By Tanvi Dhulia Oct. 03, 2017
Sangeeta’s aging mother-in-law was a compulsive pill-popper. She took six Combiflam tablets a day to get rid of her migraine and other aches. One day, her body gave way.
Sangeeta’s mother-in-law had a peculiar habit. After her morning chai and biscuit, maaji would partially shut the door of her room. Through the narrow opening, Sangeeta would spy on her fishing out a pouch from her closet, and proceeding to swallow a few white spheres.
Maaji would do this every day, without fail. Sangeeta casually mentioned this to her husband. “I think maaji really likes prasad makhanas. I see her eating them quietly in her room each morning.” That’s when he chuckled and clarified that she actually slunk away to take her pain medication. At the time, it hadn’t occurred to any of them that maaji’s acute dependency on over-the-counter painkillers would have an adverse affect on her health. Maaji suffered from migraine from a young age, and every time she felt a hint of pain – a headache, sore back – she’d pop a pill. Doctors in their village in Jharkand would prescribe painkillers liberally. Over the years, she switched from Saridon to Analgin to Combiflam.
Then in 2015, maaji became lethargic; she suffered from constant abdominal and chest pain. A capsule endoscopy conducted at AIIMS, New Delhi, revealed ulcers lining her stomach. They stood a chance of turning cancerous. Medical professionals quizzed her regarding her daily diet, and after a lot of pestering, she admitted that she took Combiflam at least six times a day. The treatment, they said, could only begin when she would cease consumption of the pill completely, and after some verbal jostling, she agreed to stop.
Her younger son took her in for the recovery period, only to discover ten strips of Combiflam hidden everywhere in his mother’s room. Furious, he reprimanded her for poor self-control.
After all the drama, she finally admitted to herself that she had a problem – a serious pill addiction.
Pill addiction among the elderly is an epidemic often overlooked. According to a recent study, 33 per cent of all citizens above the age of 65 in the US consume prescribed medication, out of which 17 per cent admitted that they abuse it. By just pure numbers, this is over four million people in the US. In India, the number could be even larger, as we have not paid much heed to this menace.
The most usual way to find out about pill addiction, as a doctor states here, is a bad fall or an accidental overdose, and even then it is often dismissed as symptoms of ageing such as confusion, shaky hands, and mood swings.
Prescription opioids stimulate receptors in the brain to produce a powerful pain-numbing effect like heroin and morphine. They have the same euphoric effect as drugs, and the “high” is heightened if the pills are crushed, snorted, or injected. Though Combiflam is a non-narcotic painkiller and is not psychologically addictive, its constant use can make a person physically dependent on the pill for relieving pain.
Over the years, maaji became a compulsive pill-popper. In April, she was visiting her second son, when she fell severely ill again.
Sangeeta and her husband were in Ahmedabad when they received a frantic call from a relative – maaji’s platelet count had dropped beyond measure.
She had to be dragged back to the ICU, where she was forced to hand over all her immediate belongings, one of which was a carefully hidden maroon pouch. After a drawn-out scuffle between maaji and the tag team comprising Sangeeta and the nurse, they found 25 Combiflam tablets, removed from their foil casing, inside her secret bag, ready to be devoured.
When maaji had changed out of her clothes into hospital scrubs, the nurse noticed that she had hidden a key in the pillowcase on her bed. At first, out of sympathy, people refrained from questioning her about it. Elderly women like maaji would often keep money and jewellery hidden, far from the reach of the men in their family. But as Sangeeta watched her mother-in-law wither away on the linen, the hint of suspicion got her thinking. It took her three days, but she and the nurse stole the iron key. From its the faded logo and bent neck, they figured it belonged to the large Godrej cupboard in maaji’s room. There, sitting in the back of her most valuable belongings, sat a box containing 10 strips of Combiflam, each containing 15 tablets each. The dosage was enough to bring down an elephant.
Pill addiction is not unlike drug addiction. Addicts usually lie because when someone takes an addictive substance repeatedly for a long period of time, it begins to create changes in the structure and function of the brain. Aging adults tend to get depressed post-retirement, a sudden loss of self-worth fuelling sleepless nights. These symptoms are harder to spot in aging adults than in super hungry, lazy teenagers with droopy, pink eyes, as drug tolerance builds over time, and slows the metabolism of an aging body, which gives drugs a bigger effect. It’s mental as much as physiological, like in maaji’s case.
Sangeeta and her husband eventually figured out how maaji was getting her daily dosage, via her building watchmen. The wily, old lady had threatened the wiry watchman into becoming her dealer. After the house of cards fell apart, maaji went through withdrawal. During this time, it seemed like the fire had gone out of her. Frail and heavily medicated, she would cry for her daughter-in-law to be by her side. The manner in which she addressed Sangeeta had now changed completely. Earlier, all she did was berate Sangeeta and now all she did was cry out for her. The withdrawal was difficult as her body and mind protested against this sudden absence of the stimuli her system was now used to. Maaji looked a lot worse in this stage than she did when she was getting her daily dosage of Combiflam.
The de-addiction process took a few months, and then one morning, maaji’s voice cracked like a whip as she snarled at Sangeeta about the dust in her bedroom. Sangeeta only smiled at her. Now she knew for sure that maaji was getting better.