Substance Abuse in Older Adults: How Common Is It?

Unfortunately, chronic pain can also increase older adults’ risks of developing substance misuse issues. As they age, people may experience more aches and pains and seek out medications – both prescription and over-the-counter – to relieve their discomfort. Up to a quarter of all prescription drugs in the U.S. are used by older adults, and this increased exposure to drugs increases the risk of addiction or other negative consequences. Mental health conditions such as depression or anxiety can affect how a person perceives and responds to stimuli. This makes them more vulnerable to risky behaviors like substance misuse. Seniors with co-occurring psychiatric disorders may be more likely to try drugs or alcohol to cope with their symptoms.

Treatment Planning

For more information on the creation of the revised weights, investigations to update the 2021 weights, and the effects of the recalibrated 2021 weights on the 2021 estimates, see the 2022 Methodological Summary and Definitions report. Our writers and reviewers are experienced professionals in medicine, addiction treatment, and healthcare. AddictionResource fact-checks all the information before publishing and uses only credible and trusted sources when citing any medical data. The Verified badge on our articles is a trusted sign of the most comprehensive scientifically-based medical content.If you have any concern that our content is inaccurate or it should be updated, please let our team know at [email protected]. Physicians rely on the criteria outlined by the DSM to diagnose substance abuse disorder in the general population. That is perhaps the main reason for misdiagnosis and lack of treatment of seniors – these criteria are less relevant to them.

Chapter 3—Identifying, Screening for, and Assessing Substance Misuse in Older Adults

Also, the percent of their body weight composed of water decreases, and alcohol affects them more quickly and more strongly. Alcohol takes longer to metabolize in older persons, accumulating in their bodies and leading more quickly to intoxication if consumption https://sober-home.org/ketamine-effects-medical-uses-risks/ is not controlled. Because of their physical make-up, older women are more vulnerable to the negative effects of alcohol. SUD experts generally agree that addiction is a mental health disorder, much like depression, anxiety disorders, and similar conditions.

How are substance use disorders treated in older adults?

Older adults may resist addiction treatment and other mental health services due to internalized stigma regarding mental illness. According to NIDA research, these substances include alcohol, marijuana, opioids, and other prescription medications. However, research on mental health among older people indicates that when these adults do experience mood disorders, they experience more negative health outcomes as a result. Generally, older adults are less likely than young people to misuse drugs and alcohol.

Why Are Seniors Vulnerable To Addiction?

1. Combined 2007 to 2014 NSDUH data indicate that, on an average day, 6.0 million older adults used alcohol (Figure 1).5 Older adults who used alcohol in the past month drank an average of 1.8 drinks per day on the days they drank.
2. Among older people assessed for treatment for alcohol misuse,387 the most commonly reported reason for using alcohol among women (24 percent) was “to reduce tension or anxiety.” This was also the second-most-common reason reported by men (20 percent).
3. „There will always be some patients who have no alternative than opioids, but we established some discipline with urine tox screens and pain agreements, and over time, we’ve been able to reduce the number of high-risk opioid prescriptions,” she said.

The American Geriatrics Society’s 2019 Beers Criteria® address medications that are potentially inappropriately prescribed for older adults.319 See the Chapter 6 text box on the 2019 Beers Criteria®. NSDUH is an annual multimode survey sponsored by the Substance Abuse and Mental Health Services Administration within the U.S. NSDUH covers residents of households and people in noninstitutional group settings (e.g., shelters, boarding houses, college dormitories, migratory workers’ camps, halfway houses). Addiction Resource is an educational platform for sharing and disseminating information about addiction and substance abuse recovery centers. Addiction Resource is not a healthcare provider, nor does it claim to offer sound medical advice to anyone.

Symptoms of Substance Abuse

Treatment planning includes preparing to provide treatment or refer to the most appropriate treatment provider. You should start with treatment planning, and then either give the treatment or refer to an outside provider if your program cannot provide the services or level of care the client needs. Although rare, age-specific treatment settings and programs may provide the most effective care for older clients. Note that substance use greatly increases the risk of intimate partner violence. Screen all women who seek SUD treatment for intimate partner abuse, regardless of their age.512 Substance use increases the risk of abuse toward older adults,513 and experiencing elder abuse can contribute to substance misuse among older adults. If you suspect an older adult is misusing substances, screen for elder abuse.

The health consequences of drug abuse vary, depending on the type of drug used and the method of drug consumption. As a result, they are often prescribed for chronic and acute pain conditions, which older adults experience more often than younger adults. Marijuana use has also increased slightly among older adults, possibly due to increased legalization and the prevalence of medical marijuana.

The SAMI330 is a five-item questionnaire for older adults who may engage in risky alcohol use. This questionnaire includes a checklist of symptoms and open-ended questions about alcohol use.331 A score of 1 or higher suggests problem alcohol use. Screening is the process of evaluating whether symptoms of substance misuse are present.

Drug and alcohol use can also make certain illnesses worse and keep clients from feeling their best. Drug and alcohol abuse is harmful to health at any age, but never more so than in seniors. The impact of alcohol-related injuries is much more severe, the general physical effects of drugs and alcohol are more serious, and dangerous medical interactions https://sober-home.org/ are a distinct and scary possibility. Greater numbers of older men have substance use problems, but women are more likely than men to start drinking heavily later in life. According to Dr. Blow’s article, substance use is more prevalent among persons who suffer losses, such as the death of loved ones, retirement and loss of health.

Older adults have not demonstrated high rates of drug or alcohol use over time compared with younger adults. It has contributed to a misconception that seniors do not abuse alcohol or drugs, and there is no such problem as alcoholism in the elderly. An ever-growing body of evidence suggests that substance abuse in older adults has gone unnoticed for decades. The baby boom generation, which is currently in its 60s, faces some frighteningly real risks. Dr. Blow and other experts in the field note that people’s sensitivity to alcohol changes as they age; specifically, their tolerance to alcohol decreases and their sensitivity increases.

Alcoholism in the elderly is more likely to cause functional impairment, compromising their ability to perform everyday tasks such as shopping, cleaning, and cooking. In addition, many older adults have binge drinking issues (five or more standard drinks in one sitting). Almost 20% of men and just over 6% of women in this age group are binge drinkers.

Alcohol is the most commonly abused substance among virtually all demographics, including older adults. Older adults may struggle to form new memories, and they may lose some long-term memories as well. Other studies indicate that older adults are less likely to experience severe mood disorders such as bipolar disorder. According to NIDA, older adults are more likely than younger adults to experience mood disorders. If a patient has a high-risk score, their clinician considers additional risk mitigation strategies, such as seeing the patient more frequently or using an abuse deterrent formulation of an opioid.

Combined 2007 to 2014 NSDUH data indicate that, on an average day, 6.0 million older adults used alcohol (Figure 1).5 Older adults who used alcohol in the past month drank an average of 1.8 drinks per day on the days they drank. NSDUH data indicate that older adults who used alcohol in the past month drank on an average of 11.1 days per month. Recent research has found that people addicted to cocaine in their youth may have an accelerated age-related decline in temporal lobe gray matter, which increases their risk of addiction. This is because cocaine use during adolescence and young adulthood can cause brain structure and function changes that persist into later life.

Be aware that not all of these measures have been validated—in other words, tested and approved for use—in older adults. Your practice should also identify steps to take when screening tests are positive (see the section “Communicating Screening Results”). The marijuana section of the 2022 NSDUH questionnaire included new questions to assess the variety of ways that people consume marijuana, including vaping. The questions about marijuana vaping remained in the emerging issues section of the 2022 questionnaire. However, data for marijuana vaping from the emerging issues section were not used in creating the 2022 marijuana use and marijuana vaping estimates in the 2022 Detailed Tables.

You can help clients discover their own reasons for wanting to change by talking about these mixed feelings and pointing out problem areas. Use positive language to urge them to continue using substances appropriately. A “yes” response on one or more questions (other than on Question 1) is considered a positive screen. Share resources and information with clients as needed to keep them safe and feeling supported.

The final section identifies targeted resources to support your practice, from screening to referral. The detailed tables are numbered using a three-part numbering scheme (e.g., 1.15A). The first part of the table number (1.15A) is the subject matter section to which a particular table belongs. The second part (1.15A) is the number of the table within a particular section. The third part (1.15A) is a table type indicator, an alphabetic letter appended to the table number.