Addiction and Senior Adults

Addiction in Older Adults

The Centers for Disease Control and Prevention (CDC) estimates that over 100,000 drug overdose deaths have occurred in America over the past 12 months. Compared to prior years, this is a near 28.5% increase.

Unfortunately, addiction often has more than one cause, and it can be challenging to assume one identifiable risk. There are two leading umbrella causes of addiction: biological and environmental. Mental illnesses and using substances can also play a role in developing an addiction.

Some general risk factors for addiction across all ages include:

• Aggressive childhood behavior
• Reduced parental supervision
• Peer influence
• Drug experimentation
• Drug availability
• Poverty
• Genetics
• Mental other disorders
• Early use
• How a person starts taking a drug
• Prescription medication with a high risk for addiction (such as benzodiazepines, painkillers, sedatives, etc.)

Slower metabolisms and increased vulnerability to substances are specific risk factors for older adults. In addition, almost 90% of older adults take at least one prescription medication, many of which are potentially addictive.

Higher prescription medication use amongst seniors can have more noticeable side effects. These prescription medications can increase a person’s dependency on the drug.

Life changes like retirement, death, or alterations in income can also impact addiction development.

While many senior adults have been lifelong addicts, others fall into the “late-onset addiction” category, meaning they’ve developed an addiction problem later in life.

Warning Signs of Substance Abuse in Seniors

Recognizing warning signs of seniors addicted to drugs is the first step in getting help for a drug or alcohol addiction.

For those worried about an older adult, here are some common warning signs of prescription drug abuse:

• Taking too much of a drug
• Sleep pattern changes
• Borrowing medication
• Using multiple physicians for prescriptions
• Filling prescriptions at numerous pharmacies
• Mood changes
• Sleeping pattern changes
• Relationship and social life changes

Additionally, some common warning signs of an alcohol use disorder are:

• Neglecting daily responsibilities
• Increased risky behavior (e.g., drinking and driving)
• Using alcohol as an escape
• Changes in relationships
• Spending a lot of time drinking
• Cravings
• Withdrawal symptoms

Noticeable withdrawal symptoms are a likelihood if substance use is reduced or eliminated. Someone must seek medical attention when significantly decreasing or quitting drug or alcohol use. Medical professionals can reduce unwanted side effects and the potential for relapse.

Overall, signs of any addiction in senior adults can include any of these additional warning signs:

• Memory problems
• Eating behavior changes
• Chronic pain
• Lack of adequate hygiene
• Depression
• Wanting to be alone

If an older adult lives alone or in a nursing home, check on them frequently or inform their caregiver of your concerns. Consider asking neighbors about any noticeable changes.

Addiction Trends in Senior Citizens

Typically, most experts categorize senior ages starting at 62 to 65, while some may even consider 70 and older as senior citizens. Sixty-five has often been the magic number since it is when adults start qualifying for Medicare and other retirement benefits.

Recent data has looked at substance use disorders amongst adults over 60. There are over 52 million adults ages 60 and up in the United States.

The National Survey on Drug Use and Health found that in the United States, 7.4% of citizens over the age of 12 qualify for a substance abuse disorder diagnosis. However, according to The National Institute on Drug Abuse (NIDA), nearly one million adults in the senior age group suffer from substance use disorder.

Challenges for Elderly Adults With Substance Use Disorder

One challenge for elderly adults with substance use disorder is getting diagnosed. The lack of screening and regulatory addiction guidelines poses a universal challenge for all age groups.

As we age, our metabolism slows down. This change in metabolism can make it seem like fewer drinks, or prescription drug use could be less dangerous. In reality, older adults are more at risk for addiction because of these metabolic changes.

Unique Health Concerns

There are unique health concerns for elderly adults using substances. Since prescription drug use is higher amongst older adults, there is more danger of:

• Overdosing
• Mixing medication
• Combining certain medications with alcohol (such as pain medications or antidepressants)
• Misusing prescription guidelines

Natural aging might explain balance issues, but trouble with balance can also signify that a person has consumed too much alcohol. Increased alcohol use can place an elderly individual at risk for falls and fractures.

Long-term alcohol use in older adults can also lead to:

• Liver damage
• Impaired immune system
• Cancer

Alcohol abuse also worsens current health conditions that many older adults deal with daily.

Medical conditions that can worsen with alcohol use include:

• Osteoporosis
• Diabetes
• High blood pressure
• Stroke
• Memory loss

Some family members and friends could easily mistake some of these signs for Alzheimer’s or age-related memory loss. It is crucial to encourage routine physical exams and ask about alcohol or prescription drug use.

Difficulty in Getting a Diagnosis

Ageism believes in a stereotype, prejudice, or discrimination based on age. People can find ageism amongst close relatives or in institutions like medical clinics and hospitals.

Unfortunately, ageism often leaves older adults with poorer access to health and wellness checks. Ageism also leads to earlier deaths by 7.5 years and increases substance use disorder rates.

Healthcare providers, including physicians, may ignore memory and health concerns, assuming they are signs of aging. However, these health and memory issues may also indicate that seniors are addicted to prescription medications or struggling with illicit drug use.

Other Challenges

Whether attending medical appointments or drug addiction treatment, reliable transportation could be problematic for some seniors. Social isolation and mobility concerns can make it even more challenging to find help.

The Substance Abuse and Mental Health Services Administration (SAMHSA) article points out that senior adults may struggle to seek help for addiction. Many of the older adults in the senior age group grew up during a time when addiction was considered much more shameful. Seniors may also find it challenging to participate in group therapy sessions while surrounded by younger adults.

Many older adults may not know that they have an addiction or are misusing prescription drugs. For adults with cognitive or memory concerns, a lack of complete awareness can lead to accidental overdoses.

Recent studies found that opioid-related overdoses amongst older adults over 55 increased by 1,886% in the last 20 years.

Addiction Treatment for Seniors

Recovering from addictions for seniors will likely differ slightly from traditional rehab programs. Seniors are more likely to have other pre-existing medical conditions, including diagnoses such as:

• Cardiovascular disease
• Diabetes
• Stroke
• Memory loss
• Mental illness

Rehab centers must emphasize a well-rounded approach to treating seniors. Treatments should include addressing underlying medical conditions and age-specific substance use triggers.

Some rehab centers specialize in geriatric medicine and care. When searching for a treatment facility for yourself or a loved one, ask what type of support they provide specifically for elderly patients.

Here’s some good news: experts have found that approximately 75% of people with addiction will recover, and their chances significantly increase when they seek treatment and participate in ongoing recovery programs.

Addiction Treatment Centers

Approximately 10% of individuals with a substance use disorder seek treatment. Statistically speaking, women are less likely to enter a rehabilitation program than men.

When searching for an addiction treatment program, you will find various treatment options to choose from. Some treatment centers specialize in specific substances, such as prescription opioid addiction.

Inpatient Rehab

Inpatient rehab or residential treatment centers focus on 24/7 care. Inpatient care can involve a detox process (if needed) and on-site medical care.

Additional benefits of inpatient rehab include:

• Close monitoring of patients (including vitals, mental health, and overall behavior)
• Reduced risk of suicide
• Prevention of harm to others
• Access to 24/7 support and medical intervention
• High level of structure

Most patients transition from an inpatient rehab program to a less intensive treatment option like outpatient therapy. The average length of stay within an inpatient rehab varies from 30 days to 90 days.

Inpatient rehab is a highly structured program that specializes in:

• Multiple types of addiction (alcohol, opioids, painkillers, illicit drugs, etc.)
• Severe addiction issues
• Co-occurring disorders (also known as dual diagnosis)

Most inpatient rehab centers provide additional mental health services, including individual and group therapies. The most common therapy techniques include Cognitive-Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and more.

Outpatient Rehab

Outpatient rehab is a step down from inpatient care.

Outpatient programs are ideal for:

• Mild to moderate addictions
• Individuals with strong support networks
• Individuals with reliable transportation
• Patients with lower relapse risks

There are two main types of outpatient rehab: Intensive Outpatient Programs (IOPs) and Partial Hospitalization Programs (PHPs).

PHPs have more significant time commitments than IOPs, and they are ideal for those who can’t afford inpatient rehab or do not need 24/7 support. A PHP would allow a senior adult to participate in a higher level of treatment without inpatient treatment’s price tag or time commitment.

IOPs are effective for patients who have completed a more intense rehab program or those who have a minor addiction.

Medication-Assisted Treatment (MAT)

Medication-Assisted Treatment (MAT) is another tool primarily used within inpatient rehab or PHPs. Some outpatient programs also utilize MAT. MAT helps reduce withdrawal symptoms and relapse risk.

The most common medications used for alcohol and drug rehab include:

• Buprenorphine
• Methadone
• Naltrexone

MAT works best when used alongside other behavioral approaches and mental health therapies. A qualified clinic will use MAT based on addiction type, severity, relapse, and other factors.

There is substantial evidence that treatment programs using medication for drug addiction provide higher success rates for individuals in treatment. Studies have also found that MAT helped reduce overdoses five times more than other programs.

Detox Services

Medical detox helps stabilize patients undergoing withdrawals from drugs or alcohol. When a person stops consuming substances, there is a high risk for dangerous side effects as their body adjusts to the sudden lack of alcohol or drugs.

In the case of alcohol abuse, delirium tremens is a condition that causes hallucinations, high blood pressure, and seizures. Older patients are at a greater risk for experiencing complications during alcohol detox since they may have other comorbidities, such as diabetes or cardiovascular disease.

Weakened immune systems can also make it harder to combat the side effects of withdrawal. Sluggish metabolisms could prolong detoxification, and close medical monitoring is crucial to safely detox.

Medical detox provides patients with qualified medical practitioners who monitor vitals and administer life-saving medication. Many detox programs are offered on an outpatient basis, while some programs offer 24/7 monitoring and care during the detoxification process.

Mental Health and Counseling Services

Counseling and mental health services are crucial components of any successful rehab program. Previous mental health disorders can place a person at an increased risk for substance abuse.

Contrarily, substance use exacerbates mental health disorders. Some of the most common mental illnesses with substance use include:

• Anxiety
• PTSD
• Depression
• Bipolar Disorder
• Schizophrenia
• Obsessive-Compulsive Disorder (OCD)

CBT and DBT are evidence-based treatments that help co-occurring disorders. CBT and DBT— two types of psychotherapy—help recovering addicts change their mindset, develop better coping mechanisms, and learn how to deal with potential triggers in the future.

Finding Help for Senior Adult Addiction

Senior adult addiction is prevalent in the United States, and it poses unique risk factors from the high numbers of prescription drug use, comorbidities, and cognition concerns.

Ageism, social isolation, and other factors may limit an older adult’s ability to receive care. Addiction recovery is possible, and it starts with reaching out to qualified rehab and treatment centers.

Find a treatment program near you by visiting the SAMHSA program locator or calling their helpline at 1-800-662-4357.