workers' compensation. You see, while addiction is a disease, the triggers that bring it to the surface would seem different for various age groups. Youthful addiction may arise from a variety of areas; Some do start with prescriptions from their doctors - in 2011 over 8 million opioid prescriptions were written for people under 19 years of age. Other factors are experimentation, peer pressure, abuse, depression, neglect or other underlying emotional or mental conditions. And what of older prescription drug addicts? They usually are dealing with conditions of age or disease, or have sustained an injury of some kind. Some of them were injured on the job, and have been let down by a medical system unprepared to meet their needs. We own those particular people. They are our responsibility. Their addiction is our industry's affliction.

We would be wise to address that issue. Beyond the obvious price that society pays for the human suffering involved, there are economic reasons to get a handle on this problem. One of the more frightening statistics reviewed here at the Summit were the incidental costs associated with a person addicted to prescription drugs. One health insurance company discovered a number of years ago that it was spending $41 in ancillary costs for every $1 it spent on the offending medication for those addicted to their meds. Babies born to drug addicted mothers spend weeks undergoing detox in Neo-natal intensive care units, at a cost of up to $53,000 PER DAY. If that mother is an injured worker, the lines of liability are unclear, but should be considered. The financial liability to our industry is huge, and needs our full attention.

The people here at the Summit are working to address these issues. The standards and legislation they are working on will help us once enacted, but we simply cannot wait for others to solve our problems. After all, while addiction is not just an affliction of the young, it is a condition that may give us ownership in the old. 

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