Author: Alex Thompson

Older Adults National Institute on Alcohol Abuse and Alcoholism NIAAA

An important future direction will be to expand the evidence-base for the treatment of older adults. This could include new clinical trials with less restrictive inclusion criteria, use of electronic medical records and observational studies, and simulations, as well as a combination of all these approaches (Blanco et al., 2017). Societal norms tend to reinforce the perception that older adults do not have SUD (Kuerbis and Sacco, 2013). This belief can be internalized by older adults, leading them to avoid treatment.

1. The NSDUH does not publish disaggregated treatment data on individuals ages 65 and older.
2. Almost 20% of men and just over 6% of women in this age group are binge drinkers.
3. More middle-aged and older adults are misusing alcohol, opioids, heroin, and marijuana.
4. Older adults have lower prevalence of substance use than younger adults, which may lead clinicians to think that older adults do not use psychoactive substances or develop SUD.

Family members should communicate with the elderly in a respectful, empathic way. Similarly, another DSM criterion – spending a lot of time on activities necessary to obtain and use a substance or recover from its effects – is irrelevant to older adults. Effects of substance use are evident after consuming relatively small amounts.

Are older adults impacted differently by alcohol and drugs?

In this article, we will review the signs and symptoms, risk factors, screening tools, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria, and challenges of treating substance abuse in the older adults. NSDUH collects data from a nationally representative sample of the U.S. civilian, noninstitutionalized population aged 12 or older. NSDUH data are collected through face-to-face, computer-assisted interviews at the respondent’s place of residence. TEDS is a nationwide compilation of data on the demographic and substance use characteristics of admissions to substance abuse treatment. TEDS data are reported to SAMHSA by state substance abuse agencies and include information on admissions aged 12 and older to facilities that receive some public funding.

Typically, late-onset abusers experience fewer physical and emotional health problems than early-onset ones. According to a study by Moos published in the Journal of Alcohol Health, they comprise 25% of all elderly patients with a substance abuse problem. TEDS data are collected through state administrative systems and then are submitted to SAMHSA.

Substance use also can trigger or intensify medical conditions such as diabetes or cardiovascular disease, which are common among older adults (Satre, 2015). Individuals ages 65 and older have lower odds of perceived treatment need than younger individuals, and often report a lack of readiness to stop using substances as one of their primary reasons to not seek treatment (Choi et al., 2014). As a result, older adults are more likely to be referred to SUD treatment from other sources such as community social service providers than from healthcare providers (Sahker et al., 2015). Yet knowledge of substance use and substance use disorders (SUD) in this cohort lags behind knowledge about the same issues in younger age groups.

This article briefly summarizes data on the epidemiology, service use, and clinical considerations of substance use and SUDs in older adults, and suggests future directions. According to statistics from the 2005–2006 National Survey on Drug Use and Health, prevalence rates for risky alcohol consumption (more than seven drinks per week or more than three drinks in one sitting) are approximately 10.9% for women and 16.0% for men. 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. The reasons for this type of addiction involve tolerant attitudes toward substance use, family conflict, and financial troubles. Family, friends, and doctors often don’t know when older people have a problem with alcohol and drugs.

Opioid Pain Medicines

We may be paid a fee for marketing or advertising by organizations that can assist with treating people with substance use disorders. Interruption in social and occupation roles or other repercussions of elderly drug abuse may be less noticeable or likely to occur at this stage of life. With age, one departs from these roles naturally in the vast majority of cases, such as through social isolation due to age-group peer mortality or retirement. Finally, seniors have trouble identifying risky behaviors surrounding alcohol and prescription drug use, making it even harder to establish that such behavior is occurring.

DAWN was a public health surveillance system that monitored drug-related morbidity and mortality.9 DAWN used a probability sample of hospitals to produce annual estimates of drug-related ED visits for the United States and selected metropolitan areas. Although this was not the chief cause of drug-related ED visits for this age group, use of illicit drugs, use of drugs combined with alcohol, and nonmedical use of pharmaceuticals resulted in nearly 300 ED visits each day. The remaining 644,547 ED visits by older adults primarily involved adverse reactions to and accidental ingestion of drugs. A senior may not recognize risks even after undergoing some treatment therapy. One can help an elderly parent or grandparent do so by asking if they are taking any medicines that could cause drug interaction and communicating the symptoms of prescription drug misuse or abuse to them.

Looking for Treatment?

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.

Alcohol and Older People

For example, due to feelings of isolation and shame (Kuerbis and Sacco, 2013), older adults often prefer treatment settings geared toward individuals of their same age, rather than settings with broader age ranges. Being married, of minority racial or ethnic ancestry, having attained less than a high school education, and earlier age of SUD onset also tend to lower treatment rates (Blanco et al., 2015). Lack of knowledge about services available can also impede treatment-seeking among older adults (Choi et al., 2014). By contrast, having had previous treatment contact for SUD tends to increase the probability of seeking treatment for another SUD. Our writers and reviewers are experienced professionals in medicine, addiction treatment, and healthcare.

It can be challenging for seniors to remember when and how much of each of their medications to take, especially when their minds are fuzzy and they take multiple drugs for relatively long periods. As in younger adults, being white, male, divorced or widowed, and disabled, and having lower educational attainment, increases the prevalence of SUD (Chhatre et al., 2017). Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. AddictionResource aims to present the most accurate, trustworthy, and up-to-date medical content to our readers. Our team does their best for our readers to help them stay informed about vital healthcare decisions. The DSM criterion related to giving up or reducing important social, recreational, or occupational activities in favor of substance use is similarly inapplicable.

The estimates presented in this report were based on the drug-related visits made by patients aged 65 or older found through a review of 5.2 million charts for ED visits occurring in calendar year 2011 in 233 hospitals. The DSM criterion related to continued use of the substance despite recurrent or persistent problems may not apply to many seniors who do not realize that these problems, such as depression, are related to alcohol use or misuse of prescription drugs. Unfortunately, there’s no 100% way to be sure, but there are signs a loved one may be abusing that one can look out for.

They include information on admissions to substance abuse treatment primarily from facilities that receive some public funding. The 2012 TEDS data presented in this report are based on data received through October 17, 2013, and include data from 14,000 admissions aged 65 and older. 8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care. He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture. Treatment options for elderly alcohol abuse or drug addiction vary depending on the level of medical care needed. They may include educational and preventative services and support, medical detox, and outpatient or inpatient treatment.

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.

Alcohol can interact dangerously with medications taken by older adults, including over-the-counter drugs, herbal remedies, and prescriptions. On an average day during the past month, 132,000 older adults used marijuana and 4,300 used cocaine (Figure 1). In this report, the “average day” estimates are presented for only marijuana and cocaine. Because of small sample sizes, “average day” estimates of crack, heroin, hallucinogens, and inhalants could not be produced. The data used in the “average day” estimates are not collected for the nonmedical use of prescription-type pain relievers, tranquilizers, stimulants, and sedatives; therefore, those estimates are also not presented. The 2018 NSDUH estimated that for adults ages 65 and older the prevalence of alcohol, tobacco, cannabis, and opioid (including prescription opioids) use in the past twelve months were 43 percent, 14 percent, 4.1 percent, and 1.3 percent, respectively.