Taking part in 12-step program meetings such as Alcoholic Anonymous is an important approach to relapse prevention and treatment in general. Meetings with same-age cohorts enable peer bonding, provide mutual support, and help establish peer sobriety networks. Families also play a crucial role in supporting the recovery of their seniors and preventing relapse.
This would lead to more person-centered care and decrease the need for multiple appointments, which can be particularly challenging for older adults. Collaborative models of care can achieve this goal either in-person or with the use of digital technologies (Ramuji et al., 2019). There has been little research on the effects of vaping nicotine liquid marijuana (e-cigarettes) among older adults; however, certain risks exist in all age groups. Some research suggests that e-cigarettes might be less harmful than cigarettes when people who regularly smoke switch to vaping as a complete replacement. However, research on this is mixed, and the FDA has not approved e-cigarettes as a smoking cessation aid.
These include high blood pressure, ulcers, liver disease, anxiety, sleep problems, and depression. Use of illegal drugs like cocaine and heroin (and marijuana, in some states) is much lower in people 50 and up than in younger people. But it’s more common among this age group in the U.S. than almost anywhere else. It’s especially dangerous because their bodies don’t process drugs as quickly as when they were younger. Isaak learned addiction psychology at Aspen University and got a Master’s Degree in Arts in Psychology and Addiction Counseling.
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
With an estimated prevalence of 4%, substance abuse amongst persons who are 65 years and older is increasing. The most common substances abused are alcohol, prescription drugs such as opiates and benzodiazepines (BZD), and over-the-counter (OTC) medications. This increase is believed to be partially endorsed by the baby boomer generation, born between 1946 to 1964, who had significant exposure to alcohol and drugs at a younger age. Substance abuse is difficult to recognize in the older adults, but once identified, presents its own challenges as only 18% of substance abuse treatment programs are designed for this growing population. Substance abuse overall may increase the risk of fractures secondary to recurrent falls, memory loss, sleep disturbances, anxiety, and depression.
Drugs can worsen these conditions, exacerbating the negative health consequences of substance use. Additionally, the effects of some drugs—like impaired judgment, coordination, or reaction time—can result in accidents, such as falls and motor vehicle crashes. These sorts of injuries can pose a greater risk to health than in younger adults and coincide with a possible longer recovery time. Drinking alcohol, misusing medicines, or using marijuana or other drugs often starts after a big change in a person’s life. Retiring, the death of a spouse or good friend, leaving your home, or being diagnosed with a disease can trigger substance use.
- A key consideration in the treatment of older adults with SUD is that they often have co-occurring general medical illnesses (Wu and Blazer, 2014).
- The DSM criterion related to giving up or reducing important social, recreational, or occupational activities in favor of substance use is similarly inapplicable.
- Older adults have not demonstrated high rates of drug or alcohol use over time compared with younger adults.
- Moreover, they can unknowingly become addicted to these medications, making it another cause of substance abuse in the elderly.
As a result, the elderly have higher blood alcohol concentrations than younger adults, suffer more significant impairment, and are less aware of it. Alcoholism in the elderly is more likely to cause functional impairment, compromising their ability to perform everyday tasks such as shopping, cleaning, and cooking. 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. On the positive side, because individuals ages 65 and older are eligible for Medicare, insurance is less often a barrier to care. In older adults, alcohol can trigger some health problems or make them worse.
Drugs & Supplements
In fact, most seniors experience reduced tolerance due to age-related physiologic changes that augment the effects of alcohol and other drugs. 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. Bupropion, varenicline, and nicotine replacement are options for nicotine dependence. If you’re worried about an older loved one’s use of alcohol or drugs, talk to them about it. If that doesn’t work, consider asking their doctor, minister, or a longtime friend to approach them instead.
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 are there drops to reverse eye dilation 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. Prescription drugs, more specifically opioids and benzodiazepines, come in a close second. Also, there is a need to improve the integration of mental health and general health services.
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The effects of tobacco and alcohol, the two most commonly used drugs, on multiple organs, are well known. Other drugs, such as opioids and benzodiazepines can cause or exacerbate respiratory depression. Injection drug use can cause a variety of infections (e.g., endocarditis), which are more likely to occur in individuals with general medical conditions. Substance use also can trigger or intensify medical conditions such as diabetes or cardiovascular disease, which are common among older adults (Satre, 2015). Older adults may be more likely to experience mood disorders, lung and heart problems, or memory issues.
Older Adults
Admittedly, studies on the effects of treatment of substance abuse in older adults are few and far between, which is why it is crucial to find specific ways to engage the senior. Belonging to an older cohort decreased the probability of ever receiving treatment (Blanco et al., 2015). The NSDUH does not publish disaggregated treatment data on individuals ages 65 and older. However, the Treatment Episode Data Set (TEDS), which collects data on publicly funded substance use treatment admissions, found that individuals ages 65 to 69 represented only 1.18 percent of the total admissions.
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. A senior may not recognize risks even after undergoing some treatment therapy. One can help an elderly parent or grandparent do so by asking older adults national institute on alcohol abuse and alcoholism niaaa if they are taking any medicines that could cause drug interaction and communicating the symptoms of prescription drug misuse or abuse to them. If they are taking several prescription drugs for different health conditions at once, it would be very helpful to write down the doses and administration times in big letters on a sheet and put it up where they will see it, like on the fridge.
Clinical Considerations
These are not to be underestimated, as they can progress swiftly at this age. In particular, irritable colon and bladder inflammation have been linked to colon cancer in persons over 60. In addition, elder substance abuse causes an increased risk of household-related accidents, like falls, bone fractures, and burns. Potential triggers for late-onset alcoholism and drug abuse (which developed after 65) include retirement, loss of income, death of a loved one, placement in a nursing home or relocation in general, trouble sleeping, and health decline.
Many behavioral therapies and medications have been successful in treating substance use disorders in older adults. Treatment for substance use disorder in older adults is the same as for younger people. Medicines are often used to help control cravings, ease withdrawal symptoms, and prevent relapse.
Increased Sensitivity to AlcoholAging can lower the body’s tolerance for alcohol. Older adults generally experience the effects of alcohol more quickly than when they were younger. This puts older adults at higher risks for falls, car crashes, and other unintentional injuries that may result from drinking. The liver processes alcohol more slowly, and brain neuronal receptor sensitivity to alcohol and blood-brain barrier permeability increase.
The twelve-month prevalence of alcohol use disorder (AUD) and drug use disorder (DUD) (the NSDUH does not publish disaggregated information on specific drugs for adults ages 65 and older), were 1.6 percent and .4 percent, respectively. 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. 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.
At present, SUD treatment for older adults is based on clinical experience and on studies conducted in younger populations, as most clinical trials for SUD tend to exclude older adults (Blanco et al., 2008; Blanco et al., 2015; Okuda et al., 2010). 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).
