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Neurologic Diseases

The brain, spinal cord, and nerves make up the nervous system. Together they control all the workings of the body. When something goes wrong with a part of your nervous system, you can have trouble moving, speaking, swallowing, breathing, or learning. You can also have problems with your memory, senses, or mood.

There are more than 600 neurologic diseases. Major types include:

  • Diseases caused by faulty genes, such as Huntington's disease and muscular dystrophy
  • Problems with the way the nervous system develops, such as spina bifida
  • Degenerative diseases, where nerve cells are damaged or die, such as Parkinson's disease and Alzheimer's disease
  • Diseases of the blood vessels that supply the brain, such as stroke
  • Injuries to the spinal cord and brain
  • Seizure disorders, such as epilepsy
  • Cancer, such as brain tumors
  • infections, such as meningitis

Nutrition for Older Adults

What is nutrition and why is it important for older adults?

Nutrition is about eating a healthy and balanced diet so your body gets the nutrients that it needs. Nutrients are substances in foods that our bodies need so they can function and grow. They include carbohydrates, fats, proteins, vitamins, minerals, and water.

Good nutrition is important, no matter what your age. It gives you energy and can help you control your weight. It may also help prevent some diseases, such as osteoporosis, high blood pressure, heart disease, type 2 diabetes, and certain cancers.

But as you age, your body and life change, and so does what you need to stay healthy. For example, you may need fewer calories, but you still need to get enough nutrients. Some older adults need more protein.

What can make it harder for me to eat healthy as I age?

Some changes that can happen as you age can make it harder for you to eat healthy. These include changes in your:

  • Home life, such as suddenly living alone or having trouble getting around
  • Health, which can make it harder for you to cook or feed yourself
  • Medicines, which can change how food tastes, make your mouth dry, or take away your appetite
  • Income, which means that you may not have as much money for food
  • Sense of smell and taste
  • Problems chewing or swallowing your food
How can I eat healthy as I age?

To stay healthy as you age, you should:

  • Eat foods that give you lots of nutrients without a lot of extra calories, such as
    • Fruits and vegetables (choose different types with bright colors)
    • Whole grains, like oatmeal, whole-wheat bread, and brown rice
    • Fat-free or low-fat milk and cheese, or soy or rice milk that has added vitamin D and calcium
    • Seafood, lean meats, poultry, and eggs
    • Beans, nuts, and seeds
  • Avoid empty calories. These are foods with lots of calories but few nutrients, such as chips, candy, baked goods, soda, and alcohol.
  • Pick foods that are low in cholesterol and fat. You especially want to try to avoid saturated and trans fats. Saturated fats are usually fats that come from animals. Trans fats are processed fats in stick margarine and vegetable shortening. You may find them in some store-bought baked goods and fried foods at some fast-food restaurants.
  • Drink enough liquids, so you don't get dehydrated. Some people lose their sense of thirst as they age. And certain medicines might make it even more important to have plenty of fluids.
  • Be physically active. If you have started losing your appetite, exercising may help you to feel hungrier.
What can I do if I am having trouble eating healthy?

Sometimes health issues or other problems can make it hard to eat healthy. Here are some tips that might help:

  • If you are tired of eating alone, try organizing some potluck meals or cooking with a friend. You can also look into having some meals at a nearby senior center, community center, or religious facility.
  • If you are having trouble chewing, see your dentist to check for problems
  • If you are having trouble swallowing, try drinking plenty of liquids with your meal. If that does not help, check with your health care provider. A health condition or medicine could be causing the problem.
  • If you're having trouble smelling and tasting your food, try adding color and texture to make your food more interesting
  • If you aren't eating enough, add some healthy snacks throughout the day to help you get more nutrients and calories
  • If an illness is making it harder for you to cook or feed yourself, check with your health care provider. He or she may recommend an occupational therapist, who can help you find ways to make it easier.

NIH: National Institute on Aging

Opioid Overdose

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your provider. However, people who take opioids are at risk for opioid use disorder (OUD) and overdose. These risks increase when these medicines are misused. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's opioids.

What is an opioid overdose?

Opioids affect the part of the brain that regulates breathing. When people take high doses of opioids, it can lead to an overdose, with the slowing or stopping of breathing and sometimes death.

What causes an opioid overdose?

An opioid overdose can happen for a variety of reasons, including if you:

  • Take an opioid to get high.
  • Take an extra dose of a prescription opioid or take it too often (either accidentally or on purpose).
  • Mix an opioid with other medicines, illegal drugs, or alcohol. An overdose can be fatal when mixing an opioid and certain anxiety treatment medicines, such as Xanax or Valium.
  • Take an opioid medicine that was prescribed for someone else. Children are especially at risk of an accidental overdose if they take medicine not intended for them.

There is also a risk of overdose if you are getting medications for opioid use disorder (MOUD). MOUD is a treatment for OUD. Many of the medicines used for MOUD are also controlled substances that can be misused.

Who is at risk of an opioid overdose?

Anyone who takes an opioid can be at risk of an overdose, but you are at higher risk if you:

  • Take illegal opioids
  • Take more opioid medicine than you are prescribed
  • Combine opioids with other medicines and/or alcohol
  • Have certain medical conditions, such as sleep apnea, or reduced kidney or liver function
  • Are over 65 years old
What are the signs of an opioid overdose?

The signs of an opioid overdose include:

  • Very small pupils of the eyes
  • Falling asleep or loss of consciousness
  • Slow, shallow breathing
  • Choking or gurgling sounds
  • Vomiting
  • Limp body
  • Pale, blue, or cold skin
  • Faint heartbeat
  • Purple lips and fingernails
What should I do if I think that someone is having an opioid overdose?

If you think someone is having an opioid overdose:

  • Call 911 immediately.
  • Give the person naloxone, if it is available. Naloxone is a safe medication that can quickly stop an opioid overdose. There are two forms. One is a nasal spray that you spray info the nose. The other type is injected into the muscle under the skin, or into the veins. Naloxone works by blocking the effects of the opioids on the body. It's important to read the product instructions and check the expiration date before you give it to someone.
  • Try to keep the person awake and breathing.
  • Lay the person on their side to prevent choking.
  • Stay with the person until emergency workers arrive.

Naloxone won't harm someone if they're overdosing on drugs other than opioids, so it's best to use it if you think someone is overdosing.

Can an opioid overdose be prevented?

If you are taking opioid pain medicine, there are steps you can take to help prevent an opioid overdose:

  • Take your medicine exactly as prescribed by your provider. Do not take more medicine at once or take medicine more often than you are supposed to.
  • Never mix the pain medicines with alcohol, sleeping pills, or illegal substances.
  • Store your medicine safely where children or pets can't reach it. Consider using a medicine lockbox. Besides keeping children safe, it also prevents someone who lives with you or visits your house from stealing your medicines.
  • Dispose of unused medicine promptly.

It is also important to teach your family and friends how to respond to an overdose. If you are at higher risk of an overdose, you will want get naloxone and carry it with you wherever you go. You can buy naloxone at a pharmacy.

Opioid Use Disorder (OUD) Treatment

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers, such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some health care providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your provider. However, opioid use disorder (OUD) is still a possible risk.

What is opioid use disorder (OUD)?

Opioid use disorder (OUD) means that you have a problematic pattern of using opioids. The pattern causes a lot of distress and impairment (meaning that it causes problems in and interferes with your daily life). Instead of OUD, sometimes people use the terms "opioid dependence" and "opioid addiction." Dependence means feeling withdrawal symptoms when not taking the drug. Addiction is a chronic brain disease that causes a person to compulsively seek out drugs, even though they cause harm.

What are the treatments for opioid use disorder (OUD)?

Treatments for OUD include:

  • Medicines; this kind of treatment is known as medications for opioid use disorder (MOUD)
  • Counseling and behavioral therapies
  • Residential and hospital-based treatment
Which medicines treat opioid opioid use disorder (OUD)?

The medicines used in MOUD are methadone, buprenorphine, and naltrexone:

  • Methadone, buprenorphine, and lofexidine, which can decrease withdrawal symptoms and cravings. They work by acting on one or another of the targets in the brain that opioids act on. But these medicines are different because they do not make you feel high. Some people worry that if they take methadone or buprenorphine, it means that they are substituting one addiction for another. But it is not; these medicines are a treatment. They restore balance to the parts of the brain affected by addiction. This allows your brain to heal while you work toward recovery.

    You may safely take these medicines for months, years, or even a lifetime. If you want to stop taking them, do not do it on your own. You should contact your provider first, and together you can work out a plan for stopping.

  • Naltrexone works differently than methadone and buprenorphine. It does not help you with withdrawal symptoms or cravings. Instead, it takes away the high that you would normally get when you take opioids. Because of this, you would take naltrexone to prevent a relapse, not to try to get off opioids. You have to be off opioids for at least 7-10 days before you can take naltrexone. Otherwise you could have bad withdrawal symptoms.

  • A combination drug that includes buprenorphine and naloxone. Naloxone is a drug to treat an opioid overdose. If you take it along with buprenorphine, you will be less likely to misuse the buprenorphine.

How does counseling help treat opioid use disorder (OUD)?

Counseling for OUD can help you:

  • Change your attitudes and behaviors related to drug use
  • Build healthy life skills
  • Stick with other forms of treatment, such as medicines

There are different types of counseling for OUD, including:

  • Individual counseling, which may include setting goals, talking about setbacks, and celebrating progress. You may also talk about legal concerns and family problems. Counseling often includes specific behavioral therapies, such as
    • Cognitive-behavioral therapy (CBT), which helps you recognize and stop negative patterns of thinking and behavior. It teaches you coping skills, including how to manage stress and change the thoughts that cause you to want to misuse opioids.
    • Motivational enhancement therapy, which helps you build up motivation to stick with your treatment plan.
    • Contingency management, which focuses on giving you incentives for positive behaviors such as staying off the opioids.
  • Group counseling, which can help you feel that you are not alone with your issues. You get a chance to hear about the difficulties and successes of others who have the same challenges. This can help you learn new strategies for dealing with the situations you may come across.
  • Family counseling, which includes partners or spouses and other family members who are close to you. It can help to repair and improve your family relationships.

Counselors can also refer you to other resources that you might need, such as:

  • Peer support groups, including 12-step programs like Narcotics Anonymous
  • Spiritual and faith-based groups
  • HIV testing and hepatitis screening
  • Case or care management
  • Employment or educational supports
  • Organizations that help you find housing or transportation
What are residential and hospital-based treatments for opioid use disorder (OUD)?

Residential programs combine housing and treatment services. You are living with your peers, and you can support each other to stay in recovery. Inpatient hospital-based programs combine health care and OUD treatment services for people with medical problems. Hospitals may also offer intensive outpatient treatment. All these types of treatments are very structured, and usually include several different kinds of counseling and behavioral therapies. They usually also include MOUD.

Opioids and Opioid Use Disorder (OUD)

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. Some opioids are made from the opium plant, and others are synthetic (man-made).

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

What are the side effects and risks of opioids?

Opioids can cause side effects such as drowsiness, mental fog, nausea, and constipation. They may also cause slowed breathing, which can lead to overdose deaths. If someone has signs of an overdose, call 911. These signs may include:

  • Very small pupils of the eyes
  • Falling asleep or loss of consciousness
  • Slow, shallow breathing
  • Choking or gurgling sounds
  • Vomiting
  • Limp body
  • Pale, blue, or cold skin
  • Faint heartbeat
  • Purple lips and fingernails

When using opioids, there is also a risk of opioid use disorder (OUD).

What is opioid use disorder (OUD)?

Opioid use disorder (OUD) means that you have a problematic pattern of using opioids. The pattern causes a lot of distress and impairment (meaning that it causes problems in and interferes with your daily life). Instead of OUD, sometimes people use the terms "opioid dependence" and "opioid addiction." Dependence means feeling withdrawal symptoms when not taking the drug. Addiction is a chronic brain disease that causes a person to compulsively seek out drugs, even though they cause harm.

The risk of OUD is higher if you misuse the medicines. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's opioids.

Opioid use disorder and overdoses are serious public health problems in the United States. As more people misuse opioids, more women are misusing opioids during pregnancy. This can lead to health risks for the mother and baby. The baby may be born with neonatal abstinence syndrome (NAS). NAS is a group of withdrawal symptoms that a baby has after being exposed to drugs during pregnancy.

Another problem with increased opioid misuse is that it can also lead to more heroin use. There are some people who switch from prescription opioids to heroin because heroin may be cheaper and easier to get.

How are opioid use disorder (OUD) and opioid overdose treated?

There are effective medicines to treat OUD. Using medicines to treat OUD is called medications for opioid use disorder (MOUD). MOUD can help you stop using the drug, get through withdrawal, and cope with cravings. It is often combined with behavioral therapy and counseling. Having support from family and friends can also help.

There is also a medicine called naloxone which can treat opioid overdoses. It can reverse the effects of the overdose and prevent death if it is given quickly.

How can I prevent problems when taking prescription opioids?

To prevent problems with prescription opioids, be sure to follow your doctor's instructions when taking them. Do not share your medicines with anyone else. Contact your doctor if you have any concerns about taking the medicines.

NIH: National Institute on Drug Abuse

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