Addiction In The Elderly

Substance Abuse In The Elderly

Substance abuse among the elderly (adults over the age of 65), particularly of alcohol and prescription drugs, is one of the fastest-growing health problems in the United States.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcohol and prescription drug abuse affect up to 17% of adults over the age of 65. However, it is often underestimated and underdiagnosed, which can prevent them from getting the help they need. Due to insufficient knowledge, limited research data, and hurried office visits, health care providers often overlook signs of substance abuse among the elderly.

This is made worse by the fact that the elderly often have medical or behavioral disorders that mimic symptoms of substance abuse, such as depression, diabetes, or dementia.

According to the Office of Alcoholism and Substance Abuse Services, substance abuse among senior citizens can be classified into two general forms:

• Those who have been abusing substances for many years and have reached age 65
• Those who begin to misuse substances and form addictions later in life

Fortunately, regardless of your age or when your addiction started, there are treatment options available to help you get back on a healthy path.

Signs Of Addiction In Senior Citizens

As people age, their mental health, physical health, and personal relationships may start to deteriorate. Although addiction may be more challenging to recognize in this demographic, it’s essential to pay attention to any unusual signs your elderly loved one displays.

Some signs of substance abuse in the elderly population include:

• Memory problems
• Changes in sleeping habits
• Unexplained bruises
• Irritability, sadness, and depression
• Unexplained chronic pain
• Changes in eating habits
• Wanting to be alone often
• Failing to bathe or keep clean
• Losing touch with loved ones
• Lack of interest in usual activities

Causes Of Addiction In The Elderly

​​Several age-specific risk factors are known to contribute to addiction in this population. The following are known factors that contribute to addiction in the elderly:

• Loss of loved ones (spouse, friends, etc.)
• Loneliness
• Moving into assisted living
• Chronic medical illnesses
• Financial strain
• Slower metabolism
• Taking multiple medications
• Chronic pain

These major life and biological changes can cause many older adults to struggle with loneliness and chronic medical concerns that can take a toll on their mental and physical well-being.

Loneliness And Isolation

Many changes in older adulthood can lead to loneliness. Retirement can be isolating, being far from family can be lonely, and losing elderly friends or a spouse can cause unwanted solitude.

Additionally, needing to relocate to an assisted living or nursing home facility removes them from their social support network and can also feel isolating. To cope with these feelings, elderly adults may misuse alcohol, marijuana, and prescription medications, such as opioids and benzodiazepines, to self-medicate.

Medical Concerns

As adults grow into their golden years, they tend to spend more time at doctor’s visits, navigating the complicated medical insurance system, and being diagnosed with medical conditions and chronic pain that require prescription medications with a high addiction potential, such as benzodiazepines or opioids.

Having to remember to take multiple types of prescription medications can be very confusing, especially if a memory deficit is present. As a result, older adults are more likely to accidentally misuse medications by forgetting to take their medications, or they either take them too often or take the wrong amount. This increases their risk of addiction, even if it is by accident.

As the elderly population continues to use medications with high addiction potential to help treat their pain or other chronic medical conditions, they will need more of a dose to feel the desired effects. This is known as tolerance, and as an individual’s tolerance increases, so does their risk of addiction.

What Are The Dangers Of Substance Abuse In The Elderly?

As people age, their metabolism slows down, meaning that addictive prescription medications will take longer to metabolize, so that they will stay in the person’s system for a longer period of time. This can be problematic if the person consumes alcohol during this time or takes other medications, as mixing medications and alcohol can have harmful side effects.

Because of a slower metabolism in this aging population, the elderly can develop a tolerance to these substances and can also experience dangerous side effects. This is often unintentional, as many people in the aging population are unaware of how their metabolism works and how drug interactions can affect their minds and bodies.

Smaller amounts of substances have bigger effects in older individuals because of changes in absorption and metabolism. Even low levels of use—one or two drinks, for example—can have a big impact on everyday functioning.

The following are known dangers of substance abuse in the elderly:

• Increased risk of falls
• Impaired memory and concentration
• Increased risk of overdose
• Increased risk of motor vehicle accidents
• Worsened existing medical conditions such as heart disease
• Worsened insomnia
• Worsened mental health conditions such as depression

Challenges In Identifying Addiction In The Elderly

Alcohol or drug abuse often mimics symptoms of other medical or mental health disorders. This makes it easy for doctors who encounter an older patient to attribute some addiction symptoms to declining mental or physical health. These symptoms can also be seen as part of normal aging (mild cognitive impairment) or as part of other medical conditions diagnosed in the elderly population.

Commonly misdiagnosed symptoms associated with drug abuse in the elderly include:

• Memory loss
• Confusion
• Irritability
• A decline in hygiene
• Changes in sleep and appetite

Symptoms of addiction often overlap with symptoms of the following medical conditions:

• Dementia (Alzheimer’s, Parkinson’s, vascular dementia, frontotemporal dementia, Lewy Body dementia)
• Depression
• Diabetes
• Vitamin deficiencies or malnutrition

As a result, many medical professionals misdiagnose addiction in this population.

How Do I Help A Parent Or Grandparent With An Addiction?

If your elderly parent or grandparent is struggling with addiction, it is important to compassionately intervene and help them so their condition does not worsen.

You can start by going to doctors’ visits with them and speaking with their primary care physician. You can also seek help from a geriatrician (a physician who specializes in elder care), a therapist specializing in elderly care, or an addiction treatment center that offers programs for elderly addiction.

You can also help your parents or grandparents with addiction by becoming more involved in their daily life, especially if they live alone or are lonely due to a significant life change.

• Spend time with them at home, monitor their alcohol consumption, and acquaint yourself with acceptable levels of alcohol consumption for seniors.
• Become acquainted with their daily medications and monitor if they are taking them correctly. If they are not, offer to help with their medications or develop a system where they can take them independently without mixing up their dosage and schedule.
• Be part of their active daily life by going on walks with them, playing games with them, or offering to help around the house or with errands.
• Have conversations with them about their alcohol and drug use and ask them how they are feeling. Maybe they are depressed and lonely and do not know what else to do.
• Consider senior day programs or outings where they can interact with community members their own age.
• Encourage them to volunteer doing something they love.
• Introduce them to new senior-friendly activities such as games, puzzles, books, and hobbies that can keep them entertained and improve their memory.

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How Is Addiction Treated In The Elderly?

Addiction in the elderly is best treated in age-appropriate, respectful, and supportive environments where seniors are given as much decision-making and independence as possible. If you are considering addiction treatment for an elderly loved one, a primary care physician can do an assessment and suggest the most appropriate form of treatment.

Educational Intervention

Studies have shown that many older adults who use illicit drugs, misuse prescriptions, and misuse alcohol can benefit from education about their substance misuse. Older adults often respond well to nonjudgmental conversations about:

• How their substance misuse can negatively affect them
• The risks of drug interactions
• Slower metabolism in their age group
• Education about the medications they are taking
• Potential harms that can occur when they take medications differently from how they are prescribed.

Other important treatment aspects include:

• Appropriately treating their pain
• Appropriately addressing any sleep issues to ensure they are getting adequate sleep
• Addressing specific topics for this age group, such as loss, grief, isolation, life changes, social support, and finding purpose

Often these are the culprits of addiction, so when the above aspects are addressed and treated, it can also treat the addiction at hand, without having to undergo formal addiction treatment.

Addiction Treatment Programs

If formal addiction treatment is deemed beneficial, many rehabs have specific programs tailored to treat the unique needs of older adults. Studies have shown that brief interventions that include cognitive behavioral therapy, skills-based approaches, and motivational interviewing have the best outcome, in addition to medication-assisted treatment (MAT).

Because the aging population has a slower metabolism, if detoxification is needed, it must be done in a supervised setting where healthcare professionals have experience with treating withdrawal in the elderly. Medications should be monitored closely for any interactions, and once the older adult is safely out of the withdrawal phase, treatment interventions and medications can be started.

Studies have also shown that engaging family members in treatment can help them understand what is happening and appreciate the importance of keeping their elderly family members involved in the community.

Family interventions can also help family members understand that encouraging their elderly family members to take a woodworking class or a pottery class is a healthy way to cope with their age-related changes, and can be a healthy replacement for misusing drugs and alcohol.

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How To Find A Rehab For Senior Citizens

The alarming rate at which individuals 65 years of age and older are developing addictions to various substances is a reason for concern and something that should not be ignored by medical professionals, caretakers, or family members. It is important to seek out rehabs that specialize in treating the elderly. If you or someone you know is struggling with addiction issues later in life and needs help finding a treatment program, explore our rehab directory or contact a treatment provider today to get started.