Substance Abuse in the Elderly is a Problem

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There’s a stigma surrounding substance abuse that has many assuming that drugs and alcohol are mainly abused by college students, criminals, and others who fall under the “addiction” stereotype. In reality, addiction can affect anyone — regardless of age, education, background, and other socioeconomic factors. Senior citizens and elderly adults can also suffer from substance abuse, and are often affected more severely by addiction on behalf of the natural aging process.

Substance abuse in the elderly continues to be a growing problem, since many of today’s seniors, or Baby Boomers, grew up during the 1960s and 1970s when drug experimentation was a major part of U.S. culture. Addiction in the elderly is commonly overlooked, especially since many seniors who abuse drugs and alcohol do so to treat physical and psychological symptoms, and not to get high or seek thrills.

Elderly substance abuse has become a serious problem in the U.S., but it can be reversed and managed with professional addiction treatment and general knowledge about the way drugs and alcohol affect the aging body. If you or someone you know is an elderly adult who struggles with addiction, understand that it’s never too late to seek addiction treatment, regardless of one’s age or health status.

Here’s a close look at substance abuse in the elderly, and at what you can do to seek help for you or an elderly loved one who needs help fighting addiction.

Substance Abuse Among the Elderly in the U.S.

There are roughly 2.5 million U.S. adults over the age of 65 who suffer from drug and alcohol abuse. Between six and 11 percent of all elderly hospital admissions are related to drug and alcohol abuse, while 14 percent of all elderly emergency room admissions are caused by alcohol poisoning, drug overdoses, and other complications associated with drug use.

Alcohol is the most commonly used substance abused among the elderly, followed by prescription drugs. An estimated 50 percent of elderly nursing home residents suffer from alcohol-related health problems — including addiction — while widowers over the age of 75 are more likely to suffer alcohol use disorder than any other age group. In regards to prescription drug use, seniors over the age of 65 make up roughly 13 percent of the U.S. population, but account for over one-third of all spending on prescription drugs in the country.

Though U.S. seniors who suffer from addiction tend to favor alcohol and prescription drugs over illicit substances, illicit drug use is more prevalent among American seniors than seniors in all other countries. When it comes to illicit drug use, a 2012 survey found that the majority of senior users favor marijuana, followed by cocaine, inhalants, hallucinogens, meth, and heroin. Today, a higher number of seniors are turning to illicit opioids and heroin on behalf of the country’s ongoing opioid crisis.

Researchers say drug and alcohol use disorder in seniors can be described as early onset or late onset. Elderly adults who fall into the early-onset category are most likely to have become addicted to drugs or alcohol very early in life, and may have struggled with substance abuse for most of their lives. Those who fall into the late-onset category most likely began abusing substances in their 40s and 50s, and are often more receptive to addiction treatment due to being in better physical and mental health than those in the early-onset category.

What Drives Substance Abuse in the Elderly?

Addiction in the elderly stems from a number of causes that differ from those seen in younger individuals. As people age, they begin to experience a number of major lifestyle changes that can sometimes pave the way for substance abuse and addiction. Retirement, divorce, and the death of a spouse are examples of major lifestyle changes and challenges that can influence seniors to start using drugs and alcohol.

Substance abuse in the elderly is also driven in part by injuries and health problems commonly suffered by this demographic. For instance, conditions such as arthritis, hip replacements, and back pain are just some conditions that are commonly treated using opioid painkillers. Many times, doctors won’t even hesitate to prescribe painkillers to seniors who experience chronic or moderate to severe pain caused by one or more health conditions.

Elderly individuals do not commonly turn to drugs and alcohol for the euphoric highs, but instead use these substances to self-medicate physical and psychological symptoms. Feelings such as depression, loneliness, sadness, and guilt can often be masked with the effects of drugs and alcohol, as well as pain related to serious health conditions. For instance, many seniors use alcohol as a sleep aid to avoid problems with sleep disturbances and sleep disorders.

Why Senior Citizens Are More Vulnerable to Addiction

As a person becomes older, they begin to experience a decrease in total body water and lean body mass as part of the natural aging process. Elderly individuals in poor physical health or who have been abusing drugs and alcohol for many years are more likely to experience a decrease in liver function. Since the liver is responsible for metabolizing and detoxifying drugs and alcohol, seniors with poor liver health can become more easily impaired when using these substances.

Also, since the liver works harder at breaking down drugs and alcohol in the average senior body, these substances can remain in the body for longer than normal. This can lead to tolerance and dependence, which is when the brain and body adapt to the presence of drugs and alcohol, and require these substances to avoid withdrawal. Seniors who become tolerant to or dependent on drugs and alcohol may continue using the same amounts of these substances despite already being intoxicated and under the influence.

Seniors who take strong prescription drugs such as opioids or benzodiazepines are at high risk for becoming dependent on these substances even when using their medications properly. Many times, doctors prescribe these drugs to elderly patients in abnormally high doses, and issue multiple refills that aren’t really needed. Today, physicians are urged to use caution when prescribing opioids and benzodiazepines to senior citizens, since these drugs can cause more extreme sedation in those who are older.

Risk factors commonly associated with substance abuse and addiction are genetics, environment, and mental health disorders. In the elderly, these risk factors join a number of others that make seniors more vulnerable to addiction.

Common risk factors that drive substance abuse in senior citizens:

substance abuse in the elderly

Chronic pain and social isolation make the elderly more susceptible to substance abuse.

  • Chronic pain
  • Reduced mobility
  • Physical disabilities
  • Poor immunity
  • Chronic physical illness
  • Transitions in care and living situations
  • Using avoidance as a coping method
  • Personal history of drug and alcohol abuse
  • Personal history of mental health disorders
  • Grief
  • Social isolation
  • Unplanned or forced retirement

Seniors who take prescription medications should remain aware of all potential side effects and the risk for dependence — especially those who already have a history of drug abuse and dependency. Highly potent drugs including opioids, benzodiazepines, and barbiturates can easily lead to toxicity, dependence, and addiction when misused, or when overprescribed by doctors. Familiarize yourself with common signs of prescription drug abuse to help you determine if your elderly loved one suffers from addiction.

Medical Side Effects of Elderly Drug Abuse

Substance abuse in the elderly can be hard to detect, since many signs and symptoms of addiction and withdrawal can easily be confused with those triggered by other health conditions. For instance, shaking and tremors caused by alcohol and drug abuse can often be mistaken for essential tremors, which commonly affect 10 million Americans — the majority of whom are seniors.

Elderly drug abuse poses many of the same health risks as those faced by younger individuals — only the risks among elderly are often exacerbated due to factors including physical disabilities and poor immunity.

Here are potential medical risks of substance abuse among the elderly:

  • Sleep disorders such as insomnia
  • Slowed breathing and respiration
  • Incontinence
  • Worsened memory and cognition problems
  • Increased headaches and dizziness
  • Increased sensitivity to drugs and alcohol
  • Decreased tolerance to drugs and alcohol
  • Excessive daytime fatigue and drowsiness
  • Gastrointestinal problems
  • Worsened liver disease, heart disease, and diabetes
  • Higher number of falls, injuries, and accidents
  • Feelings of delirium and disorientation
  • Alcohol poisoning or drug overdose
  • Heightened risk for adverse drug interactions that cause coma or death

Elderly individuals who suffer from addiction are also at heightened risk for mental health disorders such as depression, anxiety, and schizophrenia. Those who already suffer from these mental health disorders may experience worsened, more intense symptoms on behalf of addiction. Seniors who suffer co-occurring disorders can be treated for both their drug use disorder and mental health disorder at most addiction treatment centers.

How to Intervene When an Elderly Loved One is Suffering from Addiction

Elderly adults who suffer from addiction often tend to avoid seeking help for fear of losing their independence or putting extra burden and responsibilities on their loved ones. They may feel embarrassed, ashamed, or guilty about their addiction, or be in denial that they have a problem in the first place. Elderly individuals may blame symptoms or accidents caused by their addiction on other health problems that may or may not exist, or lie about their addiction to avoid being placed in nursing homes, hospitals, and rehab facilities.

Though many elderly adults visit their doctors regularly in outpatient settings, it can be difficult for doctors to determine whether their patients have problems with substance abuse. Elderly adults will often mask or disguise symptoms of addiction while at their appointments to avoid an intervention of any kind. In most cases, friends and family members often take responsibility for initiating the process of seeking addiction treatment so their elderly loved ones can get help recovering from substance abuse.

Here are signs that indicate your elderly loved one may be suffering from addiction.

  • Weight loss
  • Decreased appetite
  • Occasional slurred speech
  • Uncharacteristic irritability, agitation, and short temper
  • Increased sleep disturbances and insomnia
  • Unusual sadness or depression
  • Decline in personal hygiene
  • Higher number of falls
  • Unexplained bruises
  • Problems with concentration and memory
  • Sudden increase in anxiety
  • Increase in health complaints for non-existing health problems
  • Social withdrawal and isolation
  • Loss of interest in long-held hobbies and activities
  • Physical withdrawal symptoms (e.g., shaking, sweating, nausea)
  • Hiding or lying about drug and alcohol use
  • Hiding pill and alcohol bottles
  • Taking prescription drugs with alcohol
  • Drinking rituals and patterns, such as drinking alcohol before and after dinner
  • The emergence of mental health disorders

If you suspect that your elderly loved one is suffering from addiction and needs help, consider staging an intervention— especially if your loved one is in denial, or refuses to seek help for their condition. An intervention can connect your elderly loved one with the treatment needed to improve their physical and psychological health, and help them get back to living a sober, addiction-free life with fewer side effects and health problems.

When staging an intervention, gather a small group of people who truly know and care about your elderly loved one. This may include your loved one’s spouse, adult children, best friend, caregiver, or a clergy member from the church your loved one attends. Intervention experts recommend choosing older adults to participate in the meeting, since older adults are often more skilled at helping their elderly loved ones understand the importance of seeking treatment and overcoming addiction.

Before holding the intervention, ask everyone in the group to prepare written statements that inform your elderly loved one how their drug and alcohol addiction has affected them personally. For instance, your loved one’s best friend can mention how addiction has taken your loved one away from fishing, gardening, and other activities they frequently enjoyed together. Make sure everyone stresses that they are staging an intervention out of love, and because they want to see your elderly loved one conquer addiction and become healthier.