Substance abuse and drug and alcohol addiction were, for a long time, considered “younger people” issues, due to the high rates of substance use disorders in young adults. Because of this, there are some misconceptions about addiction within the elderly population.
Substance abuse and addiction among seniors is often overlooked due to limited research data and insufficient knowledge about just how much substance abuse affects the older population. However, substance abuse in adults over the age of 60 (often referred to as the baby boomer generation) is one of the fastest-growing health problems in the United States.
In fact, alcohol and prescription drug abuse affect up to 17% of senior citizens, based on calculations from the NIAAA. 
Understanding Addiction in the Elderly Population
In 2009, SAMSHA did a national survey that revealed that one-quarter of the prescription drugs that are sold within the United States are used by the elderly population, and the prevalence of abuse of these drugs can be as high as 11%.
This study also showed that this age population had the highest inpatient admissions for substance abuse, with most of those substances being cocaine and stimulants. 
Because drug and alcohol addiction in the elderly population is often overlooked, some of the facts below might surprise you – but this is all the more reason we need to be raising awareness about substance abuse and addiction in the elderly population.
Some surprising facts about substance use disorders within the elderly population are:
- Widowers over 75 years old have the highest rate of alcoholism within the United States.
- Hospitalizations of the elderly population are quite common, but did you know that up to 11% of these admissions have to do with alcohol or drug problems?
- About 25% of older adults use prescription medications that have extremely high abuse and addiction potential.
- The elderly population is much more likely to have long-term psychoactive medication prescriptions that they subsequently become addicted to. 
There are essentially two types of addiction in senior citizens:
- Early-Onset Addiction
- Late-Onset Addiction
Early-onset addicts will often have a long history of substance abuse and/or mental health problems. People who struggle with early-onset addiction were abusing drugs or alcohol before the age of 65 and have simply continued their use. These are people who have been life-long addicts or people who were in recovery and relapsed.
Late-onset addicts, on the other hand, are often referred to as “situational elderly drug abusers”, and these people often don’t start abusing drugs or alcohol until their later years (after age 40 or 50). These are the individuals who often struggle with the different physical and mental challenges of aging and are looking for ways to self-medicate.
While people who fall into the late-onset category are often in better physical and mental health due to not abusing drugs over years or even decades, each category has its own difficulties in recovery.
Causes of Substance Abuse as an Elder
There are a variety of reasons why a senior may be struggling with a substance abuse issue.
Just as with younger adults, these could be health-related issues that brought them to prescription medicines that they eventually began to abuse, or life circumstances that took an emotional toll they tried to cope with by abusing drugs and alcohol.
However, unlike substance abuse in the younger population, there are quite a few potential triggers that apply only to the older population, such as:
- Retirement, feelings of boredom or unhappiness with where they are in life
- The death of a family member or spouse
- Financial strains that come with losing a job or retiring
- Relocation or placement in a long-term care facility
- Insomnia or the worsening of health conditions related to old-age
- Family conflict relating to adult children, grandchildren or an ageing spouse
- Mental health decline (memory loss, depression)
- Physical health decline (major surgery, worsening of physical ailments)
While drug and alcohol abuse of any kind in any person can have detrimental effects, these are often amplified in the elderly population for two main reasons:
- They are more susceptible to deteriorating effects caused by their substance abuse
- There is less help/less awareness of substance abuse in the ageing population. Problems caused by substance or alcohol abuse is often misdiagnosed as other health concerns brought on by age.
Did you know that senior citizens (in this case, individuals who are over the age of 65) don’t have as much ability to metabolize drugs or alcohol as younger individuals? Along with that, the increased brain sensitivity to drugs and alcohol as you get older often makes it extremely dangerous for the elderly to use drugs or alcohol at all.
This means that having an alcohol or drug problem as an elderly individual comes with all kinds of side-effects, negative consequences and potential dangers that young people struggling with substance abuse just don’t have.
Signs of Drug or Alcohol Abuse in the Elderly Population
Seeing the signs of addiction in senior citizens can be extremely difficult, because many alcohol and drug abuse symptoms present very much like symptoms of other medical concerns they already have or mental health issues they are facing due to old age (such as depression, dementia or diabetes, for example).
Because of this, it’s extremely easy for health care professionals to overlook the signs of addiction in elderly patients.
Knowing what to look for can help you determine if your elderly loved one is struggling with a substance use disorder and get them the help they need. These signs can include:
- Isolating themselves from loved ones
- Drastic changes in eating habits or daily routine
- Changes in their sleeping habits (sleeping too much or suffering from insomnia)
- Deteriorating mental health at an accelerated rate
- Chronic pain with seemingly no cause
- Nausea and/or vomiting that can’t be explained by health problems they are having
- Lack of personal hygiene
- Being secretive about the prescriptions they have, not being honest about their medication use
- Hoarding medications, not wanting to throw away empty bottles
- Memory loss that can’t be explained by any of the medical conditions they have
- Loss of balance or continued loss of coordination
- Bloodshot eyes or large/small pupils
- Slurred speech
- Mood swings
Recognizing the symptoms of substance abuse in your elderly loved ones can significantly reduce the inevitable decline in their health that they will face if their addiction continues.
Without help, senior citizens who are struggling with a substance abuse problem can experience a quick and unexpected decline in their mental and physical health, as well as a decline in their quality of life.
The Dangers of Elderly Substance Abuse
While addiction can be dangerous to anyone, the elderly population faces a unique set of problems when it comes to the way it impacts their physical and emotional health.
The elderly population can face worsening health conditions due to their drug or alcohol addiction, including things like:
- Congestive heart failure
- High blood pressure
- Liver and kidney problems
- Memory impairment
- Mood disorders
Along with the physical impact substances have on an elderly body (listed above), each specific drug’s effects can be amplified due to the deterioration of the person’s body and mind as they get older.
For example, cocaine can cause things like delirium, heatstroke and myocardial infarction. If you are a senior citizen who is frequently abusing cocaine, the risk of these conditions is much higher than if a younger adult were to have the same level of use.
Prescription Drug Abuse in the Elderly Population
According to the National Institute on Drug Abuse (NIDA), more than 80% of elderly patients (between 57-85 years old) use at least one prescription medication on a daily basis. More than 50% of those people are taking more than FIVE medications or supplements every single day. 
With this number of prescriptions, elderly patients are more likely to misuse or abuse their medications.
While some elderly patients may be abusing their prescriptions without knowing it (such as mixing up dosages or taking pills at the wrong time), quite a lot of elderly people misuse or abuse their medications on purpose.
This is quite easily done, due to the fact that opioid pain relievers (extremely addictive prescription medications like Percocet or Vicodin) are often prescribed to elderly individuals to treat conditions that they have been diagnosed with.
On top of that, there is the abuse of medications that were prescribed to aid a mental health concern, such as Xanax for depression or Ambien prescribed to help with sleep difficulties. These are the classes of drugs that are most commonly abused by this age group.
Treatment Options for Elderly Individuals Struggling with Substance Abuse Problems
The elderly population may turn to drugs or alcohol for a variety of reasons that can include not only emotional pain but physical pain as well. These older adults who are struggling with addiction often have unique treatment needs which may require alternative treatments and therapies.
There are various tailored recovery programs that are designed to help a certain group of people, and many of these groups can include the elderly population.
For example, there are recovery programs specifically geared towards war veterans. This kind of treatment centre would put a heavy focus on PTSD therapy to help recovering addicted veterans overcome their traumas. Other treatment plans for elderly addicts may include specific pain management for health conditions or health problems they are facing due to their older age.
Choosing a recovery plan that can be tailored to what the individual needs and that focuses on the real reasons for their drug and alcohol abuse can be the best way to address their addiction, and bring them one step closer to a sober life.
Photo credit: robdu91. This picture has a Creative Commons attribution license.