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The elderly use approximately one-third of the prescription medication in the United States, often for problems such as chronic pain, insomnia, and anxiety. This study will describe the use of prescription medication, specifically drugs of abuse such as benzodiazepines and opioid analgesics, in a sample of community dwelling elderly referred to Texas Adult Protective Services for self-neglect. We hypothesize that self-neglecting behavior may result in increased use of prescription drugs with known abuse potential. Self-neglecting elders (n = 100) were matched with community controls and interviewed by geriatric nurse-practitioners in their homes. Benzodiazepine use among self neglecting elderly was four-fold that of matched controls, (OR = 4.2, 95% CI = 0.9–20.4), and the use of opioid analgesics slightly higher among self-neglecting elders, (OR = 1.1, 95% CI = 0.5–2.4). Self-neglecters were significantly less …