Drug and Substance Use


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 that you used when you were younger.  For example, you may have a lower tolerance for alcohol, because it breaks down more slowly in your body as you age. If you have been smoking for a long time, 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 poor metabolization of both your medication and alcohol, leading to higher blood levels of the drug even 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 or anti-psychotic medications
  • antihistamines
  • anti-depressants

For some older adults, increased use of alcohol, drugs, or a smoking habit is the continuation of a pattern that began earlier in life. But for other older people, increasing use of alcohol may be an attempt to cope with the stresses that come with normal aging. Unfortunately, alcohol and drug abuse tend to worsen any problems that come with getting 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
  • a diagnosis of substance use disorder 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 about how to take medications
  • over-prescription of drugs that affect mood (especially for older women)
  • not reporting unwanted medication side effects
  • disability
  • boredom

Mental Health Problems

If you are addicted to a medication or another substance, you may also be suffering from an underlying mental health disorder. 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. Quitting alcohol can slow down or even reverse many of these conditions. 

Memory impairment in older adults caused by drinking, such as dementia from chronic alcoholism, can improve if you stop drinking.


Last Updated July 2020

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