Substance Abuse & Addiction Among Senior Citizens

Substance Abuse among Seniors

Results from the 2018 National Survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration, show that nearly 1 million adults aged 65 years or older (2% of all seniors) reported a substance use disorder during the past year.1  Survey findings show that alcohol and prescription opioids are the two most commonly abused substances among seniors. Other results from the survey pertaining to individuals over the age of 65 include:1
  • 10.7% of seniors reported binge drinking in the last month. 
  • 2.5% of seniors reported heavy alcohol use in the last month. 
  • 1.6% of seniors reported having an alcohol abuse disorder. 
  • 1.3% of seniors reported misuse of opioids during the past year.
  • 0.5% of seniors reported misuse of tranquilizers during the past year.
  • 0.4% of seniors reported misuse of benzodiazepines during the past year.
  • 0.2% of seniors reported misuse of sedatives during the past year.

Concerns for Elderly Drinkers

Researchers have determined that the use and misuse of alcohol among older individuals has significantly increased. Overall, alcohol is the most frequently reported substance of abuse for persons aged 65 or older.2  There has been a steady increase in alcohol use among men and women aged 60 years or older in recent years, with a significant increase in binge drinking among women age 60 or older.3  Alcohol abuse is especially dangerous in senior citizens. Over time, the abuse of alcohol causes harmful effects on brain structure and function that can lead to decline in cognitive function and memory.4 A recent study conducted by the Stanford University School of Medicine showed that these effects are particularly pronounced in adults aged 65 years or older.5  As summarized by Dr. Edith V. Sullivan, the lead researcher of the study, “these findings provide compelling evidence that alcohol misuse during later adulthood could confer a greater risk of deficits… beyond the deficits that typically occur with aging.”6   The body’s ability to break down alcohol is also decreased with aging, causing alcohol to remain in a person’s system longer.7 This leads to older people feeling increased central nervous system effects from lower amounts of alcohol. For this reason, seniors who consume alcohol are at an increased risk for accidents, including falls, fractures, and car crashes. Many seniors take medications on a daily basis, including drugs that interact with alcohol. Consequently, alcohol consumption puts seniors at an increased risk for the harmful effects associated with alcohol–medication interactions.  A study published in the Journal of General Internal Medicine reported that more than one in three drinkers aged 60 years or older consume alcohol in quantities that are excessive or potentially harmful when combined with medications that they are taking.8 Drinking can be especially dangerous for seniors because alcohol can modify serum drug concentrations and increase drug toxicity.7 

Prescription Drug Abuse among Seniors

Seniors are particularly vulnerable to prescription drug abuse and addiction. A large national study of individuals aged 57 to 85 years found that 37.1% of men and 36.0% of women are concurrently prescribed at least 5 different medications.9  One study estimated that the prevalence of prescription drug abuse in the elderly may be as high as 11%.10  Opioids are the second most commonly reported substance of abuse by seniors.1 The number of fatal opioid overdoses among seniors has risen dramatically over the last decade.  According to drug overdose mortality data from the National Center for Health Statistics, baby boomers (individuals born between 1947 and 1964) are the demographic group most affected by the current opioid epidemic. Since 2010, individuals in this age group have experienced significantly increased rates of death from prescription opioid overdose.11 

Treatment Options

Alcohol and drug abuse among seniors can contribute to, or complicate, other health problems, including liver and pancreas diseases, immune system disorders, osteoporosis, diabetes, high blood pressure, stroke, and seizures.12 If you believe that an elderly loved one may be suffering from an addiction to drugs or alcohol, do not hesitate to intervene on their behalf. One option is to alert their physician about your concerns.  Your loved one may be referred to one of the many drug treatment programs designed specifically for seniors. Treatment often includes age-specific addiction support groups that allow seniors to motivate their peers and receive support from other individuals struggling with similar disorders and hardships.  If detox is needed as part of the treatment for seniors, inpatient care is recommended due to their significantly increased risk for complications during the detoxification process.

Sources

  1. Substance Abuse and Mental Health Services Administration. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed Tables.
  2. Substance Abuse and Mental Health Services Administration. (2019). Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health.
  3. Breslow, R.A., Castle, I.P., Chen, C.M., & Graubard, B.I. (2017). Trends in Alcohol Consumption Among Older Americans: National Health Interview Surveys, 1997 to 2014. Alcoholism, Clinical and Experimental Research, 41(5), 976-986.
  4. Mende, M.A. (2019). Alcohol in the Aging Brain – The Interplay Between Alcohol Consumption, Cognitive Decline and the Cardiovascular System. Frontiers in Neuroscience, 13(713), 1-7.
  5. Sullivan, E.V., Zahr, N.M., Sassoon, S.A., Thompson, W.K., Kwon, D., Pohl, K.M., & Pfefferbaum, A. (2018). The Role of Aging, Drug Dependence, and Hepatitis C Comorbidity in Alcoholism Cortical Compromise. JAMA Psychiatry, 75(5), 474-483.
  6. National Institute on Alcohol Abuse and Alcoholism. (2018). Alcohol and the Aging Brain.
  7. Meier, P., & Seitz, H.K. (2008). Age, alcohol metabolism and liver disease. Current Opinion in Clinical Nutrition and Metabolic Care, 11(1), 21-26.
  8. Barnes, A.J., Moore, A.A., Xu, H., Ang, A., Tallen, L., Mirkin, M., & Ettner, S.L. (2010). Prevalence and Correlates of At-Risk Drinking Among Older Adults: The Project SHARE Study. Journal of General Internal Medicine, 25(8), 840-846.
  9. Qato, D.M., Alexander, G.C., Conti, R.M., Johnson, M., Schumm, P., & Lindau, S.T. (2008). Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States. Journal of the American Medical Association, 300(24), 2867-2878.
  10. Culberson, J.W., & Ziska, M. (2008). Prescription drug misuses/abuse in the elderly. Geriatrics, 63(9), 22-31.
  11. Huang, X., Keyes, K.M., & Li, G. (2018). Increasing Prescription Opioid and Heroin Overdose Mortality in the United States, 1999–2014: An Age–Period–Cohort Analysis. American Journal of Public Health, 108(1), 131-136.
  12. Kuerbis, A., Sacco, P., Blazer, D.G., & Moore, A.A. (2014). Substance abuse among older adults. Clinics in Geriatric Medicine, 30(3), 629-654.
Last Updated on December 10, 2019
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