Substance Abuse In the Elderly

December 23, 2014

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Substance Abuse Among The Elderly

Aging gracefully can be difficult on many fronts. It begins with unidentifiable aches and pains that literally appear overnight and progress to difficulty in accomplishing tasks that were previously performed without a second thought. Chronic illnesses pop up, such as elevated blood pressure, arthritis, and even Type II Diabetes. What are frequently overlooked are alcohol and substance abuse among the elderly. This problem is frequently overlooked by family practitioners because they are unaware of the symptoms of the problem.

Substance abuse among the elderly is one of the fastest growing health problems in the United States. People are living longer and are abusing drugs and alcohol in their later years. Thirty-five million people in this country are 65 years or older. Substance abuse affects 17 per cent of this number, and the number is expected to double by 2020. One reason there is an increase in alcohol and drug abuse in the elderly is because they are the baby boomers, those born from 1946 to 1964. These individuals have been more liberal in using alcohol and even illegal drugs during their lifetime than previous generations. For this reason, they are more inclined to accept the use of prescription drugs to cure things, which has resulted in more problems with abuse. While being more accepting of over-the-counter and prescription drugs, they have continued their intake of alcohol, and in some cases, illegal drugs.

Symptoms of Substance Abuse Among The Elderly

Studies show that as people age, they become more sensitive to alcohol, and their tolerance to it decreases. In other words, the number of drinks that hardly affected someone at a younger age will now make the person drunk. Alcohol is also metabolized more slowly in the aging body, so blood alcohol levels remain high for a longer period of time. This may result in an increased incidence of falls. Older adults have more chronic illnesses, which predisposes them to bad reactions to alcohol. They also take more prescriptions and over-the-counter medications, which, when mixed with each other or alcohol, result in a negative reaction.

Because this age group frequently suffers from pain, they are usually prescribed pain medications. Over time, they develop what is termed dependence. This means if the drug is withdrawn abruptly, they experience uncomfortable symptoms. This is to be distinguished from addiction in which the individual craves increasing doses of the medication and leads to substance abuse and  illegal activity in order to obtain the medication. What family members may believe is the normal aging process or dementia may actually be the result of bad drug combinations or drug and alcohol combinations.

Some of these effects include:

  • Disorientation
  • Memory loss
  • Delirium
  • Confusion
  • Poor coordination, falls
  • Tremors
  • Sleepiness
  • Depression
  • Mood swings
  • Difficulty making decisions

Women are more likely to start drinking heavily later in life than men. This may be due to the loss of a loved one, retirement, isolation, or illness. Yet, there is a larger number of men than women who have a drinking problem.


As stated above, healthcare providers frequently do not recognize drug or substance abuse among the elderly. It may be due to the fact that they don’t know what to look for, or they don’t believe the older patient can be successfully treated. Research shows this belief to be in error, for the elderly actually respond to treatment better than their younger counterparts. Once a provider recognizes the problem, he can counsel the elderly patient concerning the importance of taking medications at the proper time and caution them about taking certain medications together.

It is important for the patient to be educated concerning the danger of combining alcohol with sleep aids, tranquilizers, pain medications, antidepressants, and anti-anxiety medications. Examples of these medications include diazepam, Ambien, hydrocodone, oxycodone, or morphine. Even if these medications are taken in the morning, and an alcoholic beverage is not consumed until evening, there may be an addictive effect. An individual who has developed a dependence on alcohol or a medication should be encouraged to seek professional help. It is usually advisable for the patient to be admitted as an inpatient to a facility that specializes in drug and alcohol dependence.

Some alcoholics and drug addicts have developed personality traits that are secretive, manipulative, angry, and self-centered. An inpatient facility provides the advantage of a controlled environment where certain behaviors are expected. The patient is usually expected to be responsible for completing simple tasks like making his bed and keeping her room tidy. Patients must also agree to attend lectures and group sessions and must be willing to talk to other patients during these group sessions. The atmosphere of these facilities is one of kindness, where the patient is treated with dignity. Gone are the days of shaming the individual. This is because of a change in the manner in which alcoholism and drug dependence is viewed.

Most facilities adopt principles similar to the following:

  • Alcoholism is a primary condition, not a symptom of some other disorder.
  • Alcoholism is an actual disease. This is what has led to the cessation of shaming or chiding.
  • Alcoholism affects the individual spiritually, mentally, and physically. Therefore, treatment must have a three pronged approach.

Substance abuse among the elderly is a real and exploding problem. It is also a complicated problem, because this segment of the population takes many needed medications that they may have become dependent on. Drug and alcohol misuse and abuse may lead to other problems, such as the inability to think clearly and an increased number of falls. However, there is a bright light at the end of this dark tunnel, for treatment is most likely to be successful.

Don’t delay another second
when help is so close.

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