Substance Abuse Among Seniors

Learn the signs, symptoms, dangers, and treatment options available for seniors who suffer from substance use disorder.

Substance Abuse in Elderly

In its research, the National Institute of Health-funded study revealed that substance use disorder (SUD) increases susceptibility to Covid-19. The increased susceptibility to Covid-19 is a result of the compromised lungs and cardiovascular system in people with SUD.1

Older adults are not resistant to substance use disorder. Substance use in elderly persons is one of the nation’s fast-growing problems. This invisible pandemic has remained underestimated and underdiagnosed.2

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The Struggle of Senior Living

Underestimated

Not so much attention is paid to alcohol and drug dependence among the elderly. It’s believed that seniors know better than to use prescription drugs or alcohol illicitly. The use of prescription medication has moved beyond just taking a pill to relieve pains, anxiety, or sleep well at night. Many seniors take way more than they should and have developed use disorders as a result. Substance use in the elderly has become more prevalent over the last decade.

Underdiagnosed

While there is a reawakening in the need to better assess the possibilities of substance use in the elderly, it’s undoubtedly challenging to diagnose symptoms. Symptoms of substance use in older adults disguise as ailments associated with old age, such as depression, diabetes, and dementia. Hence, it’s tough to interpret except when closely observed. Drug abuse and substance use disorder occurs between the early-onset and late-onset groups in seniors.

Early-Onset Groups

The early onset groups are the baby boomers (1946-1954) who grew up in a different time and place. In their time, the use of drugs and alcohol wasn’t so much discouraged. This group grew up being accustomed to the use of drugs and alcohol.2

Late-Onset Groups

The late-onset groups are people who get accustomed to prescription drugs and alcohol as they age. Prolonged use of these substances makes their body dependent on prescription drugs. Substance use disorder is possible with both groups, but relapse is more common with the baby boomers as stopping substance use is more difficult.

substance abuse in elderly

Causes of Addiction in Elderly

substance abuse in elderly
After stressful life situations and changes happen, older citizens may turn to substance use to stay happy. The following are some of the triggers of substance use in the elderly.

Trouble Sleeping

Older people may find it more difficult to fall asleep and rest well naturally. It’s normal to take prescriptions to relax the body and sleep well. However, prolonged use of these drugs could cause the body to become dependent. If care is not taken, addiction will set in. They won’t be able to fall asleep without these pills.

Retirement

The loss of social, occupational, or recreational activities may lead to filling the void with drugs and alcohol. A sense of purpose goes along with employment that is missing after retirement. Also, family conflicts and financial concerns with no progressive alternative to solving issues could encourage substance use in older adults.

Loneliness

Loneliness can mess with the mind and create the need for substance use. Upon retirement, there is reduced social interaction and peer support. More alone time, absence of a partner, fewer visits, and interaction from close family members make the elderly feel lonely or isolated. These encourage the need to unintentionally turn to drug and alcohol use to fill the void.

Most of the time, the initial intention for illicit use of substances is as a distraction. This distraction becomes increasingly difficult to resist until drug and alcohol addiction creep in. The aftermath of drug addiction and alcoholism in elderly persons worsens loneliness. The after-effects of drug and alcohol addiction don’t do much to attract companionship. Instead, it makes family and friends widen the gulf between them and the senior with substance use disorder.

Death of Loved Ones

Loss of loved ones can aid substance use or relapse in older adults. Seniors are not as expressive when dealing with sadness. The pain is mainly handled internally. Very often, alcohol consumption may triple in a bid to suppress grief. Substance use in the elderly is more likely to happen after the demise of a loved one who was a caregiver. Occasional drinking may snowball into the frequent intake of alcohol. Some seniors will have a bottle with them most of the time after the demise.

Mental and Physical Decline

At one age, there is a general decline in seniors’ mental and physical health. The aging process often results in dementia, decreased mobility, and higher rates of disease. These are major risk factors that aid in using drugs and alcohol in senior citizens. These mental and physical limitations are usually a source of worry and self-pity. These tend to lead many seniors to drug and alcohol addiction.
Some of the common fallouts of alcoholism in elderly persons include a decline in cognitive function and dementia. Studies have shown that substances that contain benzodiazepines will raise the risks of cognitive disability in seniors when they enter the body at alarming rates or amounts. While it’s true that benzodiazepines help to remedy the loss of mobility and loss of loved ones, misuse of them will be detrimental to seniors’ health.

Highly Addictive Prescription Drugs

Addiction in senior citizens and substance use is most prevalent in the use of prescription drugs. In the absence of supervision, many seniors tend to take more than the required dosage or even less of their prescription drugs. Continued misuse will cause the body to develop tolerance and dependence on these drugs, leading to addiction.

A Further Look at Addiction in the Elderly

Prescription Medication Leading to Addiction

Health conditions associated with aging will require prescribed treatments. Older adults tend to use more drugs because of chronic health conditions and ailments. This leaves them with a high risk of being addicted to these medications. Study shows that 37.1% of men and 36.0% of women aged between 57 and 85 use five prescription medications or more at the same time.3 This heavy use of prescription medication opens the door to substance use disorders.

Mixing Substances

In addition, mixing prescriptions and dietary supplements with non-prescription drugs is common in senior citizens and may lead to substance use. Misuse of these prescription drugs may include:

Opioids are very common depressants prescribed to relieve physical and emotional pain in older adults. Opioid prescription in older adults is reportedly up to 80% in patients with advanced cancer, 77% in heart disease patients, and 40% in the outpatient of 65 and older.4 More than 17.5 million older adults are estimated to be affected. The odds of inappropriate opioid use are greater in baby boomers. While growing up, there was widespread use of prescription drugs with little or no stigma. Substance use disorder (SUD) is projected to substantially increase among this age group as they become older.

Dependence

When drug or alcohol use is discontinued after a while, the body goes through withdrawal. Withdrawal symptoms may range from mild symptoms to life-threatening symptoms. Continued use of substances over some time can cause dependence. Supervised gradual withdrawal is needed to avoid withdrawal discomforts and minimize symptoms.

Tolerance

After prolonged use of substances, the body may no longer respond to the drugs. The body then requires a higher dose of the drug to achieve the same effect as normal. This encourages substance use in the elderly as they will need to use the drug more to get the result they seek. Tolerance in senior citizens and substance use is encouraged to seek out alternative medications or include additional ones.

Addiction

Unlike tolerance and dependence, addiction results from repeated use of drugs or alcohol. Addiction comes with the inability to stop using these drugs or alcohol even when one wants to.
substance abuse in elderly

Dangers of Substance Use in Elderly Persons

Dangers of Substance Use in Elderly Persons
The impact of drug or alcohol use among the elderly is notably more severe when compared to younger people. The deteriorating effects of these substances result from the mental and physical decline of the body due to aging. Lower body mass means that minor amounts of illicit drugs and alcohol can produce pronounced effects.

Metabolization of Drugs

Older adults over 65 years have a decreased ability to metabolize drugs. This decrease in metabolic rate results from major changes like a decline in renal functionality, which can impact response to medicines in older people.5 As a result of aging, there is reduced liver blood flow, size, protein binding, and drug-metabolizing enzyme content.6

Sensitivity

Alongside the inability to metabolize drugs as fast as they would at a younger age is sensitivity. As older adults age, there is an increase in brain sensitivity. Their brains become more sensitive to drugs making them more vulnerable to the adverse consequences of this drug use.

Alcohol Poisoning

One of the results of alcohol use disorder is alcohol poisoning. Alcohol poisoning is a potentially fatal drinking pattern that results from consuming large amounts of alcohol in little time.7

Binge drinking may lead to alcohol poisoning, which increases heart rate, negatively affects breathing, and may lead to coma or death. Symptoms include vomiting, pale skin, and confusion. Victims should be taken to the hospital to be revived and receive alcohol treatment.

Challenges in Identifying Addiction in Elderly

Compared to young adults, substance use in the elderly shows up as medical psychiatry. In young adults, tolerance withdrawal, loss of control, reduced social and occupational performance are symptoms of substance use. But, this criteria for detecting substance use doesn’t often apply to older adults.

Problems Mimic Other Health Issues

The signs of addiction are not always there in senior citizens compared to younger adults. Care providers often confuse symptoms of substance use in older adults as natural ailments from aging.

Substance use may mimic symptoms of other medical or mental health issues most found in older adults. This makes it difficult to connect these ailments to drugs or alcohol addiction.

Functional Alcoholism

Functional alcoholism is a significant contributor to alcohol addiction in that the alcohol symptoms are primarily suppressed, and almost everyday life continues. The senior with functional alcoholism may be difficult to convince of the existence of a problem and even refuse alcohol treatment. Alcohol poisoning is usually a popular result of this situation.

Not Seeking Professional Help

The misconception surrounding senior citizens and substance use is that it’s untreatable. If discovered, caregivers or family may also decide it’s best to let them make the most of their lives through this addiction.

Hence, they see no need in seeking professional help. Also, senior citizens may see no need to seek professional help for fear of stigmatization and judgment. Reduced social interaction as they may be retired or home alone often makes it easy to hide substance use in older adults.

substance abuse in elderly

Symptoms Of Substance Use in Elderly Persons

Symptoms Of Substance Use in Elderly Persons
The loss of peer support for seniors is one factor that makes it difficult to detect symptoms of substance use in seniors. Close interaction with seniors by friends and family will help spot substance use symptoms in good time. These symptoms are physical and psychological.

Physical Symptoms

The most common physical signs of substance use to look out for include:

Psychological Symptoms

Psychological symptoms may include:

Drug Withdrawal Signs

Withdrawal is the body showing its dependence on the presence of a drug. The withdrawal symptoms are often the opposite of the wanted drug effect. Signs and symptoms of withdrawal largely depend on the type of drug and its level of use. Its level of use shows its dependence.
Withdrawal symptoms emerge once substance use stops or are abruptly withdrawn without the necessary withdrawal measures. These symptoms are the body’s way of calling out in protest for the substances it’s now dependent on. The development of withdrawal symptoms from the discontinued use of these substances can be both physical and psychological.

Alcohol use helps the body to stay relaxed and calm. Withdrawal symptoms will include super excitability and nervousness. Opioids are central nervous depressants that act via opioid receptors to relieve pain and release dopamine-producing euphoric emotions. Withdrawal symptoms will consist of stomach cramps, diarrhea, and agitation.

Stimulants like nicotine give energy and suppress appetites. If the drug is taken away, the body becomes tired, irritable, and has increased cravings.

Physical Signs of Drug Withdrawal

Physical symptoms are physiological conditions caused by chronic use of drugs from the abrupt or gradual withdrawal of these substances. Certain medications like stimulants, opioids, and alcohol indiscriminately can cause physical dependence. The higher the dose and duration of use, the more severe its withdrawal symptoms are. It could be as severe and life-threatening as seizures. Some common physical signs of drug withdrawal in elderly persons include:

Psychological Signs of Drug Withdrawal

Psychological dependence is a cognitive disorder. Substance use in the elderly affects them emotionally and psychologically. Some of these are:

Aging in Addiction

Substance Use Disorder Treatment for Seniors

Treatment methods may differ based on the patient’s overall risks after assessment. The patient placement follows the six criteria as established by the American Society of Addiction Medicine:

Detoxification

There is a need for detoxification of the system to gradually expel alcohol, opioids, and sedative-hypnotics (tranquilizers). Detoxification is the process of expelling drugs or alcohol an individual has consumed from the system. This detoxification process is to be handled by medical experts to avoid complications. Supervised reduction of dosage, education, and cooperation from the elderly and family will increase the rate of success. This process is safer if carried out as inpatient detoxification.

Detoxification comes with different experiences and withdrawal symptoms — the drug type and duration of drug use affect these experiences. The length of withdrawal symptoms also varies and can take days or months. Hence the need to safely manage withdrawal symptoms when drug or alcohol use stops.

Medications

This step is a stabilization process for the patient. The stabilization process involves both medical and psychological treatments. Doctors will prescribe treatment medications to reduce withdrawal symptoms and any other complications. Addiction treatment may include medications like acamprosate, naltrexone, buprenorphine in outpatient settings.

Therapies

This process is psychological therapy. Therapy should be age-specific and non-confrontational. An empathetic approach is necessary for rebuilding the patient’s self-esteem and social support groups. Therapy provides the platform for listening to seniors with substance use disorder, emphasizing with them, and guiding them through the path of recovery. The common types of therapy for substance use disorder in seniors are:

Outlook

While substance use disorder is widely unnoticed and even considered unlikely, many seniors have suffered its effects. Elders are less resistant to its dangers because of their not so strong immune systems. Due to other age-induced health challenges, substance use disorders have enjoyed a great deal of invisibility. For this reason, there is a need for improved awareness about its causes, symptoms, health risks, and treatment options. Family members, friends, and neighbors can certainly do more to help.