Addiction in the Elderly People: Symptoms and Treatment

Many adults aged 65 and older engage in illicit and prescription drug abuse, but alcohol remains the most widely abused substance. Abuse of opioids, prescription drugs, and marijuana is also common.

30 percent of the U.S. population consists of “baby boomers,” born between 1946 and 1964. In 2011, the first wave of this generation turned 65 years old.

Baby boomers have changed the country’s views concerning alcohol and drug use. For example, substance use disorder (SUD) is common in this age group.

The National Survey on Drug Use and Health suggests that 20% of adults between 60 and 64 are binge drinkers.¹

Commonly Abused Drugs Among the Elderly

Americans over 50 may take certain medications to subdue the effects of anxiety or help reduce pain. These medications include Ambien, Lunesta, Sonata, Xanax, or Valium.

Many also self-medicate by taking prescription or over-the-counter medications with alcohol to aid in sleep and cope with mental health issues.

The most commonly abused substances among the elderly include:

1. Alcohol

The Office of Alcoholism and Substance Abuse Services defines two forms of alcohol misuse among elderly Americans:

• The hardy survivor: Refers to people 65 years of age or older abusing alcohol for many years, typically beginning in their 20s
• The late-onset individual: Began abusing alcohol later in life, often happening 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 liver’s ability to process alcohol declines, and the brain’s sensitivity to alcohol increases.

Older adults are less aware of their impairment after alcohol consumption and may experience worse hangovers in the morning after drinking heavily. They are also more likely to get in car accidents or unintentionally hurt themselves than younger people who drink.

Health issues related to alcohol use in late adulthood are most common in those who take certain medications, have existing medical conditions, suffer from a cognitive impairment, or drink heavily.

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

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

It's never too late to sober up. If you're married to or dating an alcoholic, you should try to help them.

2. 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

3. Illicit Substances

Illicit drugs refer to any addictive and illegal substance. They chemically alter how the brain works, which can lead to an accidental and uncontrollable addiction.

Commonly abused illicit drugs include:

• Cocaine
• Crack cocaine
• Heroin
• Ecstasy
• Inhalants
• Ketamine
• Meth

Hallucinogens and marijuana are also illicit, but they are not as addictive as other substances in this category.

From 2002 to 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. Over 19 percent of this group reported using illicit drugs in their lifetime.²

4. Marijuana (Cannabis)

Marijuana use is significantly more common among older adults than other drugs. Some marijuana users legally take the drug strictly for medical reasons, while others abuse it recreationally.

In 2019, 5 million adults over 50 reported using cannabis, but less than one million of them used meth, heroin, cocaine, hallucinogens, or inhalants.³

5. Prescription Medications

Older adults take and abuse prescription drugs more often than younger adults, which increases their risk for addiction. Many also mix prescription drugs with other substances, such as alcoholic drinks, which raises an elderly person’s likelihood of experiencing an overdose.

Two types of prescription drugs that the elderly commonly take have a high potential for addiction:

Opioids

To reduce chronic pain, many older people use opioids. Opioid addictions can develop quickly since these drugs have a high potential for abuse. Even prescription opioids still have a high risk of addiction.

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

Some common opioids include:

• Oxycodone
• Hydrocodone
• Morphine
• Codeine

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, a class of psychoactive drugs that have sedating effects on the body and are used to treat anxiety or mental illness.

Well-known types of benzos include:

• Xanax
• Valium
• Librium
• Klonopin
• Ativan

Doctors prescribe benzos to older adults with psychiatric conditions more than any other age group. However, many of them are misdiagnosed or have too many prescription drugs, which can lead to alcohol and drug abuse 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 it can lead to falls, mobility problems, and sleep difficulties.⁴

Causes of Abuse & Addiction in the Elderly

There are many reasons why an older person may begin abusing substances, including:

• 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 (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 exacerbated by substance abuse.

Risks of Substance Abuse in the Elderly

As people get older, their physical and mental health declines. Many elderly adults self-medicate to reduce chronic physical pain or minimize the negative effects caused by a mental health disorder.

Older people who abuse opioids or other prescription medications are more likely to overdose, which can lead to death. They also commonly develop health problems, such as:

• Breathing issues
• Lower pain tolerance
• Painful muscle spasms
• Reduced bone density
• Increased risk of falls

Seeking Treatment

If you or someone you know is misusing alcohol or experiencing substance abuse problems, it's crucial to seek treatment right away. Senior citizens, in particular, are more susceptible to developing serious health complications due to substance abuse, such as heart problems or a fatal overdose.

Substance abuse treatment options for elderly people with substance disorders include:

• Detoxification and withdrawal management
• Behavioral therapies, such as cognitive-behavioral therapy (CBT) or dialectical behavioral therapy (DBT)
• Individual therapy, family therapy, and group therapy
• Inpatient or outpatient rehabilitation
• 12-step programs and other addiction resources

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

Summary

Prescription drug abuse affects millions of seniors in the United States. Many resort to abusing prescription drugs for pain relief as a coping mechanism for loneliness, mental health issues, and conflicts with family members or friends.

An elderly person with an alcohol or drug problem will most likely use over-the-counter medications, marijuana, and illicit substances.

Senior citizens with substance use disorders significantly increase their risk of liver damage, memory issues, heart failure, and death.

Always seek help as soon as you notice warning signs. 

Other Resources

• What Happens When You Call an Addiction Hotline?
• Dual Diagnosis Rehab
• Luxury Rehabs
• Quitting Alcohol Cold Turkey
• What Is A Halfway House?
• How to Safely Detox from Alcohol at Home
• Drug and Alcohol Rehab for Couples
• Clonidine for Opiate Withdrawal
• What is Considered an Alcoholic?
• When to Hire an Interventionist
• Alcohol Shakes (Tremors)
• How to Sober Up
• Tapering off Alcohol
• Pink Cloud Stage of Addiction Recovery