How to Approach an Aging Parent on Substance Use

The Population Reference Bureau (PRB) notes that “the number of Americans ages 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060.” This is mainly due to the high number of people born in the “Baby Boom Generation,” which were born between the years of 1946 and 1964. As more people age, they are likely to keep working, experience health care issues, and have to deal with the problems that come with growing older.

Age-related health problems can run the gamut from arthritis to dementia. Chronic medical problems may also be experienced, such as high blood pressure, diabetes, chronic obstructive pulmonary disease (COPD), osteoarthritis, and mood disorders, like depression or anxiety. These and other health and mental health concerns may lead to regular use of substances that might ease discomfort. Regular use of substances, such as alcohol or pain medication, can lead to tolerance and possibly a severe substance use disorder known as addiction.

How does an adult child approach an aging parent about substance use? That’s a good question to which we hope to supply information and answers. Keep reading to find out which substances are the most common culprits.

Most Commonly Misused Substances Among Older People

Alcohol

The National Institute on Drug Abuse (NIDA) states that alcohol is the most used substance among adults over age 65, with a tenth of those reporting current binge drinking (five or more drinks on the same occasion for men, and four or more drinks for women). NIDA also notes that most substance use treatment admissions in this older adult demographic were for alcohol misuse.

A National Council on Aging report provides alarming statistics about alcohol misuse and the aging population:

As the body ages, it takes longer for it to break down and absorb alcohol and other substances. Alcohol can be consumed in excess as a form of “self-medication” when major life changes occur. Some examples of major life changes are divorce, retirement, change in living situation, or death of a loved one.

It can be a real challenge to observe the not-so-obvious signs of alcohol misuse because they often are similar to those of aging. These signs are:

• Fatigue
• Sleep problems
• Depression
• Anxiety
• Confusion
• Memory problems 
• Irritability 

When approaching an aging parent about alcohol use, it is best to be patient, kind, and understanding.

Prescription Drug Misuse

Prescription drugs are the second most misused substances for aging parents.  As people grow older, the possibility of chronic diseases may increase, along with being prescribed more medication to take to manage their chronic ailments. NIDA notes in one study that over 80 percent of participants took at least one prescription medication daily, and nearly half were taking more than five medications or supplements.

Opioid pain medication and benzodiazepines are the two most misused prescription medicines among older people, according to the American Academy of Family Doctors. When someone takes more medication than ordered or mixes one medication type with another, there is a strong possibility for a drug interaction to occur. When prescription medication is taken with alcohol, the aging parent could experience a severe adverse reaction.

Marijuana Misuse

It is not uncommon for people over the age of 55 to use marijuana these days. Eleven U.S. states have laws that allow recreational use of marijuana, and there are 22 states that allow the medical use of marijuana, as Esquire reports.

A study conducted found that past-year marijuana use among adults ages 50 to 64 was at 9%, and almost 3% among adults over age 65. The study’s authors also note that marijuana users in these age groups put themselves at a higher risk of using other drugs.

Aging parents seeking relief from chronic disease symptoms and/or mental health problems may be able to obtain marijuana legally for medicinal use. However, overuse of the substance can lead to tolerance of its effects, and the person may use more of it to feel the same effects as before. Also, it is not uncommon for people between the ages of 55 and 73 to use marijuana to relieve stress, anxiety, and the symptoms of depression and PTSD.

Identifying Substance Use Problem of an Aging Parent

Identifying a substance use problem your aging parent might have can be a challenge. There are signs to observe that indicate a substance use issue is possible. Among them are:

• Having prescriptions for the same medication from different doctors.
• Having prescriptions of the same medication from different pharmacies.
• Taking more than the prescribed dose.
• Taking the medication at different times than prescribed.
• Storing extra pills in wallets, pockets, purses, or other easy-access places.
• Becoming forgetful or confused.
• Acting withdrawn or angry.
• Talking about medication all the time.
• Refusing to go anywhere without taking the medication.
• Becoming defensive if you ask about their use of the medicine. 

In addition to the above, some signs of prescription drug abuse are also similar to aging:

• Mood changes
• Lack of activity and energy
• General loss of interest
• Irritability
• Lack of concentration
• Short-term memory loss

It is vital to know these substance misuse signs an aging parent might exhibit. If you do observe the signs, approach your parent gently with patience. If they become defensive or are reluctant to answer, there are resources available at The Palm Beach Institute in which to delve. If you are concerned about their health and safety as it pertains to substance use, it might be wise to consult with their doctor.

Increased substance use in the aging population is sometimes called “a hidden problem” or “an invisible problem.” This is primarily due to the “lack of screening in primary care and few guidelines for assessing older adults who might be using,” as noted by Susan Lehmann, a geriatric psychiatrist from Johns Hopkins Medicine. She also says it may be difficult for primary care providers and adult children to broach the subject of substance use with an aging parent because it would seem disrespectful.

It is not easy or comfortable to approach an aging parent on substance use. It may seem like the roles are reversed as parents become older. Try to reach out to your parent as you would hope they would come to you if you seemed to have a substance use disorder. Keeping the lines of communication open can help.

Sources

Population Reference Bureau. (2019, July 15) Fact Sheet: Aging in the United States. Mather, M., Scommengna, P., Kilduff, L. from https://www.prb.org/aging-unitedstates-fact-sheet/

American Psychiatric Association. (2017 January) What Is Addiction? Parekh, R. MD, MPH. from https://www.psychiatry.org/patients-families/addiction/what-is-addiction

NIDA. (2020, July 9). Substance Use in Older Adults DrugFacts. from https://www.drugabuse.gov/publications/substance-use-in-older-adults-drugfacts

Clinics in Geriatric Medicine. (2014, August 1) Substance Abuse Among Older Adults. Kuebis, A. et. al. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146436/

American Academy of Family Physicians. Prescription Drug Abuse in the Elderly. from https://familydoctor.org/condition/prescription-drug-abuse-in-the-elderly/

National Institute on Drug Abuse. Drug Use and Its Consequences Increase Among Middle-Aged and Older Adults.William Ross Perlman, Ph.D., CMPP from https://www.drugabuse.gov/news-events/nida-notes/2019/07/drug-use-its-consequences-increase-among-middle-aged-older-adults

Esquire. (2020, February 7) Here Are All the States That Have Legalized Weed in the U.S. Rense, S. from https://www.esquire.com/lifestyle/a21719186/all-states-that-legalized-weed-in-us/

U.S. National Library of Medicine. PubMed.gov. Drug and Alcohol Dependence. (2018 October) Marijuana use by middle-aged and older adults in the United States, 2015-2016. Han, B. et. al. from https://pubmed.ncbi.nlm.nih.gov/30197051/

NIDA. (2020, May 29). Is there a difference between physical dependence and addiction?. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence-addiction

John Hopkins Medicine. News and Publications. (2019, May 1) Substance Use Disorders in Older Adults: A Growing Threat. Minkove, J. from https://www.hopkinsmedicine.org/news/articles/substance-use-disorders-in-older-adults-a-growing-threat