As the general US adult population ages, more people will find themselves battling addiction in their golden years. Who the “typical addict” is and what he or she looks like is rapidly changing, and the issue is far more complex than older people using their post-retirement free time just to get high.
It is estimated there are about 78 million baby boomers nationwide and, “every day, 10,000 baby boomers—the drugs, sex and rock ‘n’ roll generation—turn 65,” said Harry L. Haroutunian, MD, who specializes in recovery and addiction issues in a recent commentary by the Betty Ford Center.
Many in this group are grappling with addictions to illicit and prescription drugs and alcohol, and other things some may not want to talk about at all. Metal rocker Ozzy Osbourne, 67, a recovering addict with a history of substance abuse, recently revealed he is receiving treatment for sex addiction.
Treatment centers are seeing more admissions from people 50-plus seeking recovery from substance abuse, and by 2020, the number of addicted older adults needing treatment is expected to double to about 6 million in this country. By 2030, older adults will account for roughly 20 percent of the US population, according to data from the State of Aging and Health in America 2013 report.
But judging from the focus on younger groups and their substance abuse issues, you might not know baby boomers, the generation born post-World War II, is having addiction troubles.
“We know that 17 percent of older adults in the United States misuse alcohol and prescription drugs, as opposed to 10 percent of the general population,” Haroutunian, MD, said.
Aging adults aren’t typically seen as candidates for addiction and their struggles are largely missing from the national conversation about substance abuse.
This needs to change, and there are plenty of reasons why.
Medications abuse not so easy to recognize
Alcohol remains the most commonly abused substance among older adults; it’s socially accepted and widely accessible, which makes it easier to hide a drinking problem. But problems can hide only for so long, especially when prescription medications enter the picture.
Older adults have a slower metabolism and their organs and central nervous system react to alcohol differently. So any amount of alcohol can interact poorly with the prescription drugs needed to manage chronic health issues. While some people mistakenly mix their medication and alcohol, others purposely use the two together, putting themselves at risk.
Dr. Marvin Tark, a board-certified anesthesiologist and pain management specialist, tells AgingCare.com that prescription drug addiction is no different from alcoholism or other substance abuse addiction. “If a person has a history of alcoholism or substance abuse, there is a higher chance that they will abuse prescription medication,” he said.
Stephen Scheinthal, DO, an osteopathic geriatric psychiatrist from Stratford, NJ, said abusing medication in this manner is not always easy to detect among the elderly.
“On average, seniors take four to nine pills per day between their prescription drugs and over-the-counter medications and abuse of these medications is not always easy to spot,” he said in an article published on the American Osteopathic Association’s site.
Such abuse, whether the person is young or up in age, and whether the drugs are legal or not legal, stems from a desire to cope with grief, anxiety, depression or pain, Scheinthal said.
Opioid addiction rising among baby boomers
Adding to the urgency to address addiction among baby boomers is the realization that they are now the fastest-growing demographic dealing with opioid dependence and addiction in the US, a situation that has already reached epidemic levels, according to the Centers for Disease Control and Prevention (CDC).
According to an article published on MedScape.com, older adults in the US who are age 50 to 69 years old represent the fastest-growing population of opioid addicts, and the number of people age 65 years and older who have at some point abused opioids increased by 34 percent from 2011 to 2012, data show.
“What this tells us is that there’s some evolving demographics for opioid addiction and guess what, it’s not just that young college student who is the addict; it’s actually also working people. and it’s more mature adults,” said Joseph V. Pergolizzi Jr, MD, told Medscape.
That group of mature adults includes the late pop icon and musician Prince, who died in April 2016 from an overdose from the powerful painkiller fentanyl, and R&B soul singer Chaka Khan, 63, who recently entered intensive rehabilitation in July 2016 to get help with her dependence on the same synthetic opioid that caused Prince’s death.
Adults 65-plus buy more prescription meds than anyone else
Perhaps one reason for the increase in older people dependent or addicted to opioids is they make up the largest group buying prescription medicines.
According to the National Institute on Drug Abuse (NIDA), while people age 65 and older are only 13 percent of the US population, they account for more than one-third of total outpatient spending on prescription drugs in the US.
The medication bought includes benzodiazepines, such as Xanax and Valium, that are used to treat anxiety and insomnia; and opioids, such as OxyContin, Percocet, Vicodin, and fentanyl to help older adults treat chronic pain and ailments. However, misuse and abuse of these drugs can and does result in addiction and overdose deaths.
Emergency departments in the US saw a 78 percent rise in the number of visits among older adults with misuse of prescription or illicit drugs between 2006 and 2012, according to a study presented at the Gerontological Society of America meeting in November 2015. The study’s author, Mary Carter, an associate professor at Towson University, said about 11 percent of that misuse involved opiate drugs, according to a US News & World Report article.
Opioid overdose deaths follow pain treatment
As the faces of addiction are changing, so are the places where “drug deals” take place. People in search of their next “fix” don’t have to head to a sketchy street corner or a dark back alley–they can just go to their doctor’s or dentist’s office instead. Some even resort to “doctor shopping.”
The “dealers” are physicians and other general practitioners who write prescriptions in response to their patients’ complaints about aches and pains. In 2014, it is estimated that US doctors wrote nearly 200 million prescriptions for opioid painkillers, while deaths linked to the drugs climbed to roughly 19,000—the highest number on record.
The CDC recently issued guidelines to physicians to urge physicians to seek other pain treatment methods and use more discretion when prescribing pain medication. In many cases, dependence and addiction start off as legitimate treatment of pain that somewhere takes a turn for the worse.
“We see the highest rates of overdose deaths in individuals who appear to be receiving legitimate prescriptions for chronic pain problems,” Dr. Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing and chief medical officer of the Phoenix House Foundation, told US News & World Report for its story on seniors and addiction.
According to Kolodny, older people in their 40s to 80s are developing addictions to pain medication while treating a chronic pain problem. “Some of them have very severe, intractable pain,” Kolodny said. “They are able to find doctors to prescribe them all the opioids they might want.”
’60s counterculture to blame?
Observers say baby boomers are bringing their drug and alcohol habits that formed during the carefree and experimental ‘60s and ‘70s into their later years and that drug use in this group is higher than that of teenagers.
“For example, a 2011 study by the Substance Abuse and Mental Health Services Administration (SAMHSA) found that among adults aged 50 to 59, the rate of current illicit drug use increased to 6.3 percent in 2011 from 2.7 percent in 2002. Aside from alcohol, the most commonly abused drugs were opiates, cocaine and marijuana,” says an article in The New York Times.
Some note these habits are costing boomers their lives.
The drugs most often involved in the overdose deaths among baby boomers are opioid followed by antianxiety drugs, cocaine, and the illegal opioid heroin, according to the article. Marijuana also is a drug of choice for older adults as well.
An article written by the Wall Street Journal article includes these interesting insights:
“Over the past decade, illicit drug use among people over 50 has increased at the same time that the rate for teens—the group that draws the most public concern when it comes to substance abuse—has declined, according to the federal government’s annual survey on drug use. A similar pattern exists for drug arrests: rates fell in nearly every younger age group in the country between 1997 and 2012, but not for those between the ages of 45 and 64.”
Baby boomers are also being admitted to hospitals in higher numbers for drug-related health problems.
The WSJ reports that experts consider two key factors responsible for the baby boomer drug trends: “a predilection for mind-altering substances and growing older in an era widespread opioid painkiller abuse.”
Addiction and recovery expert Haroutunian, said, “They [baby boomers] have been conditioned to turn to substances for relief.”
Could this be true of some baby boomers’ sexual habits as well? This generation’s willingness to take risks and try new things as they came of age in the ’60s and ’70s also led them to break with tradition and establish sex and sexuality on their own terms.
If they are reverting to drug use habits of past days, as some say, could this be why some older adults are engaging in sexual behavior that could lead to addiction to sex, something fellow baby boomer Ozzy Osbourne is now facing?
Stay tuned on next Tuesday, Sept. 27, for the final article in the series, “Sex, Drugs, and Ozzy: Intimacy in the Golden Years Still a Risky Affair,” in which we examine sex addiction and other sexual practices common among older adults.
Read more from this series:
Substance abuse among the aging and elderly often goes unnoticed or undiagnosed, especially in longtime drug and/or alcohol users. If you, or someone you know, have an older parent, spouse or other family member, friend or someone else you are concerned about who is an older person battling addiction, call (844) 318-0071 now to speak with one of our Palm Beach Institute specialists. They can help you find a treatment program tailored to your specific needs today. They are standing by around the clock, waiting for your call.