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petshah cootshah

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'Geron' Greek menaing 'old man', 'Addictus' Latin meaning ' ... Hormonal problems. Diabetes. Thyroid abnormalities. Interactions with prescribed drugs ... – PowerPoint PPT presentation

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Title: petshah cootshah

1
Geriaddicts?
Physical health issues in the older substance
user. Dr. Ian Guinan Dr. Euan Lawson Delphi
Medical Consultants 'Geron' Greek menaing
'old man', 'Addictus' Latin meaning 'assigned
by decree' ie. obligated.
1
2
I hope I die before I get old.
- 1965 My Generation Pete Townshend, The
Who. Now aged 64......
2
3
The Rolling Stones, 1964
Keith Richards, 2nd from right, at the time
described himself as elegantly wasted.
3
4
Keith Richards, 2004
4
5
Physical Health IssuesWhat happens when we get
old?Not good news......

all of our bodies systems begin to stop working
we don't recover as quickly from challenges
we begin to suffer consequences of chronic harm
risk of cancer is increased
our immunity to infection is diminished

5
6
Lungs and Respiratory

Tobacco smoking
Chronic bronchitis
Damage from heroin and crack smoking
Increased TB risks
Lung cancer

6
7
Heart, cardiovascular and circulation

QTc and Torsade De Pointes?
Role of ECGs and implications for treatment
Increased risk of DVT
Reduced circulation, ischaemia
Leg ulcers

7
8
Liver

Hepatitis C
Cirrhosis
Hepatoma

8
9
Kidneys

Impaired renal function and prescribing

9
10
Brain nervous system

Dementia
Cognitive impairment
Poor vision
Mental Health abnormalities

11
Muscles Skeleton

Increased risk of falls
Osteoarthritis reduced mobility, difficulty
with handling medication
Osteoporosis (poor nutrition, reduced physical
activity)?
Loss of limbs complicated by other pathology

12
Hormonal problems

Diabetes
Thyroid abnormalities

13
Interactions with prescribed drugs

warfarin
analgesia (opiates?)?
drugs prolonging the QTc interval (long list!)?
antiepileptics
enzyme inducing drugs

13
14
Differing pattern of drug use?

increased smoking?
increased use of alcohol (reasons?)?
historic drug use amphetamines/barbiturates
abuse of OTC medication
abuse of prescribed medication. Availability?

14
15
Others?

Nutrition
Dentition
Poverty
Housing
Family support
Carer support
Coping with disability

15
16
How can we address these problems?

Recognition that we will increasingly be dealing
with the health problems of an older cohort of
patients with differing needs
Improve delivery of substance misuse treatment in
primary care so that holisitic healthcare for all
health problems can be delivered.

16
17
Summary

Chronic drug use has long term implications for
health which are cumulative.
Increasing age brings cumulative health
problems.
A combination of both will create an increasing
challenge for future services.

17
18
I hope I die before I become Pete Townsend.....
1992 Kurt Cobain, singer of Nirvana, died April
5th, 1994. Age 27.
18
19
Questions and Discussion?
20
References

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20093741383-91.
2. Baldwin GC, Choi R, Roth M, et al. Evidence of
chronic damage to the pulmonary microcirculation
in habitual users of alkaloidal ("crack")
cocaine. Chest 20021211231-38.
3. Benson MK, Bentley AM. Lung disease induced by
drug addiction. Thorax 1995501125-27.
4. Story A, Bottomley G, Hayward A. Crack cocaine
and infectious tuberculosis. Emerging Infectious
Diseases 200814(9)1466-69.
5. Mehra R, Moore BA, Crothers K, et al. The
association between marijuana smoking and lung
cancer. Archives of Internal Medicine
20061661359-67.
6. Department of Health (England) and the
devolved administrations. Drug Misuse and
Dependence UK Guidelines on Clinical Management.
London Department of Health, the Scottish
Government, Welsh Assembly Government and
Northern Ireland Executive, 2007. Online
www.dh.gov.uk.
7. Pieper B, Templin T. Chronic venous
insufficiency in persons with a history of
injection drug use. Research in Nursing Health
200124423-32.
8. Health Protection Agency, Health Protection
Scotland, National Public Health Service for
Wales, CDSC Northern Ireland, CRDHB. Shooting Up.
Infections among injecting drug users in the
United Kingdom in 2008. London Health Protection
Agency, October 2009.
9. Rosen D, Smith ML, Reynolds CF. The prevalence
of mental and physical health disorders among
older methadone patients. American Journal of
Geriatric Psychiatry 200816(6)488-97.
10. Beynon C, McVeigh J, Roe B. Problematic drug
use, ageing and older people trends in the age
of drug users in northwest England. Ageing
Society 200727799-810.