Center for Addiction Medicine

12/07/2007 - The "Hidden Epidemic" Substance Abuse Among Older Adults

Alcohol and drug use within older populations remains a significant issue, particularly in the context of the increasing senior population. In Clark County alone, households with retirees grew by 10.6%, and people aged 55 or older counted for 22.4% of all new residents to the Las Vegas Valley in 2006.

Whether age and wisdom, increasing symptoms and medical conditions associated with aging, medication use or acute health events, older Americans tend to lower their alcohol intake and smoking as they age.

On the other hand, overall health burden, loss of loved ones, increasing pain or other medical symptoms, depression or anxiety disorders, and access to addictive prescription drugs may increase the likelihood of substance abuse in the senior community.

Substance abuse is an issue for older adults, and one that is frequently misdiagnosed by family physicians. Little research has been done to show the exact numbers of substance abuse and addiction in the 55+ population. As a result, older adults are significantly underserved with effective treatment programs.

Physicians often fail to recognize elderly substance abuse for many different reasons:

•  Lack of awareness by the physician.
•  Embarrassment by the physician at the idea of suggesting that his/her elderly patient be screened for abuse.
•  Failure to perceive the importance of substance abuse in the elderly.
•  The idea that, “he is old, let him have his small pleasure.”

Data for the year 2001 for all American public and private substance abuse program admissions that receive public funding revealed 58,073 admissions of persons older than 55 years compared with 1.04 million admissions aged 30-54 years. For older persons, the primary problem substance was alcohol (76.3%), followed by opiates (14.3%).

Although only a small percentage of older persons use illegal drugs, a much larger percentage use potentially addictive prescription medications, such as benzodiazepines and prescribed opioid pain medications.

According to a report by the National Institute On Drug Abuse, as many as 1.8 million Americans over the age of 65 may be dependent on Medicare-provided prescription drugs.

Additionally, older persons frequently use both alcohol and prescription medications.
Data from a national prescription medicine assistance program for older persons found that 19% were using alcohol-interactive medicine and concomitantly using alcohol.

The good news is that the few studies that have focused on treatment for older adults have shown that this demographic responds well to intervention and early treatment.

Screening and early identification of alcohol misuse and drug abuse for older adults is not provided enough to tackle the problem of addiction among seniors. However, with some awareness and good medical treatment, this issue can be controlled.

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