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Substance Abuse in Seniors

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Substance abuse and addiction are widespread problems in the US, with rates of prescription painkiller abuse on the rise. It’s important to realize though that not all demographics are at equal risk when it comes to substance abuse. Some groups of people are at a higher risk than others for abusing alcohol, illicit drugs, and prescription drugs. One demographic that is often left out of the conversation when it comes to substance abuse is the elderly population. Indeed, substance abuse is a serious issue for many senior citizens.

In this article, we will explore the nature of this problem, offer some explanations as to why so many elderly people fall prey to substance abuse, and then highlight the most effective treatments available.

No one wants to spend the last years of their life struggling with mental health issues, substance abuse, or addiction. But support and help are out there. Recovery is always possible, no matter what your age may be.


The Problem of Substance Abuse in the Elderly Population

According to the National Council on Alcoholism and Drug Dependence (NCADD), 2.5 million older adults suffer from alcohol or drug abuse. Moreover, 6% to 11% of emergency room admissions and 20% of psychiatric hospital admissions by senior citizens are due to alcohol or drug-related problems. It’s also worth emphasizing that substance abuse is often misdiagnosed in older adults. This is because substance abuse may have symptoms that appear similar to the symptoms of conditions like dementia, diabetes, and depression. This is why healthcare clinicians who care for seniors need to be keenly aware of the signs of substance abuse.

Without the recognition that substance abuse is the problem at hand, clinicians won’t be able to recommend an appropriate course of treatment. Accurately diagnosing alcohol or drug abuse in seniors as soon as possible is a crucial aspect of recovery.




Which Substances Do Seniors Abuse the Most?

When it comes to substance abuse among different demographics, some types of substances are abused more than others. And this certainly applies to senior citizens as well. For example, research has shown that, while the abuse of illicit and prescription drugs are rising among the elderly population, alcohol is the most commonly abused drug in this demographic. Within healthcare settings, the rates of alcohol use disorder (AUD) can be up to 22%, although it is believed the figure could be much higher since many cases of heavy drinking go unreported. Senior citizens are hospitalized for alcohol-related problems just as often as they are for heart attacks. Risky drinking behavior is also more prevalent among older men than older women.

Prescription drugs, specifically opioids and benzodiazepines, are the second most commonly abused substance among seniors. One study found that 36% of elderly women and 37.1% of elderly men were using at least five prescription drugs at the same time. Other research underscored that 2.9 million adults over the age of 50 were using opioids non-medically.

The abuse of illicit substances is less prevalent among senior citizens compared to alcohol and prescription drugs. However, this is likely influenced by the ease of access (i.e. alcohol is widely available, whereas illicit drugs have to be purchased through dealers). But this doesn’t mean illicit substance abuse isn’t a serious issue for older adults. The evidence shows, for example, that illicit substance abuse is more prevalent among American senior citizens than among older adults in any other country in the world. Among American seniors who do use illicit substances, 11.7% meet the criteria for having a substance use disorder (SUD) in the past year.


fearful senior


The Dangers of Substance Abuse Among Seniors

Senior citizens who abuse drugs put their physical health and emotional well-being at risk in a variety of ways. For instance, substance abuse among seniors is especially risky because it can contribute to mental illness, kidney and liver disease, and dangerous falls. These harmful effects can be more pronounced among older adults than others due to the greater likelihood that seniors will have pre-existing physical and mental health conditions. Vital organs – such as the brain, heart, kidneys, and liver – slowly lose their function with old age, and these are also organs that can be greatly impacted by substances like alcohol. For this reason, the risk of organ damage, drug overdose, drug-related death, and early death is higher for seniors who abuse drugs than it is for their younger counterparts.

In order to live a long and healthy life, seniors need to get treated for substance abuse as soon as they – or others – realize that it’s a problem.

Signs of Substance Abuse in Seniors

There are many different ways that you can spot substance abuse in seniors, with some symptoms being more common with certain substances than others. Let’s take a look at some of the typical signs of substance abuse as they relate to different substances:

  • Signs of alcohol abuse in seniors. If you’re worried a loved one is abusing alcohol, possible signs may include secretive or solitary drinking, drinking rituals (e.g. drinking during dinner or at night), a loss of interest in activities one used to enjoy, and consuming alcohol in spite of possible interaction with prescription drugs. Other common signs are slurred speech, a change in physical appearance, increased unhealthy habits, smelling of alcohol, confusion, hostility, depression, and memory loss.
  • Signs of prescription drug abuse in seniors. There are four kinds of symptoms of prescription drug abuse in senior citizens: cognitive, social, physical, and psychological. Cognitive symptoms would include disorientation, memory loss, and difficulties with decision-making. Social symptoms include social isolation, family, legal, or financial issues, borrowing medication, doctor shopping (getting a prescription for the same drug from multiple doctors), increasing the frequency of drug use or the dosage, and running out of medication early. Physical symptoms could be poor hygiene, incontinence, reduced self-care, dizziness, poor diet, and blackouts. Psychological symptoms, meanwhile, may include insomnia, anxiety, depression, rapid mood swings, forgetfulness, and confusion.
  • Signs of illicit substance abuse in seniors. Many of the symptoms of alcohol abuse and prescription drug abuse in seniors may be present in illicit drug abuse as well. However, the latter can involve unique signs too. A loved one may, for example, be deceptive about their whereabouts, if they are going to street dealers to obtain illicit drugs. They may also have certain drug paraphernalia that is associated with illicit drugs, including glass pipes for smoking (used for crack cocaine and methamphetamine), baggies, needles and spoons (used for injecting heroin), and razor blades (used for cutting up cocaine). Other signs of illicit substance abuse in seniors would be issues with the law.


person drinking


Why Are So Many Seniors Abusing Drugs and Alcohol?

There is no single answer to the question: “Why are seniors abusing substances at such high rates?” Truth be told, the answer involves myriad factors. Also, for each individual, the reason for his or her substance abuse will be highly personal and complex. However, let’s examine some of the most typical factors that may influence a senior citizen’s drug abuse habits.

Coping With Stress

Substance abuse can be a way for an older adult to cope with the stress that comes with the aging process or disease. For many people, health issues during old age can be distressing and difficult to cope with. Certain substances, however, can temporarily relieve this age-related stress. Of course, if you rely on substances to relieve stress, you put yourself at risk of abusing them and developing additional problems in the process.


older adult


Isolation is a huge problem among senior citizens. According to the US Census Bureau, 12.5 million older adults (28% of the older population) live in one-person households. One survey found that around a third of senior citizens in the US suffer from loneliness. Since we experience loneliness as a form of pain, it is common for people to use substances to relieve that social and emotional pain and to find contentment through the high from drugs and alcohol. Indeed, loneliness and social isolation are considered risk factors for substance abuse. Part of the reason, then, that so many senior citizens abuse substances is that they do so as a way to cope with chronic loneliness.

Mental Health Issues

Mental health conditions are extremely common among older adults. According to the Centers for Disease Control and Prevention (CDC), 20% of adults aged 55 and older suffer from some form of mental health issue. It’s estimated that 7 million adults over the age of 65 suffer from depression each year. And older adults account for 20% of all suicide deaths. Many changes take place in old age that can contribute to poor mental health, including:

  • Ill health
  • Bereavement
  • Relationships breakdown
  • Loneliness
  • Loss of independence
  • Loss of routine and social contact following retirement
  • Moving into a care home
  • Loss of money

Similar to stress and loneliness, people will try to manage the emotional pain of mental health issues through the use of alcohol, prescription drugs, and illicit drugs. Since substances can only offer short-term relief, older adults may find themselves using substances in the long-term, more frequently, and at increasingly higher doses, in order to maintain the relief that they’re seeking. This is how substance abuse and addiction eventually develops.


older adult with pain

Chronic Pain

Many older adults suffer from chronic pain. This pain could result from many different issues, such as a physical disease or condition or back issues. It’s common practice for doctors to prescribe opioids to help older adults manage their pain. As a result, older adults represent one of the largest demographic of Americans prescribed opioids for pain relief. While these drugs do help to improve the quality of life of many senior citizens, opioids do also carry the risk of addiction. Indeed, many people become addicted to opioids because they were first prescribed them for medical reasons, they start to develop tolerance and a desire for the euphoria and high associated with the particular drug, and so they eventually continue to use the drug for non-medical reasons. When older adults abuse prescription drugs for non-medical reasons, despite negative outcomes, this can often be a sign of substance abuse or addiction. 

Loss of Mobility

The loss of mobility in old age can affect one’s life in all sorts of ways. It can result in a reduced ability to do activities one used to enjoy or benefit from, such as certain forms of exercise and sport. It can also lead to increased isolation and a reduced ability to carry out daily activities and functions, both of which can impact one’s emotional well-being. Since the loss of mobility can lead to a loss in quality of life, some older adults may abuse substances in an attempt to feel better about their difficult changing circumstances. It’s important for carers to be aware of how changes in mobility affect older adults and to make sure that they can still live a highly sociable, well-functioning, and active life, as this will help protect them from substance abuse.



Treatment Options for Seniors With a Substance Abuse Problem

Given the above discussion, it is clear that there is a growing need for substance abuse treatment for older adults. Fortunately, there are many options for effective treatment. Any treatment plan for a senior citizen with a substance abuse problem should be highly personalized and involve the care and attention of a well-trained addiction recovery team. An individualized treatment plan should take into account:

  • The nature of the substance abuse, including the substance(s) of choice and the severity of the abuse
  • The person’s mental health, including any family history of mental health conditions, past mental health issues, and any present psychiatric disorders
  • Current use of medication
  • Lifestyle factors, such as the person’s diet and level of exercise
  • The presence of any chronic pain and physical conditions
  • People in the individual’s life who can be depended on for support and as contacts in emergency situations

There is a wide range of treatment options available for older adults struggling with substance abuse. Inpatient treatment and outpatient treatment are common avenues of treatment.

Inpatient Drug Treatment

This would involve staying at a drug rehabilitation center for 24 hours a day, usually over several weeks. During this time, you would receive a range of treatments, such as medical detox, counseling and therapy, drug education, support group meetings, and activities like exercise, yoga, and meditation. Inpatient treatment is best suited to older adults who require a higher degree of care and supervision and whose substance abuse or addiction problem is quite severe.

Outpatient Drug Treatment

Outpatient treatment for substance abuse usually involves the same kinds of treatments as inpatient treatment. The important difference, however, is that clients will attend the treatment center in the day and then go home and be able to live out the rest of their life as normal. Another option is to return to a sober living home in the evening, which can ensure that an older adult doesn’t relapse while trying to maintain recovery. Also, many patients may not need to attend treatment at the drug rehab facility every day in the week. Outpatient treatment is best suited to older adults with milder forms of substance abuse and who don’t require a great deal of medical care and supervision. Older adults who choose outpatient treatment can often rely on support outside the center, such as from spouses, family, friends, their community, and carers. 

If you feel that a loved one may be struggling with a substance abuse problem, it’s vital that you consider the above treatment options and find a way to support them in their recovery. A lot of time, older adults may not even realize they have a substance abuse problem. This can be dangerous. Left undiagnosed and untreated, substance abuse can turn into a serious addiction, leading to a whole host of emotional and physical issues. Be sure to explore every option with your loved one and encourage them, with compassion and non-judgment, to seek support. Effective drug treatment can completely turn around the life of an older adult struggling with substance abuse. 



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