Elderly is defined as being past middle age, and it is generally accepted to mean at or over the age of 65. Substance abuse and dependency rates among the elderly population may be higher than statistics show, as it can be sometimes difficult to diagnose or recognize in this population.
An article in Today’s Geriatric Medicine estimates that about eight million older adults show symptoms of substance abuse. As the baby boomer generation (those born between 1946 and 1964), who lived through a culture of drug experimentation and acceptance, is rapidly approaching retirement and entering elderly age, experimentation with illicit drugs and the rate of elderly addicts may increase.
Rates of Substance Abuse
The New York Times reports that illicit drug use among adults between ages 50 and 59 rose from 2.7 percent to 6.3 percent from 2002 to 2011. The number of adults reaching elderly age is expected to rise from 40 million to 73 million from 2010 to 2030. Life expectancy has risen over the years, meaning that the elderly population is growing as well.
Around 40 percent of the American population aged 65 and older drink alcohol, according to a 2008 national survey published by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Additionally, the New York State Office of Alcoholism and Substance Abuse Services (OASIS) reports that 17 percent of American adults over the age 65 have an alcohol use problem.
As we age, our bodies process and handle drugs and alcohol differently. Tolerance to alcohol goes down, and drugs may stay in our systems or organs longer, for example.
When you add in over-the-counter (OTC) medications, potential hazards and risk factors for combining drugs with alcohol increase. In the United States, people aged 65 and older comprise 13 percent of the nation’s population and make up a third of all outpatient prescription medication spending, according to the National Institute on Drug Abuse (NIDA). Much of this population takes more than one medication at a time. As the rate of prescription medications goes up, so does the potential for abuse and misuse. Between 12 and 15 percent of elderly patients seeking medical attention abuse prescription drugs, the Community Prevention Initiative (CPI) reports. Alcohol is the most commonly abused substance by the elderly population, with prescription medications such as opioid analgesics and benzodiazepine sedatives and tranquilizers coming in second.
How and Why the Elderly Become Addicts
There are two types of elderly addicts: those who become addicted to drugs or alcohol before age 65, termed “early-onset addicts”, and those who do so after age 65, termed “late-onset addicts.” Early-onset addicts are those who have abused drugs and alcohol throughout their lifetime, becoming dependent and addicted to illicit substances at a younger age and perpetuating this addiction as age advances. This group of elderly addicts is thought to make up two-thirds of the geriatric alcoholic population and may have more physical and psychiatric issues than late-onset addicts, according to the Psychiatric Times.
The New York Times further publishes that between 14 and 20 percent of the elderly population have suffered from either a mental health disorder, substance abuse disorder, or both, according to a national survey in 2010. Mental illness often co-occurs with substance abuse. Those diagnosed with a mood disorder may be twice as likely to also battle a drug abuse disorder, NIDA reports. In fact, psychiatric disorders and substance abuse may occur as often as between 21 and 66 percent of the time. As we age, physical and mental capacities may deteriorate further blurring the lines between substance dependence and mental illness.
Stressful life changes that often occur as we age may increase the incidence of drug or alcohol abuse, which can develop into a late-onset addiction. For instance, as age advances, loved ones or significant others may pass away, living situations can change, retirement begins, and physical maladies may increase. Drinking or using drugs may begin as a method of coping with these difficult psychological and physical changes.
The elderly population is less likely to abuse drugs as a method of getting high, or for the euphoric effect, and more likely to instead use them as a form of self-medication, as a way to numb physical and emotional pain.
Almost a third of adults between 57 and 85 also take five or more prescription medications, and 68 percent of Americans take supplements or over-the-counter medications as well, ABC News publishes. Sedatives, tranquilizers, antidepressants, anti-anxiety and pain medications are commonly prescribed. All these medications have psychoactive effects, and many are considered highly addictive. When mixed, the drugs may interact with each other and heighten all the potential effects.
Signs of Abuse
Much of the elderly population may feel isolated. As a person’s social circle diminishes, so does the support network that may be able to recognize problem drinking or an issue with drug abuse. Drugs and alcohol make changes to the chemical pathways in the brain, and over time, repeated misuse or abuse may lead to a physical and psychological dependence indicated by drug tolerance, withdrawal symptoms when substance is removed, compulsive drug-seeking behavior, and cravings for the substance. Many of the symptoms of addiction may be overlooked in elderly population, as they may often also be signs of aging or mental illness.
Treatment for Elderly Addicts
Staying in close contact with friends and family as they age, and being aware of any and all medications they may be taking, can help to prevent substance abuse or negative drug interactions that can lead to addiction. Maintaining an active social and recreational schedule can also help keep older adults involved and may decrease the rates of substance abuse and dependency.
Peer and 12-Step programs can be an effective method of treatment for addicts, and finding a group of people around the same age can help to form a support network of likeminded people who are experiencing the same type of life events and circumstances. There are differing levels of treatment, depending on the severity of the addiction or dependency. Treatment can range from hospitalization and residential care to outpatient treatment. The first step is often a comprehensive evaluation to ascertain all potential medical, mental health, family history, and substance abuse patterns. At times, a medical detox protocol may be the next step, and this is performed under the supervision of consulting physicians in a specialized facility. It often includes the use of pharmaceuticals to manage drug cravings and withdrawal symptoms.
When mental illness and substance abuse or dependency are both present in the same person at the same time, an integrated dual diagnosis approach may produce the best results.
Medical and mental health teams of professionals will all work together to form a comprehensive treatment plan that will address any and all medications that need to be taken while also taking into consideration the potential for prescription drug misuse, abuse, and addiction for a substance abuser or addict. Certain medications may need to be avoided.
Therapy is beneficial for treating both addiction and mental illness symptoms, as behavioral therapy models can help to modify harmful coping mechanisms and teach new and more positive behaviors.
Holistic methods may be very beneficial during the recovery of an elderly addict as well. Holistic treatment can include nutritious diet plans to promote physical health and exercise plans that are relevant to this population. Meditation and yoga may improve the mind and body connection as well as teach the concept of mindfulness wherein individuals learn to respect and appreciate themselves fully.
FRN treatment centers offer a full and comprehensive range of services to benefit patients of all ages who are battling substance abuse, dependency and mental health issues. Admissions coordinators are standing by to answer any questions and guide you through a confidential and completely free evaluation in order to determine what level of care is right for you or your loved one. Call now.
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton