Substance Abuse And Addiction Among Senior Citizens

While often overlooked, substance abuse and addiction in the senior community are more common than most people would think. Understanding the signs of a senior struggling with alcohol or drug abuse is critical in order to create a plan to get them the help they need. The stigma associated with addiction is even more prevalent in the senior community which can create more barriers to getting help for a loved one.

Substance use disorder can impact anyone at any age, including your aging loved one. When substance use becomes problematic, it can be debilitating for seniors to deal with the side effects of withdrawal, the consequences of lost funds and health issues due to substance use disorder, and many more negative effects that can be life-changing and long-lasting.

Fortunately, there are several signs you can look for to determine if an aging loved one is living with substance use disorder, as well as different resources so your senior can get the help they need to achieve sobriety.

Rates of Substance Abuse Among Seniors

According to the National Institute on Drug Abuse (NIDA), there are an estimated one million adults over the age of 65 who are currently living with substance use disorder.

To put that into perspective, there are also an estimated 54.1 million seniors living currently in the United States. This means that close to 2% of the older population in the United States is living with substance use disorder, which isn’t an insignificant number.

Most Commonly Abused Substances Among Senior Citizens

Older adults use all the substances that younger adults also abuse. However, some risk factors may increase the chances of abusing some substances over others, such as alcohol and prescription drugs.

Alcohol Abuse And Seniors

Research shows that over 10% (one in 10) of older adults binge drink alcohol. These numbers show just how prevalent alcohol use is, and how dangerous it can be for older adults to binge drink and mix medications.

Unfortunately, alcohol is readily available to older adults, and its abuse often goes unnoticed by loved ones and caretakers. It is considered the most commonly misused substance among older adults.

Prescription Drug Abuse And Seniors

Prescription drug use is also on the rise, with 4% to 9% of older adults using pain relievers on a daily basis to relieve pain. Unfortunately, using opioids for pain also increases the risk of abuse. Even when prescribed by a doctor, regular use can increase the risk of misuse, according to NIDA.

Other Commonly Abused Substances Among Seniors

Although alcohol and prescription medications/opioids are the most prevalent to be abused among older adults, new studies also show that substance use is increasing among seniors with other drugs.

These substances include:

  • cocaine and crack cocaine
  • marijuana and hashish
  • heroin
  • non-prescription methadone, which is used to help curb heroin cravings
  • other opiates and synthetic drugs such as fentanyl

Risk Factors for Senior Substance Abuse

There are a number of risk factors that put older adults in a more vulnerable position for substance use disorder. These risk factors include:

Decreasing Support System

Around 28% of older adults in the United States currently live alone and without a support system. For older adults in this situation, this can lead to a plethora of mental health issues and negative emotions, including loneliness and social isolation according to studies.

For these adults, turning to substances like alcohol and drugs can be one of the only ways for them to cope. Addiction becomes even more difficult to treat for adults who have no support system and no family to encourage them to seek treatment.

Loss Of Purpose

During retirement, adults will spend much of their time alone at home or with family. This loss of purpose can lead to increased depression, more time on an aging loved one’s hands, and even more time to think about abusing substances.

A lack of purpose has been linked to addiction and mental illness across all generations. Because this loss of purpose is felt among nearly all seniors, it puts this demographic at an even higher risk than their younger peers.

As older adults retire and lose their original mental and physical abilities due to the natural aging process, they may struggle to find ways to connect to themselves, their interests, and their communities.

Increasing Life Changes

As people grow older, many life changes will occur including the death of family and friends, children moving away, and grandchildren growing up.

Life changes are one of the biggest causes of substance use.

In fact, life stressors and catastrophic events have been shown to lead to alcohol abuse, and can pose a risk for older adults who have to live through constant adjustments.

Other major life changes that may trigger substance abuse in seniors include:

A whopping 50% of older adults live with insomnia, meaning they are either unable to fall asleep or get a full night’s rest without waking up several times.

Due to this insomnia, some adults might turn to substances like alcohol and opioids, which have a sedating effect that can help someone relax and feel calmer. This is a form of self-medication for older adults who use substances in order to sleep.

But relying on alcohol and medications not meant to treat sleep issues is risky and can lead to dependence. Over time, the very substances a senior uses to help them sleep can create or worsen existing sleep disorders.

Anxiety And Depression In Older Adults

Perhaps one of the biggest causes of substance abuse in older adults is the prevalence of mental illness in older adults. According to the Centers for Disease Control and Prevention (CDC), the most common mental illnesses in older adults include anxiety and depression.

Older adults who live with these mental illnesses and have no other way to cope might turn to alcohol and other substances, which produce euphoric effects and act as “downers,” to alleviate mental illness symptoms if only for a short period of time.

However, evidence shows that increased alcohol and substance use leads to disorders of cognitive thinking and impaired dopamine levels in the brain that are responsible for happiness and satisfaction.

So, like the effect of using substances to treat sleep issues, using substances to treat anxiety and depression can have the exact opposite effect on an elderly individual and worsen these disorders.

Signs a Senior Is Abusing Substances

There are certain signs to look out for that indicate your aging loved one is currently battling with substance or alcohol use disorder. Below are some of the signs to look for:

  • Increased money issues: If your parent or loved one seems to not have any money left from their pension, or this money isn’t enough to pay for their expenses when it covered all expenses before, this could indicate they are using their funds to pay for drugs or alcohol if there is no other explanation.
  • Changes in behavior: Using substances like drugs and alcohol can lead to both long-term and short term behavioral changes. According to NIDA, adults who use substances can have issues with clarity, memory, and attention. They can also go on to develop poor social behaviors as a result of their drug abuse.
  • Talking about substances frequently: If your parent seems more focused on drugs or alcohol and speaks about it often — such as, “I need a drink,” or “I could be drinking right now” — these are blatant signs of substance abuse that should not be ignored.
  • Social changes: If your aging loved one now struggles with finding a job, has lost their job, or is experiencing major shifts in friendships, these are also signs that your parent needs help for substance use disorder.

Dangers of Substance Abuse Among Seniors

In addition to the loss of income and lost friendships due to substance abuse, there are other complications that can result from using prescription, legal, or illicit substances. These include health complications, accidental overdose, and in some cases, overdose deaths.

Increased Health Problems

There are significant health problems associated with the use of any substance of abuse, including drugs such as alcohol, heroin, and opioids.
For instance, heavy drinking can increase your loved one’s chances of developing liver failure. Sadly, for older adults with liver failure, transplants are limited, meaning your loved one might not get the chance to get a new liver and recover.

Accidental Overdoses

Older adults also have an increased risk of harmful interactions between alcohol and prescription medications. These harmful interactions are compounded due to the fact that older adults have lower levels of metabolism, meaning they cannot process medications and alcohol as efficiently as they once used to.

These risks of medication interaction can include:

  • accidental overdoses
  • nausea
  • vomiting, which puts your loved one at risk of severe dehydration
  • diarrhea
  • seizures
  • in some cases, death with drug and drug interactions
  • Overdose Deaths

Opioid-related overdose deaths among the older population increased by 20% between 2008 and 2017. Heroin deaths and other drug overdose deaths are also on the rise, with fentanyl now more prominent and being used in everything from illicit prescription opioids like OxyContin to heroin purchased on the street.

Fentanyl is an extremely potent and dangerous opioid with a strength that is 100 times more potent than morphine and 50 times more potent than heroin.

In addition, shocking data found that the number of opioid overdose deaths increased by 1886% (from 518 deaths to 10,292 deaths) between 1999 and 2019. This statistic provides a bigger picture of how much the opioid crisis has grown and continues to affect older Americans.

Top-Recommended Treatments For Seniors With Addictions

There are various types of addiction treatment options for seniors. However, it’s important to keep in mind that many seniors might not be comfortable with all options. For instance, some seniors might find it difficult to attend group therapy sessions due to feeling as if they need to care for younger adults, as well as being unable to relate to younger populations.

Whether you choose to enroll your senior in inpatient treatment or outpatient treatment, it’s important to find specialized groups and treatment centers that specialize in caring for older adults.

That being said, some of the best treatment options for seniors with substance use disorder include the following:

Inpatient Treatment

Inpatient rehab centers can help seniors who have severe substance use disorders. These are closely monitored facilities that have staff on hand 24 hours a day, seven days a week.

Inpatient treatment is the recommended method of treatment for older adults who will experience withdrawal symptoms that need medical monitoring, or who are in the beginning stages of treatment. Seniors coming off of opioids and alcohol typically need medical supervision during this time, making inpatient rehab and detoxification the optimal approach.

Intensive Outpatient Treatment

Intensive outpatient programs (IOP) are best for aging loved ones who need more guidance after inpatient treatment. Evidence also shows that IOP is as effective as inpatient treatment at helping residents stay sober.

IOP does not require residents to spend time 24/7 in a facility. Rather, your loved one can attend anywhere between four to eight hours of outpatient treatment sessions every day or several days a week, while returning home later in the evening.

Outpatient Treatment

Outpatient treatment is a type of treatment option that is best reserved for adults with less severe cases of substance use or alcohol use disorder. If your elderly loved one can manage their own medications and doesn’t need medical detox, a standard outpatient program (OP) might be best.

It’s also a good option for people who have finished inpatient treatment and are transitioning into a sober lifestyle. These outpatient treatment centers might hold day groups, individual or group therapy sessions, and administer medications among other things to help improve your loved one’s chances of sobriety.

Support Groups

Support groups can include Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and other specialized groups for addiction recovery. These groups can provide a space for your loved one vent about their own frustrations and experiences in using drugs and alcohol, as well as help your loved one develop a network of support with others in recovery.

Many support groups have sponsors and therapists on hand to help provide emotional support, validate your loved one’s concerns, and provide treatment options and additional resources as needed. These support groups have also been shown to help adults boost their self-efficacy and develop positive coping mechanisms to help them stay sober.

Barriers To Addiction Treatment In The Senior Citizen Population

Unfortunately, there are various barriers to treatment for seniors that you must take into consideration.

Many seniors might not have a support system that is readily available to help transport them to and from therapy sessions. This includes friends, family, or relatives nearby. If this is the case, it’s important to reach out to your loved one’s primary care physician or boarding care for possible options on treatment and transportation services.

In addition, using walkers and having limited mobility might also make it difficult to attend inpatient and outpatient treatment groups, especially if your loved one is suffering from pain and must now stop their use of painkillers for treatment. A lack of accessibility for wheelchairs and walkers can make mobility difficult.

Other barriers include the stigma that surrounds substance use disorder, especially among older adults who are not as open-minded as newer generations on the realities of trauma, abuse, and mental illness. Additionally, seniors may find difficulty connecting with younger peers in recovery, especially when there are significant age gaps within recovery groups.

This is why individualized care that takes into account the unique needs of seniors is vital in providing the best care possible to our aging loved ones.

Minimizing Stigma Surrounding Senior Substance Abuse

The best way to minimize the stigma surrounding senior substance abuse is simply to talk about substance abuse with your loved one. Help your aging loved one understand that it’s okay to ask for help and offer them options for treatment.

Do not guilt or shame your parent if they are living with a substance abuse disorder. This only worsens their self-view and can lead to more drug or alcohol use to cope. Instead, follow these tips below:

  • Offer empathy and understanding to your loved one.
  • Get them help from a primary care doctor or another medical professional they trust, who can refer them to a treatment facility.
  • Find support groups and treatment centers that specialize in treating substance use disorders in older adults.

Assure your loved one you will do everything to support them through recovery, while still setting boundaries surrounding their treatment and avoiding enabling behaviors.

What to Do if Your Loved One Is Abusing Drugs Or Alcohol

If you find out a loved one of yours is abusing drugs, make sure to sit down and speak with them right away to gain clarity on the situation. Let your loved one share their side of the story, as this can help your loved one build trust in you and be more open to attending treatment.

Explore options together with your loved one, including inpatient, outpatient, or intensive outpatient treatment programs that you can enroll your loved one in (the sooner the better).

Make sure to help your loved one plan for their treatment and address their concerns, such as financing, furniture or pet storage, medical concerns, and other related concerns.

Resources for Seniors and Loved Ones of Seniors with Addictions

For more information on getting your aging loved one help for substance use disorder, explore the resources below:

Written by Aging with Care

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