Older Adults and Substance Abuse Awareness


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Alice Pomidor, MD, MPH, AGSF
Florida State University School of Medicine

Mary Palmer, PhD, RN, FAAN, AGSF
Helen W. and Thomas L. Umphlet Distinguished Professor in Aging
UNC School of Nursing

It’s been called the “invisible epidemic.” In recent years, for the first time, the number of older adults receiving treatment for substance abuse is outpacing that of younger adults.

There are many reasons why the number of older adults who are receiving treatment for substance abuse is on the rise. With aging come very real challenges that can make some older adults more likely to abuse alcohol or drugs.

Job loss, either through retirement or downsizing, caretaking for (or losing) a spouse, children moving away, illness, and financial worries are among the challenges older adults can face. What’s more, some older adults have had had lifelong problems with alcohol or drugs that can become more serious as they age.

What is Substance Abuse?

Substance abuse is an umbrella term that means misusing legal or illegal medications and drugs, as well as misusing alcohol and tobacco. Officially, substance abuse is the use of chemicals that lead to an increased risk of problems and an inability to control your use of the substance.

Addiction, dependence, or “getting hooked” on a drug or alcohol can have especially dangerous consequences for older adults. These substances can cause mental problems, kidney and liver disease, and can cause falls resulting in injuries. Even if you’ve never had a problem with alcohol or drugs, you can become dependent on them in your later years.

Because many older adults manage more than one chronic illness, they may take one or more medications that can interact harmfully. The drugs you take may also react badly with alcohol. The symptoms you may experience as a result may seem to you like typical signs of aging, such as confusion, forgetfulness, dizziness, or sleepiness. In fact, symptoms like these may be reactions due to substance abuse.

Problems of Dependency

With certain drugs, even the medicines prescribed by your healthcare provider, your body may need increasingly higher doses to get the same effect. Or, you might feel uncomfortable withdrawal symptoms when you try stopping certain medications. This is called drug “tolerance” and it means that your body’s chemistry has changed so that it depends on the drug.

How Common are Substance Abuse Problems for Older Adults?

  • 3 out of 5 older adults take painkillers regularly.
  • More than 1 in 5 older adults take drugs that affect their central nervous system.
  • About 11% of older adults take sedatives called benzodiazepines.
  • Up to 1 in 3 older adults develop new problems with alcohol.

Warning Signs

If you, or an older adult you care for, experience any of these signs, it may indicate a substance abuse problem, suggests the National Council on Alcoholism and Drug Dependence:

  • Solitary or secretive drinking
  • A ritual of drinking before, with, or after dinner
  • A loss of interest in hobbies or other pleasurable activities
  • Drinking in spite of warning labels on prescription drugs
  • Frequent use of tranquilizers
  • Slurred speech
  • Empty liquor, wine, or beer bottles
  • Smell of alcohol on breath
  • Changes in personal appearance or hygiene
  • Chronic health complaints
  • Hostility or depression
  • Memory loss or confusion

Getting Help

Discuss your substance abuse concerns with your healthcare provider. Substance abuse is not a sign of a weak character or moral fault. Your provider will not pass judgment and may be able to adjust your medications or refer you to a support group or other substance abuse program.


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