Substance Abuse & Addiction in the Elderly

Many older adults in the U.S. take prescription medications to reduce anxiety and/or body pain. They may also drink alcohol more frequently to aid in sleep and cope with mental health conditions. However, due to these factors, elderly people have a higher risk of developing substance use disorders (SUD).
Evidence Based
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Many adults 65 years of age and older misuse prescription and illicit drugs, but alcohol remains the most widely abused substance among the elderly. Other drugs, such as opioids, prescription medications, and marijuana, are also commonly abused by older adults.

Thirty percent of the U.S. population consists of “baby boomers,” which is a generation of people born between 1946 and 1964. In 2011, the first wave of this generation turned 65 years old. Over the years, baby boomers have changed the country’s views concerning alcohol and drug use. For example, the prevalence rate of substance use disorder (SUD) is currently high in this age group, which means more older people need treatment for SUD.

For adults over 50 years of age, experts believe substance use disorder (SUD) rates will rise from about 3 million in 2006 to almost 7 million in 2020.

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Commonly Abused Drugs Among the Elderly

Americans over 50 may take certain medications, such as Ambien, Lunesta, Sonata, Xanax, or Valium, to subdue the effects of anxiety or help reduce pain. Many people also take prescription or over-the-counter medications, as well as alcohol, to aid in sleep and cope with mental health issues. More specifically, common substances older adults abuse include:

Alcohol

The Office of Alcoholism and Substance Abuse Services defines two forms of alcohol abuse among older people in the U.S., which include:

  • The “hardy survivor” — this refers to people 65 years of age or older who have been abusing alcohol for many years, typically beginning in their 20s.
  • The “late-onset” individual — unlike “hardy survivors,” these people began abusing alcohol later in life, which tends to happen accidentally.

Alcohol affects the elderly differently than young or middle-aged adults. As people age, their total body water and lean body mass decrease. The way the liver processes alcohol also declines, while the brain’s sensitivity to alcohol increases. As a result, older adults are less aware of their impairment while consuming alcohol and may experience worse hangovers the morning after drinking heavily. They are also more likely to get in car accidents or unintentionally hurt themselves than younger people who drink.

There are many health consequences associated with alcohol use in late adulthood, especially for those who also take certain medications, have existing health problems, or drink heavily.

Heavy drinking and alcohol use disorder (AUD) can lead to health problems in the elderly, such as:

  • Liver damage
  • Memory issues
  • Mood disorders
  • Osteoporosis
  • Congestive heart failure
  • Diabetes
  • High blood pressure

Nonprescription and Over-the-Counter Medications

Nonprescription and over-the-counter medications can be dangerous or even fatal when combined with alcohol or other drugs. Medications that may negatively interact with alcohol include:

  • Aspirin
  • Tylenol
  • Cough syrup
  • Pain medications
  • Sleeping aids
  • Acetaminophen
  • Cold and allergy medications

Illicit Substances

Illicit drugs refer to any substances that are highly addictive and illegal to use or sell. These substances also chemically alter how your brain works, which can lead to an accidental and uncontrollable addiction. Commonly abused illicit drugs include cocaine, crack cocaine, heroin, ecstasy, inhalants, ketamine, and meth. Hallucinogens and marijuana are also illicit drugs, but they are not as addictive as other substances in this category.

Between 2002 and 2012, past-month illicit drug use among older adults between 50 and 65 years of age doubled from 3.4 percent to 7.2 percent. Further, over 19 percent of these individuals reported using illicit drugs in their lifetime.

Marijuana (Cannabis)

Marijuana use is significantly more common among older adults than other illicit drugs. 4.6 million adults over 50 reported using cannabis in the last year, but less than one million of them used meth, heroin, cocaine, hallucinogens, or inhalants. Some marijuana users legally take the drug strictly for medical reasons, while others abuse it recreationally.

Prescription Medications

Older adults take and abuse prescription medications more often than younger adults, which increases their risk of developing an addiction. Many people also mix prescription medications with other substances, such as alcohol, which raises an elderly person’s likelihood of experiencing an overdose. There are two types of prescription medications that have a high potential for abuse and addiction that the elderly commonly take, including:

  • Opioids — this is a group of prescription drugs that relieve pain. These drugs include oxycodone, hydrocodone, morphine, and codeine, among others. There are also illegal forms of opioids, such as heroin, and other legal synthetic opioids (e.g., fentanyl).
  • Benzodiazepines — these drugs are also called “benzos,” which are a class of psychoactive drugs that have sedating effects on the body. Well-known types of benzos include Xanax, Valium, Librium, Klonopin, and Ativan. Doctors prescribe benzos to older adults with psychiatric conditions more than any other age group. However, many of them are misdiagnosed or over-prescribed medications, which can lead to abuse and misuse over time.

Over 52 percent of people who are 65 years of age and older experience some type of pain. In many cases, the pain can be so severe that individuals have an increased risk of falls, problems with mobility, and difficulties falling asleep. To reduce chronic pain, many older people turn to opioids. However, opioid addictions can develop very quickly, since these drugs have a high potential for abuse.

Doctors should be extremely cautious when prescribing elderly people opioids. This is because they have a difficult time clearing the drugs from their system due to renal function decline.

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Causes of Abuse & Addiction

There are many reasons why an older person may begin abusing substances, such as alcohol or prescription medications. For example, possible triggers may include:

  • Financial strain or loss of income
  • Retirement or relocation
  • Living alone in a nursing home
  • Sleeping difficulties, usually due to chronic pain
  • Mental health issues, such as depression, memory loss, or anxiety disorders
  • A decline in physical health due to major surgery, an injury, or an illness
  • Death of a family member, spouse, pet, or friend
  • Conflicts with family or close friends

For many, these changes bring a sense of isolation and loneliness, feelings which are frequently tied to, and exacerbated by, substance abuse.

Icon with triangle signifying risk.

Risks & Dangers of Substance Abuse in Elderly People

As people get older, their physical and mental health declines. Many of them self-medicate to reduce chronic pain or minimize the negative effects caused by a mental health disorder. In turn, it is extremely dangerous for older adults to misuse and abuse substances due to these issues.

More specifically, older people who abuse opioids or other prescription medications are more likely to overdose, which can lead to death. They also commonly develop other health complications, such as respiratory depression, increased pain sensitivity, painful muscle contractions, reduced bone density, and increased risk of falls, among others.

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Seeking Treatment

If you or someone you know is struggling with a substance abuse disorder (SUD) or alcohol use disorder (AUD), it is crucial to seek treatment right away. Older adults, in particular, are more susceptible to developing serious health complications due to substance abuse, such as heart problems or a fatal overdose.

Treatment options for elderly people with substance disorders include:

Substance use disorders among elderly people (65 years and older) are increasing at alarming rates in the U.S. each year. It is difficult, if not impossible, to quit using without professional medical supervision. Find treatment today.


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Resources

Kuerbis, Alexis, et al. “Substance Abuse among Older Adults.” Clinics in Geriatric Medicine, U.S. National Library of Medicine, Aug. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4146436/.

“Older Adults.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 17 Dec. 2019, www.niaaa.nih.gov/older-adults.

“Prevalence of Marijuana Use Among U.S. Adults Doubles Over Past Decade.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 21 Oct. 2015, www.niaaa.nih.gov/news-events/news-releases/prevalence-marijuana-use-among-us-adults-doubles-over-past-decade.

Willison, Marilyn. Be Bold: Cultivating Health and Happiness for Older Adults. Creators Publishing, August 8, 2019.

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Updated on: August 7, 2020
Author
Alyssa Hill
About
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Medically Reviewed
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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