Growing older doesn’t mean you easily give up your lifestyle or what you like to do to embrace healthier habits. For some senior adults aged 65-plus, that means continuing to drink alcohol, smoke, and use other substances while also taking prescription medications to manage their ailments.
Decisions like this likely may not affect younger people who have more time before they start to feel the effects of aging. But for people in their golden years, such a decision can be a matter of life or death. There is always a chance of overdose when mixing medicines, regardless of who does it. But are senior-age adults at greater risk of having a drug overdose? Yes, they are, and there are several reasons why.
The truth is when it comes to substance abuse, age matters. While people of any age can be adversely affected by potent, habit-forming substances, read on to learn how overdose risks are a reality for older people, whether they intentionally abuse drugs or take them according to prescription.
Senior adults in the baby boomer generation—those born between 1946 and 1964—are the fastest-growing population to use substances, both legal and illegal, and for medical and non-medical reasons, during their older years.
Some observers partly attribute this increase to substance use habits they developed as younger people. While it is apparent that old habits die hard, choosing to indulge in substance use could have grave consequences for older people who won’t acknowledge that what they used to do is now risky when it comes to their health and well-being.
The use of alcohol and prescription opioid medication is widespread among this group. Alcoholic beverages are widely available and easy to access without anyone noticing that their older loved one is now drinking too much. Also, prescription pain relievers’ euphoric effects make it easier for older patients to misuse and abuse them to treat pain or engage in recreational drug use.
Nearly 1 million U.S. adults aged 65 and older live with a substance use disorder (SUD), according to a National Institute on Drug Abuse (NIDA) report. Treatment facilities that offer professional addiction recovery programs have admitted seniors who have developed SUDs from using alcohol and opioid pain medicines.
NIDA also highlights statistics showing that the proportion of older adults who entered a treatment facility during a recent 12-year period rose from 3.4 percent to 7 percent in that span.
Experts anticipate a rise in addiction and dependence among older U.S. adults as the population ages and lives longer. With the nation’s elderly population expected to nearly double by 2050, according to MedicineNet, treatment recovery programs for SUDs are likely to be in high demand.
They also use prescription medications to treat chronic health conditions, such as high blood pressure, diabetes, or asthma. According to NIDA, seniors account for more than one-third of total outpatient spending on prescription drugs in the U.S.
Among the drugs they buy are benzodiazepines, such as Xanax and Valium, and opioid medications. Some have come to abuse these medications, creating dependence and addiction. Many of those who do not get professional help for their disorder do overdose, sometimes fatally.
It is a fact that metabolism slows and organs change as we age. An older person’s brain also becomes increasingly sensitive to substance use in their older years, as well, according to the NIDA.
Older people’s reactions to medications change based on changes in their muscle mass, body fat, and water composition. As U.S. Pharmacist explains, body-fat stores increase while total body water decreases. What does not change, however, is how fast the body absorbs different drugs.
With changes in muscle mass, body fat, and water content, medications can take longer to work in an elderly person. They also are more potent because there is less water in the body to dilute them. The liver and kidneys, which are responsible for filtering the medications, may also not work as efficiently because of older age and/or chronic illness.
All of these changes are important to consider because they determine what a therapeutic drug level is for the older person taking medicine. They also affect how long a drug stays in the body and how fast it is processed and then eliminated.
An older person’s central nervous system also reacts to substances differently, which is yet another reason they must monitor what chemical substances enter their bodies.
With substances remaining in the body longer, there is a greater chance that they will come into contact with one another and interact, and such interactions can be harmful if these drugs are incompatible. The problem compounds if an older person takes more medication than they should or takes medication with a substance, such as alcohol, or an illicit substance, such as heroin, while other drugs are in the body.
Not all overdoses involve using drugs or alcohol irresponsibly. Confusion and memory problems are common in older people, so it is possible that senior adults can mix up their medications or take them in the wrong dosages, both of which can adversely affect their health. Senior adults also experience mood disorder changes, such as depression, which can also influence how much of a drug they may use.
According to NIDA, more than 80 percent of older adults between the ages of 57 to 85 years use one prescription medication daily. More than 50 percent use five medications or supplements daily to manage multiple chronic medical conditions, it reports.
It is understandable, then, how taking this many medications could put seniors at greater risk of overdose.
AgingCare.com notes that not all overdoses involve opioid pain medication. It cites data from the U.S. Centers for Disease Control and Prevention (CDC) that older adults “are more likely to be hospitalized for adverse events related to the use of blood thinners or diabetes medications than they are to be harmed by prescription painkillers.”
Anticoagulants (blood thinners), diabetes agents, and opioid analgesics—were responsible for the majority of drug-related hospitalizations among people age 65 and older, according to the CDC’s study, Aging.com says.
Further increasing their risk of overdose are overprescribing practices. Medical professionals have come under criticism for giving older people too many medications that can put them in harm’s way.
HealthDay reports that more than 33% of older people in the U.S. are prescribed medications they may not need or are inappropriate for the illness that they have, according to a recently published study. According to the article, these patients could end up in the hospital or emergency room after using these medications in high amounts.
Among these are benzodiazepines (benzos), a class of medications that treat anxiety and insomnia, among other conditions, for a short-term period. Benzos are dangerous for older people to take, as they can increase an older person’s chance of suffering falls and other adverse health problems. They also can make people drowsy and confused, which is especially dangerous if they are driving, cooking, or engage in tasks that require someone’s full attention.
According to a report from Physician’s Weekly, some research estimates that 10% to 25% of people aged 65 and older are using benzodiazepines. If any of them are drinking alcohol or using other substances, it could put them at greater risk of an adverse health event, such as an overdose.
“Even if an older patient is capable of properly and consistently managing their medications, they may still be overmedicated per their doctor’s orders and susceptible to ADRs (adverse drug reactions),” Aging.com writes.
Older adults must be prudent when taking medications to help them maintain their health. Taking prescription drugs, or even over-the-counter ones, does not necessarily mean they can’t have alcohol or other substances. It does mean, however, that they must be careful as the risk that they could take too much and overdose is always present. Here are a few tips to guard against accidental, life-threatening overdoses.
If it helps, a modern pill bottle that comes with an alarm or digital dispensing system can help you stay on track.
Of course, store your medication in a safe place and follow directions on the label. If you encounter any issues, contact your healthcare provider as soon as possible. If you suspect that you or a loved one may have taken too much medicine, get emergency help by dialing 9-1-1 or visiting your local emergency room or urgent care center.
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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
American Geriatrics. Substance Use and Misuse Among Older Adults. PDF. from https://www.americangeriatrics.org/sites/default/files/inline-files/GWEP%202019%20Substance%20Use%20%26%20Misuse%20Among%20Older%20Adults_0.pdf
Number of U.S. Elderly Will Double By 2050: Report. (2014, May 07). from https://www.medicinenet.com/script/main/art.asp?articlekey=178350
Mayo Clinic. Alcohol Use Disorder. Overview. from https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243
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Botek, A. (2020, January 07). Two Surprising Types of Medication Cause the Majority of Senior Overdoses. from https://www.agingcare.com/Articles/senior-drug-overdose-148701.htm
News, C. (2020, October 29). 1 in 3 Americans Prescribed Inappropriate Drugs. from https://consumer.healthday.com/10-29-1-in-3-americans-prescribed-inappropriate-drugs-2648532345.html