Substance Use and Older Adults: How to Recognize the Signs and Get Help

Reviewed Mar 28, 2016

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Summary

  • Drug and alcohol use is rising among older adults.
  • They may misuse prescription drugs and alcohol.
  • This is especially dangerous for this age group.

People may see drug use as a young person’s issue. But it is an issue for older adults, too. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) says it is “one of the fastest growing health problems facing the country.”

Substances

Alcohol is the most used and misused drug. Older adults may socialize with beer, wine, or cocktails. Happy hour is a common event in assisted living and retirement communities. SAMHSA advises no more than one drink a day. Some people should not drink at all.

Older adults use prescription drugs more than any other age group. Misuse of these drugs is growing. It can affect decision-making, create dependence, or cause other harm. Commonly misused drugs are:

  • Opioid pain meds such as Vicodin®, OxyContin® and Percocet®
  • Benzodiazepine and anti-anxiety meds such as Ativan®, Valium® and Xanax®
  • Sleep meds such as Ambien® and Lunesta®

Medical marijuana is legal in some states. Older adults may use it to manage or treat health symptoms. There is no good estimate of how many people use illegal marijuana.

The same is true for illegal drugs, such as cocaine, methamphetamines, and heroin. In the past, it was thought that people stopped using substances as they aged. Recent hospital records show this may no longer be true. In fact, the National Study on Drug Use and Health shows that illegal drug use in people older than 50 has more than doubled between 2002 and 2013.

Who is at risk?

Drug use touches all ethnic and social groups. Men who have had drug issues in the past have the highest risk. Late onset issues are more common for women. People who deal with a long-term health problem, pain, insomnia, or depression are also at risk.

Age-specific concerns

Older adults deal with a lot of loss. They may lose their sight or mobility. Their support networks shrink. Retirees may mourn their identity or financial security. They may miss their careers and work friends. Losing a spouse, a partner, or other loved ones can be painful. Older adults may use substances to “self-medicate” feelings of loneliness and loss.

As people age, drug use may have more consequences and risks. Bodies change with age. They lose muscle and body water. They digest and absorb things differently, often more slowly. Instead of leaving the body quickly, substances can build up to unsafe levels in the blood.

Also, older adults are more likely to deal with chronic health issues. Drugs and alcohol can make them worse. Common examples are:

  • Diabetes
  • Heart and liver issues
  • Ulcers
  • Cancer
  • Sleep disorders
  • Depression and anxiety

Drugs and alcohol do not mix well with medications. Some mixtures may not work well or may even be toxic. Examples include but are not limited to:

  • Pain relievers
  • Anti-inflammatory meds
  • Heart and blood pressure meds
  • Seizure meds
  • Sleeping pills, tranquilizers, and sedatives
  • Antidepressants
  • Antibiotics
  • Cold, flu, and allergy meds

It is vital for older adults to talk about their substance use with their doctors.

Signs of substance misuse in older adults

Drug misuse among older adults is not identified or reported enough:

  • Clear signs like missing work or being drunk in public are not as common in older adults.
  • Many people do not know substance use can be a problem for older adults.
  • Loved ones may read signs of substance use as a normal part of aging.

Awareness is the key to identifying substance use and misuse among older adults. Symptoms to watch for include:

  • Changes in appetite, personality, or behavior
  • More health problems or confusion
  • Decline in appearance or hygiene
  • Unclear or slurred speech
  • Anger or panic when asked about drug and alcohol use

Treatment

Treatment varies for older adults. The type and pace of care depend on a person’s situation. Experts advise a screening and intervention. This can include assessment, counseling, education, and goal setting. Professionals may offer referrals to medical and other services if needed.

Successful treatment plans are:

  • Supportive and age specific
  • Helpful in building support networks
  • Focused on developing coping skills
  • Run by qualified and skilled professionals
  • Take place in individual or group settings

Resources

National Council on Aging
(571) 527-3900
www.ncoa.org

National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov

Recovery.org
(888) 255-3773
www.recovery.org

Substance Abuse and Mental Health Services Administration
(877) 726-4727
www.samhsa.gov

By Beth Landau
Source: American Psychological Association's "Elder Abuse and Neglect: A Search for Solutions." (2012), www.apa.org/pi/aging/resources/guides/elder-abuse.aspx; Castle, Nicholas G., Ferguson-Rome, Jamie C., Handler, Steven M., Smith, Mary Lindsey, Wagner, Laura M. (2012) "Alcohol Misuse and Abuse Reported by Nurse Aides in Assisted Living." Research on Aging. May 2012, 34: 321-336; Center for Substance Abuse Treatment. (2012) "Substance Abuse Among Older Adults." Treatment Improvement Protocol (TIP) Series, No. 26. HHS Publication No. (SMA) 12-3918, www.ncbi.nlm.nih.gov/books/NBK64419/pdf/TOC.pdf; "Seniors and Alcohol." (2015) West Virginia University School of Public Health, http://publichealth.hsc.wvu.edu/alcohol/effects-on-society/seniors-and-alcohol; Substance Abuse and Mental Health Services Administration. 2014. "Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings." NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, Md.: Substance Abuse and Mental Health Services Administration, 2014, www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf; Taylor, Matthew H. Grossberg, George T. (2012) "The Growing Problem of Illicit Substance Abuse in the Elderly: A Review." Primary Care Companion for CNS Disorders. Vol. 14(4), PCC.11r01320; Wu, Li-Txy. Blazer, Dan G. (2011) "Illicit and Non-Medical Use Among Older Adults: A Review." Journal of Aging Health, Vol. 23(3), 481-504.

Summary

  • Drug and alcohol use is rising among older adults.
  • They may misuse prescription drugs and alcohol.
  • This is especially dangerous for this age group.

People may see drug use as a young person’s issue. But it is an issue for older adults, too. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) says it is “one of the fastest growing health problems facing the country.”

Substances

Alcohol is the most used and misused drug. Older adults may socialize with beer, wine, or cocktails. Happy hour is a common event in assisted living and retirement communities. SAMHSA advises no more than one drink a day. Some people should not drink at all.

Older adults use prescription drugs more than any other age group. Misuse of these drugs is growing. It can affect decision-making, create dependence, or cause other harm. Commonly misused drugs are:

  • Opioid pain meds such as Vicodin®, OxyContin® and Percocet®
  • Benzodiazepine and anti-anxiety meds such as Ativan®, Valium® and Xanax®
  • Sleep meds such as Ambien® and Lunesta®

Medical marijuana is legal in some states. Older adults may use it to manage or treat health symptoms. There is no good estimate of how many people use illegal marijuana.

The same is true for illegal drugs, such as cocaine, methamphetamines, and heroin. In the past, it was thought that people stopped using substances as they aged. Recent hospital records show this may no longer be true. In fact, the National Study on Drug Use and Health shows that illegal drug use in people older than 50 has more than doubled between 2002 and 2013.

Who is at risk?

Drug use touches all ethnic and social groups. Men who have had drug issues in the past have the highest risk. Late onset issues are more common for women. People who deal with a long-term health problem, pain, insomnia, or depression are also at risk.

Age-specific concerns

Older adults deal with a lot of loss. They may lose their sight or mobility. Their support networks shrink. Retirees may mourn their identity or financial security. They may miss their careers and work friends. Losing a spouse, a partner, or other loved ones can be painful. Older adults may use substances to “self-medicate” feelings of loneliness and loss.

As people age, drug use may have more consequences and risks. Bodies change with age. They lose muscle and body water. They digest and absorb things differently, often more slowly. Instead of leaving the body quickly, substances can build up to unsafe levels in the blood.

Also, older adults are more likely to deal with chronic health issues. Drugs and alcohol can make them worse. Common examples are:

  • Diabetes
  • Heart and liver issues
  • Ulcers
  • Cancer
  • Sleep disorders
  • Depression and anxiety

Drugs and alcohol do not mix well with medications. Some mixtures may not work well or may even be toxic. Examples include but are not limited to:

  • Pain relievers
  • Anti-inflammatory meds
  • Heart and blood pressure meds
  • Seizure meds
  • Sleeping pills, tranquilizers, and sedatives
  • Antidepressants
  • Antibiotics
  • Cold, flu, and allergy meds

It is vital for older adults to talk about their substance use with their doctors.

Signs of substance misuse in older adults

Drug misuse among older adults is not identified or reported enough:

  • Clear signs like missing work or being drunk in public are not as common in older adults.
  • Many people do not know substance use can be a problem for older adults.
  • Loved ones may read signs of substance use as a normal part of aging.

Awareness is the key to identifying substance use and misuse among older adults. Symptoms to watch for include:

  • Changes in appetite, personality, or behavior
  • More health problems or confusion
  • Decline in appearance or hygiene
  • Unclear or slurred speech
  • Anger or panic when asked about drug and alcohol use

Treatment

Treatment varies for older adults. The type and pace of care depend on a person’s situation. Experts advise a screening and intervention. This can include assessment, counseling, education, and goal setting. Professionals may offer referrals to medical and other services if needed.

Successful treatment plans are:

  • Supportive and age specific
  • Helpful in building support networks
  • Focused on developing coping skills
  • Run by qualified and skilled professionals
  • Take place in individual or group settings

Resources

National Council on Aging
(571) 527-3900
www.ncoa.org

National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov

Recovery.org
(888) 255-3773
www.recovery.org

Substance Abuse and Mental Health Services Administration
(877) 726-4727
www.samhsa.gov

By Beth Landau
Source: American Psychological Association's "Elder Abuse and Neglect: A Search for Solutions." (2012), www.apa.org/pi/aging/resources/guides/elder-abuse.aspx; Castle, Nicholas G., Ferguson-Rome, Jamie C., Handler, Steven M., Smith, Mary Lindsey, Wagner, Laura M. (2012) "Alcohol Misuse and Abuse Reported by Nurse Aides in Assisted Living." Research on Aging. May 2012, 34: 321-336; Center for Substance Abuse Treatment. (2012) "Substance Abuse Among Older Adults." Treatment Improvement Protocol (TIP) Series, No. 26. HHS Publication No. (SMA) 12-3918, www.ncbi.nlm.nih.gov/books/NBK64419/pdf/TOC.pdf; "Seniors and Alcohol." (2015) West Virginia University School of Public Health, http://publichealth.hsc.wvu.edu/alcohol/effects-on-society/seniors-and-alcohol; Substance Abuse and Mental Health Services Administration. 2014. "Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings." NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, Md.: Substance Abuse and Mental Health Services Administration, 2014, www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf; Taylor, Matthew H. Grossberg, George T. (2012) "The Growing Problem of Illicit Substance Abuse in the Elderly: A Review." Primary Care Companion for CNS Disorders. Vol. 14(4), PCC.11r01320; Wu, Li-Txy. Blazer, Dan G. (2011) "Illicit and Non-Medical Use Among Older Adults: A Review." Journal of Aging Health, Vol. 23(3), 481-504.

Summary

  • Drug and alcohol use is rising among older adults.
  • They may misuse prescription drugs and alcohol.
  • This is especially dangerous for this age group.

People may see drug use as a young person’s issue. But it is an issue for older adults, too. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) says it is “one of the fastest growing health problems facing the country.”

Substances

Alcohol is the most used and misused drug. Older adults may socialize with beer, wine, or cocktails. Happy hour is a common event in assisted living and retirement communities. SAMHSA advises no more than one drink a day. Some people should not drink at all.

Older adults use prescription drugs more than any other age group. Misuse of these drugs is growing. It can affect decision-making, create dependence, or cause other harm. Commonly misused drugs are:

  • Opioid pain meds such as Vicodin®, OxyContin® and Percocet®
  • Benzodiazepine and anti-anxiety meds such as Ativan®, Valium® and Xanax®
  • Sleep meds such as Ambien® and Lunesta®

Medical marijuana is legal in some states. Older adults may use it to manage or treat health symptoms. There is no good estimate of how many people use illegal marijuana.

The same is true for illegal drugs, such as cocaine, methamphetamines, and heroin. In the past, it was thought that people stopped using substances as they aged. Recent hospital records show this may no longer be true. In fact, the National Study on Drug Use and Health shows that illegal drug use in people older than 50 has more than doubled between 2002 and 2013.

Who is at risk?

Drug use touches all ethnic and social groups. Men who have had drug issues in the past have the highest risk. Late onset issues are more common for women. People who deal with a long-term health problem, pain, insomnia, or depression are also at risk.

Age-specific concerns

Older adults deal with a lot of loss. They may lose their sight or mobility. Their support networks shrink. Retirees may mourn their identity or financial security. They may miss their careers and work friends. Losing a spouse, a partner, or other loved ones can be painful. Older adults may use substances to “self-medicate” feelings of loneliness and loss.

As people age, drug use may have more consequences and risks. Bodies change with age. They lose muscle and body water. They digest and absorb things differently, often more slowly. Instead of leaving the body quickly, substances can build up to unsafe levels in the blood.

Also, older adults are more likely to deal with chronic health issues. Drugs and alcohol can make them worse. Common examples are:

  • Diabetes
  • Heart and liver issues
  • Ulcers
  • Cancer
  • Sleep disorders
  • Depression and anxiety

Drugs and alcohol do not mix well with medications. Some mixtures may not work well or may even be toxic. Examples include but are not limited to:

  • Pain relievers
  • Anti-inflammatory meds
  • Heart and blood pressure meds
  • Seizure meds
  • Sleeping pills, tranquilizers, and sedatives
  • Antidepressants
  • Antibiotics
  • Cold, flu, and allergy meds

It is vital for older adults to talk about their substance use with their doctors.

Signs of substance misuse in older adults

Drug misuse among older adults is not identified or reported enough:

  • Clear signs like missing work or being drunk in public are not as common in older adults.
  • Many people do not know substance use can be a problem for older adults.
  • Loved ones may read signs of substance use as a normal part of aging.

Awareness is the key to identifying substance use and misuse among older adults. Symptoms to watch for include:

  • Changes in appetite, personality, or behavior
  • More health problems or confusion
  • Decline in appearance or hygiene
  • Unclear or slurred speech
  • Anger or panic when asked about drug and alcohol use

Treatment

Treatment varies for older adults. The type and pace of care depend on a person’s situation. Experts advise a screening and intervention. This can include assessment, counseling, education, and goal setting. Professionals may offer referrals to medical and other services if needed.

Successful treatment plans are:

  • Supportive and age specific
  • Helpful in building support networks
  • Focused on developing coping skills
  • Run by qualified and skilled professionals
  • Take place in individual or group settings

Resources

National Council on Aging
(571) 527-3900
www.ncoa.org

National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov

Recovery.org
(888) 255-3773
www.recovery.org

Substance Abuse and Mental Health Services Administration
(877) 726-4727
www.samhsa.gov

By Beth Landau
Source: American Psychological Association's "Elder Abuse and Neglect: A Search for Solutions." (2012), www.apa.org/pi/aging/resources/guides/elder-abuse.aspx; Castle, Nicholas G., Ferguson-Rome, Jamie C., Handler, Steven M., Smith, Mary Lindsey, Wagner, Laura M. (2012) "Alcohol Misuse and Abuse Reported by Nurse Aides in Assisted Living." Research on Aging. May 2012, 34: 321-336; Center for Substance Abuse Treatment. (2012) "Substance Abuse Among Older Adults." Treatment Improvement Protocol (TIP) Series, No. 26. HHS Publication No. (SMA) 12-3918, www.ncbi.nlm.nih.gov/books/NBK64419/pdf/TOC.pdf; "Seniors and Alcohol." (2015) West Virginia University School of Public Health, http://publichealth.hsc.wvu.edu/alcohol/effects-on-society/seniors-and-alcohol; Substance Abuse and Mental Health Services Administration. 2014. "Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings." NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, Md.: Substance Abuse and Mental Health Services Administration, 2014, www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf; Taylor, Matthew H. Grossberg, George T. (2012) "The Growing Problem of Illicit Substance Abuse in the Elderly: A Review." Primary Care Companion for CNS Disorders. Vol. 14(4), PCC.11r01320; Wu, Li-Txy. Blazer, Dan G. (2011) "Illicit and Non-Medical Use Among Older Adults: A Review." Journal of Aging Health, Vol. 23(3), 481-504.

The information provided on the Achieve Solutions site, including, but not limited to, articles, quizzes, and other general information, is for informational purposes only and should not be treated as medical, health care, psychiatric, psychological or behavioral health care advice. Nothing contained on the Achieve Solutions site is intended to be used for medical diagnosis or treatment or as a substitute for consultation with a qualified health care professional. Please direct questions regarding the operation of the Achieve Solutions site to Web Feedback. If you have concerns about your health, please contact your health care provider.  ©2017 Beacon Health Options, Inc.

 

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