The United States population of aging adults has grown exponentially over the past decade. According to projections published by the U.S. Census Bureau, the number of Americans aged 60 and older increased by 34 percent from 55.7 million to 74.6 million between 2009 and 2019. Unfortunately, amid their growing numbers, more and more seniors are facing a substance use disorder problem that in large part has remained silent.
According to the Centers for Disease Control and Prevention, substance use disorders include “treatable, chronic diseases characterized by a problematic pattern of use of a substance or substances leading to impairments in health, social function, and control over substance use.”
Seniors are an overlooked group regarding substance abuse issues, but the problem is growing nationwide. Learning the extent and cause of substance abuse among seniors can help improve outcomes for this population.
Seniors often get disregarded in conversations about substance misuse. Yet according to some estimates, nearly 1 million adults aged 65 and older were reported to be living with an addiction as of 2018. Today, that number could be much higher.
Drug abuse among older adults is a dangerous problem, in part because health care providers and caregivers so often overlook it. It may even be diagnosed incorrectly as a health condition related to aging.
Seniors are likely to use one or more prescription medications. Adverse drug interactions between multiple prescriptions, nutritional supplements, and over-the-counter medication can inadvertently harm one’s health.
Misuse of certain prescriptions can also lead to a substance use disorder. Opioids, for example, have been prescribed to millions of people suffering from chronic pain. The proportion of U.S. adults aged 55 and up who have sought treatment for opioid use disorder has been surging over the past two decades; between 2013 and 2015 alone, it jumped more than 50 percent. One 2006 study stated that at least one in four older adults were using prescription drugs that have potential for abuse.
Many seniors are at risk of developing a dependence on nonprescription, over-the-counter, and illicit drugs as well. Meanwhile, research has suggested that American seniors use illicit drugs at a higher rate than older adults from most other countries.
Surveys show that alcohol use among people 65 and older has increased 22 percent over the past two decades. The extent of alcohol abuse remains unknown due to the impact of underreporting. However, seniors in some studies do report binge drinking and at-risk drinking.
People binge drink when they have five or more drinks in one setting. According to one study, more than a tenth of older adults in the U.S. are regular binge drinkers.
Research published by the National Library of Medicine defines at-risk drinking as consuming more than three drinks on one occasion or having more than seven drinks in one week. The prevalence of at-risk drinking among men is estimated at 16 percent and 10.9 percent among women.
Note that the National Institutes of Health offers a series of free worksheets that can help you evaluate your use of alcohol and learn how to make positive changes.
Seniors are less likely to abuse substances for a euphoric effect. Older adults typically use drugs and alcohol to self-medicate against the physical and emotional pain that comes with aging.
Some common causes of substance abuse among people aged 65 and older include:
A senior’s coping style early in life may correlate with late-life substance abuse. People with avoidant coping styles tend to rely on substances to deal with stress and change. If seniors spend their lives avoiding stress or problems, they are more likely to develop a late-life drinking problem than those who cope in other ways.
Various social factors appear to increase the chance of late-life drug and alcohol abuse. The following social factors are among those that may lead to increased substance misuse:
Older adults with substance abuse disorder typically have these physical factors in common:
Psychiatric risk factors among older adults with substance abuse disorder include:
Substance abuse is a serious medical condition. Prompt diagnosis and treatment can help seniors get the help they need to improve their quality of life. Caregivers and medical providers should watch out for the following symptoms of substance misuse:
Substance misuse is occurring everywhere in the U.S., regardless of age, but certain areas are seeing abuse of specific types of substances. The Agency for Healthcare Research and Quality compiled the following data for 2016 through 2018 about regions nationwide:
The health implications of substance abuse disorder are more significant for older people. Older people are more vulnerable than other groups to the effects of drug use on mental health. Seniors who take prescription medication risk negatively impacting their mental state by mixing their medicine with recreational drugs or by abusing alcohol.
Drug and alcohol abuse can also lead to increased fall risk, physical impairment, adverse psychiatric effects, worsening of other physical conditions, and death.
In fact, among people aged 65 and over, certain types of opioid overdose deaths increased by 53 percent between 2019 and 2020 alone. The number of alcohol-related deaths for this age group rose by 18 percent over the same timeframe.
Whether a senior should receive inpatient or outpatient treatment depends on their needs. Older adults with a substance use disorder may benefit from inpatient treatment if they meet some of these criteria:
Seniors may also need the following to get the most out of recovery:
Much work is needed to decrease the substance abuse rates among older adults. There is a critical need to address this problem.
Primary care physicians are the first line of defense. Education for clinicians should include skill and strategy development to treat substance abuse issues among older adults. Health care workers should know how to identify substance misuse with proper screening and assessments. Understanding co-occurring disorders and the connection between mental illnesses and substance use disorders is also crucial.
If you notice signs of addiction in a loved one, it is essential to get them professional help. In addition to improving their quality of life, you may save them from succumbing to this disease.