Many people don’t expect older adults to struggle with substance use disorder. Even medical professionals may not identify substance use problems in older people. But the epidemic of overdose and addiction in the United States has proven that addiction is a disease that affects all demographics.
Older adults who struggle with substance use problems need access to care and effective treatment options to prevent serious substance use issues from escalating.
As the next generation reaches retirement age, more people may struggle with substance use problems as older adults. Drugs and alcohol may also have different effects on people as they age. Problems that young adults face with addiction may not be the same ones that older adults experience.
Learn more about substance use disorders in older adults and what they can do to address addiction.
People in health care and demographics studies often talk about baby boomers with a lot of concern. They’re the generation of children born in the period of peace after the Second World War, and their generation is huge. This big generational swell is often given the unflattering name “pig in the python” because of the way a population graph will bulge for baby boomers.
This large generation is significant as they enter their retirement years. Medical and clinical care professionals will need to learn how to treat this generational swell effectively as they age. Historically, older adults have relatively low rates of substance use disorders and overdose, but the baby boomer generation may not have the same relationships with drugs as seniors a generation before. One of the reasons for this is that they came of age during the 1960s and 1970s when the cultural perspective on drugs was shifting.
A 2015 paper in the journal Clinics in Geriatric Medicine noted that the misconception that elderly people don’t usually have issues with substance misuse has led to some unidentified substance use problems.
Illicit drug use is more common in young adults and usually declines with age. Still, the elderly in America drink more frequently than older adults in any other country. However, a significant number of adults over age 65 have substance use problems related to illicit drugs, prescriptions, or alcohol.
According to the National Institute on Drug Abuse (NIDA), there were about 1 million adults over 65 with substance use disorders in 2018. Alcohol is the most common substance of misuse among older people. Prescription drug misuse is also common, especially among older adults who take addictive drugs for long-term problems like chronic pain.
Various factors may trigger the development of a substance use problem in older adults. A frightening medical diagnosis or chronic health conditions may cause physical or mental pain that encourages using drugs or alcohol to cope. Retirement is another significant factor that can lead to increased recreational drinking. People who usually reserved drinking for after work or on weekends may start drinking more frequently when they no longer need to work. This may be more critical if someone feels disillusioned or depressed in retirement.
Disability or decreased mobility may also cause psychological issues like depression that lead to substance misuse. If disability or health conditions cause chronic pain, this can also lead to increased substance use. Prescription drugs or alcohol may provide an escape from pain, but frequent long-term use can turn into an addiction.
As the most common form of substance misuse among older people, alcohol is a significant concern for doctors and caretakers with elderly patients. Chronic pain, depression, and a lack of a sense of purpose may encourage older adults to drink more frequently. Alcohol may also affect older adults differently than younger people. As we age, physical changes may cause alcohol to affect the body differently.
Older people have a slow metabolism, which means it takes longer for the body to process alcohol. Older people may also develop lung and heart problems with chronic alcohol use or with the use of other drugs. It can also cause mood disorders and memory issues more easily in older adults.
Alcohol can also be dangerous during withdrawal. Someone who tries to quit alcohol use suddenly after a period of chemical dependence may experience seizures or a condition called delirium tremens. This can result in heart failure, coma, or death. It’s important to speak to a doctor if you feel that you’ve become chemically dependent on alcohol or any other central nervous system depressant.
There is a wide variety of medications available to help people as they age. However, few substances can cause chemical dependency and addiction when they’re misused or used for a long time. One of the most common problem substances is benzodiazepines. Insomnia, or difficulty sleeping, is a problem many older people face.
Several medications and other treatments can be used to help with insomnia. Benzodiazepines can be used to treat sleep problems, anxiety, and muscle spasms. It’s commonly prescribed for all of these issues, but they aren’t recommended for older patients.
After age 65, your ability to process benzodiazepines effectively starts to wane. Side effects like memory impairment, cognitive impairment, impairment of motor skills, and chemical dependence are more prevalent in older people. These issues may lead to next-day drowsiness, increased risk of slip and falls, and overdose. Benzodiazepines are also central nervous system depressants, which means they can be deadly when mixed with alcohol or other depressants.
Older people may also be prescribed opioids to deal with chronic pain symptoms. Opioids are first-line drugs when it comes to managing moderate-to-severe pain, but they can also cause severe substance use disorders when misused. Opioids are more likely to cause dependence when they’re used for a long time or when they’re misused.
Opioid addiction can lead to the use of illicit opioids like heroin. Opioids can also be deadly when they’re mixed with alcohol or benzodiazepines.
For older adults, addressing a substance use disorder is vital. Addiction is a chronic disease that can take over many parts of your life, including your health, relationships, and finances. Older people may be more vulnerable to the physical and psychological effects of drugs and alcohol than young adults. Addiction is also progressive, which means it can get worse if it’s not addressed.
Addressing a substance use problem as soon as possible can help avoid some of the most severe consequences of addiction. Addiction treatment is a complex process that’s designed to address multiple aspects of life, including physical, psychological, and social needs. There are also four major levels of care in addiction treatment, and the one you need will depend on the severity of your substance use problem.
Medical detox with medically managed treatment, the highest level of care, is reserved for people who are likely to experience medical needs like severe withdrawal. Inpatient treatment is the next level of care with 24-hour access to medical and clinical treatment services. When you’re able to live on your own, you may move on to intensive outpatient and then outpatient treatment.
American Psychiatric Association. (2017, January). What Is Addiction? from https://www.psychiatry.org/patients-families/addiction/what-is-addiction
ASAM. (n.d.). What is the ASAM Criteria? from https://www.asam.org/resources/the-asam-criteria/about
Juergens, S. M., M.D. (1993, August 01). Problems With Benzodiazepines in Elderly Patients. from https://www.mayoclinicproceedings.org/article/S0025-6196(12)60643-0/fulltext
Kuerbis, A., Sacco, P., Blazer, D., & Moore, A. (2014, August). Substance abuse among older adults. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146436/
National Institute on Drug Abuse. (2020, July 31). Substance Use in Older Adults DrugFacts. from https://www.drugabuse.gov/publications/substance-use-in-older-adults-drugfacts