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Substance Abuse and the Elderly

It is a regularly said mantra among people age 55 and up—growing older is not easy. The physical and mental changes as the years march on can create a myriad of symptoms not experienced before. 

The aches and pains, moments of forgetfulness, body temperature fluctuations, sleep problems, minor and major medical issues, procedures, and surgeries all leave the older generations searching for traditional and alternative methods of coping.

The U.S. 2010 Census Bureau estimates that the older working-age population, 45 to 64 years old,  is 81.5 million people. The age 65 and over population was 40.3 million persons. That is almost 122 million people in total, and more than 40 million people are considered “elderly.” What do people in these age groups do when they seek something to alleviate symptoms?

Substances Mostly Abused

Three main types of substances most commonly misused by people considered elderly:

  • Alcohol
  • Prescription (benzodiazepines and opioids) and OTC Drugs
  • Marijuana

Alcohol

Alcohol is the most widely used (and abused) substance in this age group.  A recent medical report notes that, “Despite increasing rates of illicit and prescription drug misuse among adults older than 65 years, alcohol remains the most commonly used substance among older adults.”
The National Council on Aging relays alarming statistics about alcohol and the elderly:

  • 11 percent of older people admitted to hospitals is due to drug and alcohol-related incidents
  • 14 percent of alcohol-related admissions are emergency room visits
  • 20 percent is the rate at which the elderly are admitted to psychiatric hospitals due to issues related to drugs and alcohol

Also, as people become older, changes in the body mean it takes longer for the body to absorb alcohol.

Prescription and Over-the-Counter Drugs

Prescription drugs are the second most abused substance among the older generations. Data noted by the American Academy of Family Doctors on its website relays that opioids and benzodiazepines are the two top types of prescriptions abused. 

When older adults take more opioid painkillers than prescribed or take benzodiazepines that someone else gave them, they are at risk of possible drug interactions or experiencing adverse effects of mixing alcohol with the drug.

Another study found that of 3,005 individuals aged 57 to 85 years, “37.1 percent of men and 36.0 percent of women used at least five prescription medications concurrently. The study also found that about 1 in 25 of the participants were at risk for [a] major drug interaction, and half of these situations involved nonprescription medications.”

Marijuana

As noted by the National Institute on Drug Abuse (NIDA), “The spread of marijuana use and the opioid epidemic over the past 10 years have affected middle-aged and older Americans.”

People who are between the ages of 55 and 73 (baby boomer generation) were born and raised during the time when youth tried marijuana and enjoyed its benefits. Today, individuals who are seeking relief from age-related illnesses or symptoms may be able to obtain the substance legally, if living in a state where marijuana is legal. Those who live in states where it is not yet legal may request physician assistance in getting a medical marijuana card to obtain the products.

It should not be alarming to know that marijuana is one of the most widely used substances by people aged 55 to 73. 

Additionally, the report notes, “A large majority of both age groups indicated that they felt that using the drug as often as twice weekly conferred slight or no risk of bad consequences. Moreover, 15 percent of adults age 50 to 64, and 23 percent of adults age 65 and older reported that they had used the drug with a doctor’s recommendation.” It should be said that marijuana, like any illicit or legal substance, can be abused.

How to Determine Substance Abuse for Seniors

It can be difficult to see signs of substance abuse in older adults. These are the most common signs known of people who might have a substance abuse problem:

  • There are different prescriptions from different doctors for the same medication.
  • A prescription for the same medication is filled at two different pharmacies.
  • They are taking more of the medicine than prescribed.
  • They are taking the drug at different times than the prescription or more of it.
  • They become angry or withdrawn.
  • They are more confused or forgetful.
  • They talk about the medicine more often.
  • They don’t want to go someplace without taking the medication.
  • They get defensive when you ask about the medicine.
  • They store extra pills in purses, wallets, or pockets.
  • They sneak or hide medicine.

It should also be mentioned that the signs of alcohol abuse are similar to those of aging. 

These are:

  • Memory problems 
  • Fatigue
  • Sleep problems
  • Confusion
  • Depression 
  • Anxiety 
  • Irritability

AgingWell indicates that these signs of prescription drug abuse are also similar to aging:

  • Irritability
  • Lack of energy and concentration
  • Mood changes
  • Short-term memory loss
  • General loss of interest

If you notice these signs of substance abuse in an older person you love and care about, be gentle and ask if they might be misusing the substances. If they are reluctant or become defensive when asked about it, or have sustained an injury due to the misuse, contact their doctor and ask for help.

Sources

National Census. Age and Sex Composition: 2010. 2010 Census Briefs. May 2011. from https://www.census.gov/prod/cen2010/briefs/c2010br-03.pdf

U.S. National Library of Medicine. National Institutes of Health. HHS Public Access..Substance Abuse Among Older Adults. 2014. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146436/

National Council On Aging. ALCOHOL ABUSE AMONGST THE ELDERLY: A COMPLETE GUIDE. from https://www.aging.com/alcohol-abuse-amongst-the-elderly-a-complete-guide/

American Academy of Family Physicians. Prescription Drug Abuse in the Elderly. October 2017. from https://familydoctor.org/condition/prescription-drug-abuse-in-the-elderly/

U.S. National Library of Medicine. National Institutes of Health. HHS Public Access..Substance Abuse Among Older Adults. Prescription, Nonprescription, and Over-the-Counter Medication Use. 2014 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146436/

National Institute on Drug Abuse. Drug Use and Its Consequences Increase Among Middle-Aged and Older Adults.William Ross Perlman, Ph.D., CMPP July 10, 2010. from https://www.drugabuse.gov/news-events/nida-notes/2019/07/drug-use-its-consequences-increase-among-middle-aged-older-adults

AgingWell. AgingWell. Substance Abuse and Misuse in Older Adults By Kimberly A. Steinhagen, LMSW, and Michael B. Friedman Vol. No. 3 P. 20. Summer 2008. from https://www.todaysgeriatricmedicine.com/archive/071708p20.shtml

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