An addiction treatment center is not exactly where older adults think they will visit during their golden years. But many people age 60 and up are struggling with substance dependence and addictions that are sending them to rehab, a hospital, or a grave.
Anyone of any age can be vulnerable to the effects of drugs and alcohol. But despite the fact that drug dependence and addiction do not discriminate, senior adults tend to be left out of the conversation about who struggles with substance misuse and a need for addiction treatment to recover from substance use disorders.
Statistics illustrating trends among the elderly show a clear need for why the conversation must include the senior population and their needs for addiction treatment and recovery services.
Generally, illicit substance use declines as people age. However, that does not mean older people will not develop struggles with substance use in later life. The National Institute on Drug Abuse (NIDA) cites 2018 data that says nearly 1 million U.S. adults aged 65 and older live with a substance use disorder (SUD).
Baby boomers traditionally do not have hesitation using alcohol, prescription medications, and illegal drugs because these were widely available as they came of age. They are dealing with common issues that accompany aging, including physical changes in the body.
There are also pressures that come with major life changes in later life, such as managing the budget to make sure there is enough to live off of during the retirement years or having to downsize as the children have all left home.
Many people at this stage in life have spouses, relatives, and friends who are sick or dying. Others may struggle with depression and other mental health disorders that deserve attention. To deal with uncomfortable situations, some people self-medicate with substances. However, this only makes their problems worse. Many people will not seek treatment for their issues, but some will.
NIDA cites data showing that a proportion of older adults who entered a treatment facility between 2000 and 2012 increased from 3.4 percent to 7 percent during those 12 years.
Here, we look at the two substances many older adults struggle with—alcohol and prescription medications. We also will take a look at why substance misuse is particularly problematic for older adults and why addiction issues among this population are not addressed on a wider scale.
Alcohol remains the most widely used substance among the senior adult population. It is legal for people age 21 and older to drink, although it is widely and easily accessible. These facts make it easier for older adults to hide an alcohol problem because drinking is socially accepted overall. Few will question senior-age adults drinking a glass of wine or a beer or perhaps something stronger. However, some older adults are not just drinking alcohol; they are drinking more of it for longer periods.
AmericanGeriatrics.org reports that binge drinking, alcohol use disorders, and past-month alcohol are up among seniors. Alcohol trends also show that women in this age group are drinking more.
A Pacific Magazine report highlights a study that found that more than 10 percent of Americans older than age 65 binge-drink regularly. “That’s an increase from the 7.7 to 9 percent who reported binge drinking in similar data collected from 2005 to 2014,” the publication reports.
Binge drinking is the practice of drinking four or more drinks in a small period, usually two hours.
UCLA professor Dr. Alison Moore told Aging.com that about 10 to 15 percent of people don’t start to drink heavily until their older years.
This increase has led to a rise in alcohol-related emergency room discharges among elderly people, which hit three-quarters of a million in 2012, according to the website. It also reports that the number of people who will have alcohol use disorders is expected to rise as the senior population is projected to grow by 80 million by 2050.
While alcohol is widely used and abused, so are legal prescription medications, a problem expected to continue as the population ages and lives longer.
In recent years, baby boomer adults—those born between 1946 and 1964—have reportedly been the fastest-growing population in the country to battle SUDS, particularly with opioid medications and the illegal street drug heroin.
Chronic pain, often treated with opioid drugs, such as OxyContin, morphine, and fentanyl, among other medications, can lead to opiate addiction.
There are several reasons why prescription drug use is a significant health issue among older adults. One of them is the practice of overprescribing medications, which has come under more scrutiny in recent years.
According to NIDA’s report, more than 80 percent of patients ages 57 to 85 years use at least one prescription medicine every day, and more than 50 percent use five medications or supplements daily. It is possible that some of these people have been prescribed too many medications.
HealthDay reports that more than 33% of older people in the U.S. are prescribed medications that they may not need, according to a recently published study. According to the article, these patients could end up in the hospital or emergency room after using medications in high amounts.
This is not a new problem, but it is one that can lead to others. Having too much medication on their hands can prompt people to take too much of it or take it in incorrect dosages, a problem that can help create dependence and addiction.
According to a May 2017 report from AARP (American Association of Retired Persons), “almost one-third of all Medicare patients — nearly 12 million people — were prescribed opioid painkillers by their physicians in 2015. That same year, 2.7 million Americans over the age of 50 took pain relievers for reasons or in amounts beyond what their physicians prescribed.”
The medications induce feelings of euphoria and relaxed feelings for many users, so some people take more of the drug to feel those sensations again and again—at the risk of becoming addicted. Others will take more than what their doctor prescribed just to reduce the amount of pain felt or to feel no pain at all. But that, too, can lead to irresponsible use and physical dependence that is difficult to break without professional addiction treatment.
More seniors are ending up in the hospital due to taking too many of these medications, which are even more potent when taken incorrectly. Using too many medications puts seniors at risk for overdose and addiction.
AARP cited a Columbia University study that said baby boomers may have a 25 percent higher chance of dying from overdoses on prescription opioid medications and heroin than people born in the late 1970s.
In addition to prescription opioid medications, an increase in benzodiazepine use among older adults is also an issue. Benzodiazepines are potent sedatives used to treat various conditions, from anxiety and insomnia to alcohol withdrawal.
Some research estimates that 10% to 25% of people aged 65 and older are using benzodiazepines, according to Physician’s Weekly, which reports that use of the medicines among older adults has been linked to higher adverse event rates.
“Benzodiazepines are effective drugs for many ailments, but they may not be the best option for older adults,” Erin M. Marra, MD, told the publication. Continued benzodiazepine use can put people of any age at risk of developing a dependence on them.
They are addictive, which is why they are usually prescribed for short-term treatment, usually no more than two weeks. “These drugs can also become habit-forming, making it difficult to discontinue them after years of use. “
As the publication notes, older adults who use benzodiazepine medications are at increased risk of falls, which can cause hip fractures and other serious health problems. They can also deal with memory, delirium, drowsiness, and other conditions that can put them in danger, especially if they are performing tasks that require alertness, such as cooking or driving.
According to NIDA, many older adults use over-the-counter medicines and dietary and herbal supplements, which it says could add to the adverse health consequences resulting from nonmedical use of prescription drugs.
Addiction that occurs in later life brings unique challenges to older adults, who are not always aware of what taking these drugs means for their overall health and well-being. Below are a few reasons why senior adults tend to be prone to developing opiate addiction or dependence on addictive substances.
Age. Metabolism slows with age, and the body’s organs and central nervous system react differently when potent substances are in the body. This means that what is considered a normal dose for a younger person could be fatal or near-fatal to an older one. It also means that prescription drugs do not clear an aging person’s body as fast as they once did. For older people who take prescription drugs, or other drugs, and drink alcohol, the risk of overdose is higher. Mixing drugs and alcohol, whether intentionally or unintentionally, can be deadly.
Chronic health conditions. Aging increases the likelihood that older people will experience chronic pain and illnesses, such as arthritis, diabetes, high blood pressure, cancer, and heart disease, among others. It is common for doctors to prescribe strong pain relievers to help senior patients manage their illnesses. However, doing so has led to the practice of overprescribing opioid medications in this population.
Seniors buy more medications and take them more frequently. Older people are more susceptible to becoming addicted to opioids because they tend to buy and more prescription medications than other groups. The National Institute on Drug Abuse (NIDA) says that while people age 65 and older are only 13 percent of the U.S. population, they account for more than one-third of total outpatient spending on prescription drugs in the U.S. Senior adults also are more prone to developing prescription medication addiction because they also use prescription drugs more often than the general population, as noted above.
Overdose possibilities are real. Interactions between medications, like those of alcohol and medications, can have intoxicating effects that can lead to overdose or death. Opioids that are commonly used to treat pain, such as fentanyl, Vicodin, Percocet, and OxyContin, as well as benzodiazepines, such as Xanax and Valium, are among the medications purchased in this population.
Die-hard alcohol, drug habits. The views some older adults had about substance use in their younger years—when experimental drug use was accepted in some circles, and the risks weren’t known or considered—could make some older adults more susceptible to addiction. People who drank or did drugs excessively in their younger years may take those habits or addictions into their older years and misuse or abuse medications and illicit substances.
Senior adults with a history of substance misuse should be upfront with their doctors about it. Physicians often do not ask their patients about such things, causing problems down the road, including not recognizing the signs of when addiction has set in.
According to the North Carolina Department of Health and Human Services, the senior population remains undertreated for disorders involving alcohol and prescription drug use.
“There is a lack of attention to substance abuse in older adults. One reason is older adults’ disapproval of and shame about use and misuse of substances and a reluctance to seek professional help for what many in this age group consider a private matter,” it writes.
It goes on to say that some adult children feel shame about their older parents having SUDs, so instead of facing the issue head-on, they would rather not address it, which helps put their loved one at increased risk.
There is also a perception that some people think treatment for older people is not necessary given that they are in their older years; others think treatment for older adults will work. Some older substance users also feel entitled to indulge in whatever substances they want, making it challenging to get them to consider that they might have a substance problem that needs to be treated.
Another reason addiction among older adults flies under the radar is because some have the perception that older people don’t abuse substances or that they have other physical and mental health disorders due to their age.
For example, someone may attribute an older person’s forgetfulness to dementia or Alzheimer’s when the truth is they blacked out after drinking too much.
If you suspect a senior loved one is misusing substances or has become dependent on them, you might want to consider sitting down with them to discuss your concerns. It might be time to review treatment center options to get them the help they need.
Senior adults who struggle with substance use disorders are encouraged to get treatment for their condition. There is nothing to be ashamed of, and there is help for older substance users available.
According to NIDA, most admissions for people in the age 65+ group relate to alcohol. Alcohol use disorders are challenging to treat without professional help. Also, more seniors are seeking help to recover from opioid use disorder. Medication-Assisted Treatment (MAT) programs can help people who have disorders involving alcohol and opioids.
MAT combines government-approved medications and behavioral therapies and counseling to help people avoid uncomfortable withdrawal symptoms and relapse so that they can focus on completing a recovery program that helps them address the factors that contribute to their substance use and learn how to avoid relapse and live healthier lives.
According to NIDA, research shows that patients who are older have better results with addiction treatment when they stay in an extended program. Three months (90 days) are usually recommended to boost patients’ chances for the best outcome, but outpatient treatment could also work for patients who are able to attend treatment sessions while living away from the facility’s campus.
The best models for senior addiction recovery are still being studied, but according to NIDA, “ideal models include diagnosis and management of other chronic conditions, re-building support networks, improving access to medical services, improved case management, and staff training in evidence-based strategies for this age group.”
If you or a loved one is interested in entering a treatment program at an addiction treatment facility is advised to look for one that caters to the unique needs of the senior population with substance use disorders. Look for evidence-based programs that treat each person as an individual. Addiction recovery does not look the same for everyone.
The Palm Beach Institute has been helping people work through and overcome substance use disorders since 1970. If you or someone you know is interested in getting help, we want to talk with you about our treatment programs. Give us a call today.
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