Addiction in Older Adults: A Growing Problem

Addiction in young adults is often discussed in the media; addiction in older adults is much less a part of the national discourse. However, there are an estimated 2.5 million older adults with an alcohol problem—and widowers over 75 have the highest rate of alcoholism in the United States. Senior citizens are also the segment of the population most likely to be prescribed powerful, addictive medication. According to the University of Pennsylvania Health System, older adults are prescribed nearly 17 million prescriptions for benzodiazepines each year.  There are those older adults who have been using substances for many years, and those who have become addicted later in life. Some of the reasons people may start abusing substances later in life are: -Retirement, and the increased amount of idle time that comes with it -Death and loss -Financial strain -Health decline (memory loss, chronic pain, etc.) -Placement in a nursing home

Challenges to Identifying Substance Abuse in Older Adults

According to the Substance Abuse and Mental Health Services Administration, studies continuously show that doctors are less likely to diagnose alcoholism in older adults than in younger ones. One study of 417 patients found that house officers diagnosed 60% of younger patients with alcoholism, but only 37% of older patients. Doctors can often misidentify symptoms of substance abuse in senior citizens, such as short-term memory loss or balance issues, as signs of aging. 

Baby Boomer Generation

Historically, substance abuse has not been higher among older generations. However, as the Baby Boomer generation enters older age, things are shifting. When Baby Boomers were coming of age in the 60’s and 70’s, experimentation with drugs and alcohol was becoming more mainstream. This generation learned a different relationship to drugs and alcohol than other generations. As teens and young adults, Baby Boomers had higher substance abuse rates than any previous generations. Since 1990, when the oldest Baby Boomers were 45, substance abuse in adults over 45 has been steadily increasing. For the first time in history, the rate of accidental overdoses in older adults is higher than that of adults aged 25-44. Perhaps, as this generation ages and enters retirement, with grown kids moving out, they are falling back on old ways of relating to drugs and alcohol.

Alcohol

According to the Substance Abuse and Mental Health Services Administration, alcohol abuse is the most common substance abuse problem amongst older adults. Rates for alcohol-related hospitalizations in this age group are similar to rates of hospitalizations for heart attacks. Older adults may be dealing with things like retirement, empty nest syndrome, declining health, death and loss, and other major life events. People in this age group sometimes go through multiple of these difficult life changes at once. They may turn to alcohol or other substances to try to numb themselves out.  In addition, as people get older, their bodies metabolize alcohol differently. Sometimes older adults will try to drink as much as they have throughout their lives, but with different effects. They may not realize that their body’s reaction to alcohol has changed. But there are several physiological reasons older adults respond differently to alcohol. When people age, their total body water decreases and their body fat increases. Alcohol is water-soluble and not fat-soluble, meaning that there will be higher levels of alcohol in the blood in older adults than in younger ones for the same amount of alcohol. In addition, the gastric alcohol dehydrogenase enzyme, which helps metabolize alcohol, decreases as people age. Alcohol is metabolized slower, leaving an elderly person’s blood alcohol level raised for a longer time. Older adults are already at a higher risk for major falls, accidents, balance issues, and memory loss. Alcohol abuse makes these risks even higher. As mentioned earlier, health care providers may attribute these things to aging rather than to alcohol. Alcohol can also exacerbate some of the physical health problems that may come with age, such as impaired immune system, hypertension, decreased bone density, and malnutrition. It can also exacerbate mental health disorders.

Categorizing Problem Drinking in Older Adults

According to the Substance Abuse and Mental Health Services Administration, the DSM-IV criteria for alcoholism may not be an accurate way to diagnose alcoholism in older adults. One of these criteria is “a failure to fulfill major role obligations at work, school, or home.” However, most senior citizens have decreased responsibility in these areas, with many in retirement with grown kids.  Another criteria is “continued used of the substance(s) despite persistent or recurrent problems.” This is also tricky, as many elderly people may not attribute their health problems to drinking—and, as mentioned earlier, this view may be reinforced by their doctors. Yet a third issue is tolerance. One of the DSM-IV criteria for diagnosing alcoholism is increased tolerance. However, as previously stated, tolerance decreases in older adults for the same amount of alcohol. Therefore, it is important for clinicians to consider the individual when making a diagnosis. The National Institute on Alcohol Abuse and Alcoholism recommends that people aged 65 and over should have no more than one drink per day, and a maximum of two drinks on drinking occasions like weddings or holidays.

Prescription Drugs

Older persons often take a variety of prescription medications for the health issues that sometimes come with aging. According to the Substance Abuse and Mental Health Services Administration, about 3 in 10 older adults use at least 5 prescriptions. Opioids are a commonly prescribed class of pain medication, and benzodiazipenes are a commonly prescribed tranquilizer. Both are highly addictive. As with alcohol, medications are absorbed more slowly as we age. Another similarity between alcohol and drug abuse in older adults is that both may mirror symptoms of aging. Warning signs such as confusion, memory loss, and balance issues may be misread.

Signs of Substance Abuse in Senior Citizens

Older persons often take a variety of prescription medications for the health issues that sometimes come with aging. According to the Substance Abuse and Mental Health Services Administration, about 3 in 10 older adults use at least 5 prescriptions. Opioids are a commonly prescribed class of pain medication, and benzodiazipenes are a commonly prescribed tranquilizer. Both are highly addictive. As with alcohol, medications are absorbed more slowly as we age. Another similarity between alcohol and drug abuse in older adults is that both may mirror symptoms of aging. Warning signs such as confusion, memory loss, and balance issues may be misread.

I Suspect My Elderly Loved One Has A Substance Use Disorder. What Steps Can I Take?

Older persons often take a variety of prescription medications for the health issues that sometimes come with aging. According to the Substance Abuse and Mental Health Services Administration, about 3 in 10 older adults use at least 5 prescriptions. Opioids are a commonly prescribed class of pain medication, and benzodiazipenes are a commonly prescribed tranquilizer. Both are highly addictive. As with alcohol, medications are absorbed more slowly as we age. Another similarity between alcohol and drug abuse in older adults is that both may mirror symptoms of aging. Warning signs such as confusion, memory loss, and balance issues may be misread.

QUESTIONS ABOUT THERAPIES

First call to Amatus Recovery Centers:

  • Professionals are available around the clock to speak with you.
  • Get you started on the way to recovery.
  • Reach out to us for more information.

833-754-9301

Is your loved one struggling with heroin addiction?

Schedule a Call