Drug and Alcohol Use Over 60: A Growing Concern

Substance use disorders are often seen as a problem primarily affecting younger people. But they are increasingly prevalent among the elderly.

This trend is concerning because substance use in older adults is often overlooked, despite the fact that its effects can be particularly harmful due to changes in metabolism, overall health, and life circumstances.

As baby boomers continue to age, a growing number of older individuals are struggling with substance use disorders involving alcohol, marijuana, opioids, cocaine and benzodiazepines.

Understanding the causes, effects and challenges associated with these disorders is crucial for providing effective treatment and support.

Why is substance use a growing problem?

Several factors contribute to the rise in substance use disorders among older adults.

The “baby boomer” generation, born between 1946 and 1964, is living longer than previous generations, and many members of this group have used drugs or alcohol earlier in life. As they age, their familiarity with these substances may lead them to continued use, which may develop into substance use disorders.

Additionally, older adults face significant life changes that can trigger or worsen substance use.

Many are retiring and may feel a loss of purpose or direction, which can lead to increased feelings of loneliness, depression and boredom. Chronic illnesses, aches and pains can become more prevalent with age, and some older adults may self-medicate with alcohol or drugs.

Others may turn to substances as a way to cope with grief following the loss of a spouse, friends, or family members.

Types of substances commonly used

Aging adults are vulnerable to several types of substance use, including both legal and illegal drugs.
Common substances that older adults use include:

1. Alcohol:
   Alcohol remains one of the most frequently used substances among older adults. Social drinking can gradually develop into a habit, and many seniors do not realize how alcohol can exacerbate health problems or interact negatively with prescribed medications.

2. Marijuana:
   With the legalization of marijuana in many states, older adults may view it as a safer option for managing pain, anxiety or sleep issues. However, marijuana use can have negative effects on the aging body, including cognitive impairment and increased anxiety.

3. Opioids:
   Prescription opioids like oxycodone or morphine are commonly prescribed to manage pain from arthritis, surgery or chronic illness. Unfortunately, aging adults may develop dependency on these medications, leading to misuse and addiction.

4. Cocaine:
   Though less common, cocaine use among some older individuals is still a concern. This stimulant can raise blood pressure and strain the cardiovascular system, increasing the risk of heart attacks and strokes.

5. Benzodiazepines:
   These medications, such as Valium and Xanax, are often prescribed to treat anxiety and insomnia. Older adults are at higher risk of becoming dependent on benzodiazepines, and prolonged use can lead to issues such as memory loss and increased risk of falls.

The interaction of substance use and prescribed medications

One of the greatest risks associated with substance use as we age is the combination of recreational or illicit drugs with prescribed medications.

Many older adults take multiple medications to manage chronic conditions like hypertension, diabetes and arthritis. When alcohol or other substances are added to the mix, side effects can intensify and lead to serious health consequences.

For example:

• Alcohol can interfere with blood pressure medications, leading to dangerously high or low blood pressure.

• Similarly, combining benzodiazepines with opioids can depress the central nervous system, increasing the risk of overdose.

Increased health risks

As the body ages, metabolism slows down and organs such as the liver and kidneys become less efficient at processing substances. This means that drugs and alcohol stay in the system longer and have a stronger impact on the body.

Older adults who consume the same amount of alcohol or drugs as they did when younger may experience more severe side effects, including confusion, dizziness and impaired motor skills.

Additionally, long-term substance use can exacerbate chronic illnesses, increase the risk of falls and fractures, and negatively impact mental health.

Why are substance use disorders often unrecognized?

A major challenge in addressing substance use disorders among older adults is that these issues are often underdiagnosed.

There are several reasons for this:

1. Ageism and stereotype:
   Many people assume that substance use disorders primarily affect younger individuals, so they may not consider the possibility that an older person is struggling with addiction.

2. Similar symptoms:
   The symptoms of substance use disorder can mimic other conditions common in older adults, such as dementia, depression, confusion and memory loss. This can delay recognition and appropriate treatment.

3. Reluctance to seek help:
   Older adults may feel ashamed to seek help for substance use issues due to feelings of stigma, guilt or denial. They may fear judgment from others or believe that it is too late to change.

Treatment barriers

While substance use disorders can be treated, there are several barriers to treatment among older adults:

• Access to age-appropriate treatment:
  Many addiction treatment programs are designed for younger people and may not address the specific needs and challenges faced by older adults.

• Physical health constraints:
  Treatment options such as intensive exercise programs or group therapy sessions may not be feasible for elderly individuals, especially those with limited mobility or other physical health issues.

• Social isolation:
  Older people who are socially isolated may have fewer family members or friends to recognize the problem and encourage them to seek help.

• Financial limitations:
  Many older adults are on fixed incomes and may struggle to afford the cost of treatment. In some cases, Medicare or insurance may not fully cover expenses associated with addiction treatment.

Recognizing and treating substance use disorders

Despite these challenges, it’s essential to remember that substance use disorders among older people are treatable.

Early recognition is key. Family members, caregivers and healthcare providers should remain vigilant for signs such as:

• Mood swings or changes in behavior

• Withdrawal from social activities

• Unexplained injuries or frequent falls

• Fluctuations in weight or appetite

Individualized approaches for older adults should consider their unique needs. For instance, therapies may focus on managing chronic pain in safer ways — through physical therapy, mindfulness practices, or non-addictive medications.

Counseling and support groups specifically for older adults can also provide emotional support and help individuals feel less isolated and alone in their struggles.

Conclusion

Substance use disorders among people over 60 are a growing issue that requires attention and compassion.

The aging baby boomer generation, combined with complex life circumstances and health issues, has led to an increase in substance use among older adults. Recognizing and addressing these disorders can help individuals lead healthier, longer, and more fulfilling lives.

While there are challenges in treating substance use disorders in this population, it’s never too late to seek help. With the right support and understanding, older adults can overcome addiction and truly “get a new lease on life.”