Aging & Health A to Z

Drug and Substance Abuse

Causes & Symptoms

As you get older, your body changes and you may find that you are less able to handle the same amount of medications or alcohol.  For example, you may have a lower tolerance for alcohol, because it is broken down more slowly in your body as you age. If you have been smoking all your life, health problems related to smoking are likely to begin to appear. 

Older people are also more likely to suffer from at least one chronic illness—and maybe more—as the years go by. Because of this, they tend to take more prescription drugs and over-the-counter remedies compared to younger people.  These medicines often do not mix well, or they may alter the amount of each drug in your body—even leading to overdoses when you are actually taking exactly what was prescribed. 

When you drink alcohol with some medications, the alcohol can make the effect of the medication dangerously strong. For example, taking alcohol with pills for sleeping, pain, anxiety or depression can produce harmful effects. In particular, you should avoid alcohol if you take:

• benzodiazepines (sedatives)
• sleeping pills
• pain medications
• anti-seizure and anti-psychotic medications
• antihistamines. 

For some older adults, abuse of alcohol, drugs, or a smoking habit is the continuation of a pattern that began earlier in life. But for other older people, abusing alcohol may be an attempt to cope with the stresses that come with normal aging. Unfortunately, alcohol and drug abuse tend to worsen the any problems we must confront as we get older. 

Risk Factors

Older people have extra stresses and changes in how their bodies function that increase the likelihood for alcohol or substance abuse. The following risk factors increase the chance for developing a problem with alcohol or substance abuse:

• family member with an alcohol problem (family history)
• male gender
• living alone
• single status (separated or divorced)
• mental health issues, including depression or other chronic mental health problems
• substance abuse in earlier life
• chronic pain
• sleep problems
• life stresses (financial difficulties, retirement, loss of a spouse or family member, moving to a new home, new illness)
• being in the hospital
• living in a long-term care facility
• long-term tobacco  habit
• misunderstanding by older people about how to take their medications
• over-prescription of mood drugs (especially for older women)
• not reporting unwanted medication side effects
• boredom.

Mental Health Problems

If you are addicted to a medication or other substance, your likelihood of having some type of mental illness is higher.  In addition, the illness may be worse and harder to treat. Older adults who abuse alcohol are nearly three times more likely to be diagnosed with a mental illness. The risk of dementia, suicide, depression, anxiety, and sleep problems is much greater in older people who are dependent on alcohol. However, quitting alcohol can slow down or even reverse many of these conditions. 

Symptoms and Warning Signs of Alcohol or Substance Abuse

Your healthcare professional may not realize that you are having problems with alcohol or substance abuse unless you or a close friend or family member reports that there is a problem. Your substance abuse may also be covered up by symptoms from another condition such as depression, memory problems, or physical disability. Some healthcare professionals may not consider substance abuse in an older person.  He or she may mistake the symptoms for normal signs of aging, or for Alzheimer’s disease or other dementia. 

The first signs of misuse of a medication or of alcohol in an older person may include:

• increased confusion or mental impairment
• mood changes (e.g., agitation, depression, irritability)
• sleep problems and daytime sleepiness
• dizziness
• changes in blood pressure
• anemia
• fatigue or weakness
• altered liver function and other abnormal blood results
• a fall. 

Long-term alcohol abuse can cause severe nerve damage, confusion, clumsiness, muscle problems, dementia, and coma. Other mental disorders that commonly appear along with alcohol abuse are depression, anxiety, and sleep problems. 

If you have been smoking for many years, lung troubles may become more apparent as you get older. You may have more infections or take longer to recover from them and you may find yourself short of breath or wheezing more often. 

Withdrawal Symptoms

An addiction to alcohol or other substances can put you at risk of severe, even life-threatening withdrawal symptoms if you try to stop using these substances suddenly.  Depending on the substance, withdrawal symptoms may include: shaking, sweating, feeling hot or cold, delirium, convulsions, or sudden heart problems. For this reason, you must inform your healthcare professional so that he or she can help you withdraw from your addiction safely and help you create a plan to avoid the addiction in the future.

Updated: March 2012
Posted: March 2012