Substance Abuse and Addiction in Older Adults

Lack of social support, which often increases with age, can increase the risk for and worsen the course of, SUD. Housing, the built environment and other neighborhood characteristics also can be powerful determinants of substance use and access to treatment. Developing and implementing evidence-based approaches to social determinants of health will be key to improving substance abuse in older adults the health of older adults and decreasing the risk of SUDs. Hand-in-hand with prescription drug misuse is the prevalence of chronic pain in aging populations. Chronic pain is a common issue among senior citizens and can seriously impact their overall quality of life. The danger of negative drug interactions in older adults can occur with or without alcohol.

There is also evidence that many people continue to use both delivery systems to inhale nicotine, which is a highly addictive drug. After what seem to be great days, he will comment, “It wasn’t fun.” Few studies examine whether there are long-term effects. While researchers see evidence that points to a link between the drug and psychiatric side effects, studies vary significantly on how frequently they appear — or, in some cases, whether they appear at all. Reports include a wide range of psychiatric effects, making it challenging to pinpoint the cause. Federal regulators in 1998 initially dismissed evidence that emerged during the approval process about the drug’s potential to affect the brain and did not revise their assessment until two decades later.


What Causes Substance Abuse in the Elderly?

Consistent with this study, NSDUH data indicate that among adults ages 65 and older with SUD, in 2018, 24 percent received treatment for drug use disorders, and 16.8 percent received treatment for alcohol use disorders (Center for Behavioral Health Statistics and Quality, 2019). The NSDUH does not publish disaggregated treatment data on individuals ages 65 and older. However, the Treatment Episode Data Set (TEDS), which collects data on publicly funded substance use treatment admissions, found that individuals ages 65 to 69 represented only 1.18 percent of the total admissions.

Mental health illnesses or challenges also often become bigger issues as we age, which could be exacerbated by inappropriate drug use. For example, the accidental misuse of prescription drugs could worsen mental health issues. A 2019 study showed 25% of patients over 50 who misuse prescription opioids or benzodiazepines (benzos) experience suicidal ideation, compared to 2% who don’t use them. Older adults who drink and regularly take AI medications may experience severe negative reactions (e.g., falls, gastrointestinal bleeding, low blood pressure, drowsiness, heart problems, liver damage).59 Drinking can also make these medications less effective in treating health conditions. Healthcare and behavioral health service providers should discuss the risks of combining alcohol and AI prescription medications with older clients, especially those with a history of alcohol use.

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Misuse of illicit and prescription drugs among people aged 50 and older is a serious health issue accompanied by a number of adverse consequences (Substance Abuse and Mental Health Services Administration [SAMHSA], 2014). Studies predict that as the baby-boom generation ages, rates of alcohol and drug abuse will continue to increase through the year 2020 (Simoni-Wastila & Yang, 2006). This Research Update summarizes the current state of knowledge regarding hazardous drug use among older adults and discusses the implications of both hazardous use and dependence. When assessing or speaking to older adults about substance use, some general considerations should apply. There is a definite need for enhanced awareness by health care providers around the growing problem of substance use in the older adult population. Population predictions indicate that by 2036, approximately 25% of the Canadian population will be over the age of 65 (Statistics Canada, 2018).

Older adults may also forget about certain drug interactions, which may cause them to mix substances that should not be combined. Many pathways lead to recovery, and many treatment options work for older adults (Exhibit 1.10). 11 percent of older adults with any mental illness in the past year also had an SUD. 37 percent with a past-year SUD also had any mental illness; 13 percent, an SMI.

Treating Substance Use Disorder in Older Adults: Updated 2020 [Internet].

Naltrexone is an opioid blocker and cannot be used in clients who require prescription opioids for pain relief. Giving naltrexone to a client who takes opioid medication for pain may cause significant opioid withdrawal symptoms. The following two sections will be of greater interest to healthcare providers.

Different years of NSDUH, TEDS, and DAWN data were used in this analysis because they are the latest years of data available. All NSDUH estimates in this report are annual averages based on combined 2007 to 2014 NSDUH data. Combining multiple years of NSDUH data allows substance use among older adults to be examined in greater detail by improving the precision of estimates for making statistical comparisons. TEDS data provide information on admissions to substance abuse treatment in 2012, and DAWN data provide information on drug-related ED visits in 2011. While you might be scared regarding the financial implications of the treatment program, consider if Medicare can cover your addiction treatment. Medicare might provide coverage for elderly patients who misuse drugs in long-term care and assisted living facilities, provided your doctor follows the proper steps.

It’s essential to understand why seniors are increasingly suffering from addiction so we can better prevent it in older adults. Some medical professionals are unable to find immediate signs of addiction and pass off what is really substance abuse alcoholism in the elderly as symptoms of just getting older, not giving much more attention to the issue. Most Americans think alcohol and drug problems are issues that mainly affect adolescents or younger adults.

what are reasons for substance abuse in older adults

Thus, the first strategy for promoting ethical nursing practice when working with older adults with problematic substance use issues is educating nurses and other health care providers about using harm reduction principles; it is noted that these principles can be applied to any age group. Although this was not the chief cause of drug-related ED visits for this age group, use of illicit drugs, use of drugs combined with alcohol, and nonmedical use of pharmaceuticals resulted in nearly 300 ED visits each day. The demand for services to address substance misuse in older adults is increasing.

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Sex can be a risk factor for substance abuse, especially alcohol abuse, in older adults. Studies have shown that older women are more prone to the harmful effects of alcohol than older men due to their lower body mass and certain biological factors. Additionally, women may drink less often than men, but the same amount of alcohol will, on average, affect a woman more severely than a man. This is why it’s vital for older women – and all people – to enjoy alcoholic beverages and other substances responsibly and mindfully. A family history of substance abuse or addiction can also be a risk factor for seniors developing addiction issues.

what are reasons for substance abuse in older adults

The survey also showed that 903,000 adults ages 60 to 64 and 1.04 million adults ages 65 and older met Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for alcohol dependence or abuse in the past year. These numbers were similar among slightly younger groups of older adults, with 939,000 adults ages 50 to 54 and 1.02 million adults ages 55 to 59 meeting DSM-IV criteria for alcohol dependence or abuse in the past year. When reading this TIP, remember that some misuse is accidental or inadvertent. For example, individuals who are unaware of a medication’s potential to cause dependence or other harms may consume more than prescribed. Other individuals may have difficulty in monitoring when they have taken their medication and take more than the recommended dose.


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