Geriatric Substance Abuse Treatment

Medically reviewed by

Brenda Munnerlyn, RN, BSN

March 18, 2019

Drug and alcohol abuse is at an all time high in the United States, and it affects our children, teens, adults and elderly. Senior citizens don’t make up a large portion of the population at “13 percent… yet account for more than one-third of total outpatient spending on prescription medications in the United States,” according to the National Institute on Drug Abuse (NIDA). Not everyone who takes prescription drugs or drinks alcohol will use them inappropriately, but there may be contributing factors with age that heighten the chances of substance abuse.

Understanding Substance Abuse

Substance abuse is defined as an overindulgence in, or dependence on, an addictive substance, especially drugs or alcohol. The main issue with overindulgence though, is that over time our body and brain’s chemistry become wired to work with those substances, and not work without them. We can easily become dependent on drugs or alcohol, because they make us feel good, but even with necessary medications, too much of a good thing is not good. Substance abuse is a precursor to substance use disorders (which is when substance use leads to further problems), and addiction that makes it difficult to stop using drugs alone.

Substance Abuse In Elderly—An Invisible Epidemic

So why are senior citizens subject to substance abuse? Here are just a couple of possible reasons:

• Deteriorating mental stability
• Likelihood of injury
• More need for medication
• Boredom just to name a few.

The U.S. National Library of Medicine (NLM) states “because of insufficient knowledge, limited research data, and hurried office visits, health care providers often overlook substance abuse and misuse among older adults.”

They go on to say that “a diagnosis may be difficult because symptoms of substance abuse in older individuals sometimes mimic symptoms of other medical and behavioral disorders common among this population, such as diabetes, dementia, and depression. Often drug trials of new medications do not include older subjects, so a clinician has no way of predicting or recognizing an adverse reaction or unexpected psychoactive effect.”

Commonly Abused Prescription Medications By Seniors

Not everyone intentionally abuses drugs. It’s no different with senior citizens, but when they do, prescription medications and alcohol are often the primary culprits. Other drugs such as cocaine, heroin, and methamphetamines can be a serious cause for concern as well. “A large percentage of older adults also use OTC medicines and dietary supplements, which (in addition to alcohol) could compound any adverse health consequences resulting from prescription drug abuse” (NIDA).

Though oftentimes people become addicted to medicine that was originally prescribed to treat an ailment.

Some of the most commonly abused medications by senior citizens include:

Opiates

• Morphine (Kadian, Avinza)
• Codeine (Tylenol #2, 3, 4)
• Oxycodone (OxyContin, Percodan, Percocet)
• Hydrocodone (Lortab, Lorcet, Vicodin)
• Propoxyphene (Darvon)
• Fentanyl (Duragesic)
• Hydromorphone (Dilaudid)

CNS depressants (Barbiturates and Benzodiazepines)

• Mephobarbital (Mebaral)
• Pentobarbital sodium (Nembutal)
• Butalbital (Fioricet)
• Benzodiazepines
• Diazepam (Valium)
• Chlordiazepoxide HCI (Librium)
• Alprazolam (Xanax)
• Triazolam (Halcion)
• Estazolam (ProSom)

The Stigma Of Addiction In Senior Citizens

It can be hard to determine whether or not someone has an addiction. This can be especially true in this case, and studies show that senior citizens are less likely to ask for help potentially due to shame or not wanting to burden someone else. There’s no shame in having an addiction, and the fact is, it’s just the way our minds work. Some indications of addiction in seniors are unexplainable injuries, sharing prescriptions, doctor shopping, and prescription fraud. Not all of these examples apply to everyone, but they’re more common than you may think

Signs of Substance Abuse In The Elderly

When determining if an elderly individual has a substance abuse problem, one of the biggest challenges is that a lot of the naturally occurring symptoms that come with age, can mirror those of drug addiction and abuse. A few of those symptoms are:

• Memory loss
• Disorientation
• Lack of balance
• Shaky hands
• Mood swings
• Depression
• Chronic boredom

Senior Citizen Alcohol And Drug Abuse Statistics

What about the long-term perspective? From this summary by NLM, “it will be increasingly difficult for older adults’ substance abuse to remain a hidden problem as the demographic bulge known as the Baby Boom approaches old age early in the next century. Census estimates predict that 1994s older adult population of 33 million will more than double to 80 million by 2050.”

“Most of that growth will occur between 2010 and 2030, when the number of adults over 65 will grow by an average of 2.8 percent annually. In 1990, 13 percent of Americans were over 65; by 2030, that bloc will represent 21 percent of the population.”

The problem is that our older generations are physically, cognitively, and emotionally more susceptible to addiction. In addition to overmedicating, they may just need someone to pay attention to the signs of drug abuse. There were 47.8 million people of senior age in 2015, and according to NLM, about 17 percent of them are personally affected by drugs or alcohol—that’s 8.1 million grandparents whose lives have been changed because of substance abuse.

Consequences Of Geriatric Substance Abuse

Physical Consequences Of Substance Abuse In Elderly

There are a lot of things that can go wrong with substance abuse, but with the older population, there can be some unique complications. “Drug misuse and abuse in the elderly is of special concern because it can cause cognitive and physical impairment— putting this population at greater risk for falls, motor vehicle accidents, and making them generally less able to care for their daily needs” (CARS).

Cognitive Factors Of Substance Abuse In Elderly

As we get older, some of our minds just start to go—thinking becomes less clear, memory and sharpness go with it. “Older patients are more likely to be prescribed long-term and multiple prescriptions, and some experience cognitive decline, which could lead to improper use of medications” (NIDA).

Emotional Consequences Of Substance Abuse In Elderly

At the senior age, a lot of people become lonely after losing friends and spouses. Boredom, loneliness, and depression are some of the largest contributors to drug abuse. Drugs can make a person feel numb, or even indifferent. “Older adults who ‘self-medicate’ with alcohol or prescription drugs are more likely to characterize themselves as lonely and to report lower life satisfaction. Older women with alcohol problems are more likely to have had a problem-drinking spouse, to have lost their spouses to death, to have experienced depression, and to have been injured in falls” (NLM).

Effective Drug And Alcohol Treatments Programs For Seniors

There are a lot of different treatments available for drug and alcohol addiction. One of the first things that must be addressed, especially in the senior population, is if an individual is suffering from a co-occurring disorder. A co-occurring disorder is when an individual struggling with substance abuse also has additional mental health issues.

A co-occurring disorder (dual diagnosis) can be treated with dialectical behavior therapy, which focuses on a person’s negative behaviors. Another highly effective treatment program is cognitive behavioral therapy—which focuses on relapse prevention, negative beliefs and attitudes.

In an addiction rehab center, patients go through a professionally monitored detoxification followed by an individual evaluation to find out what kind of treatment is best suited for them. It all starts with realizing that there’s a problem, followed by a willingness to ask for help. Some of the most common treatment modalities are:

• Substance Abuse Evaluation
• Dialectical Behavior Therapy
• Cognitive Behavior Therapy
• Contingency Management
• Mindfulness and Stress Management
• Peer and Family Support
• Group Therapy
• Recreational, Art and Adventure Therapy
• Medication-Assisted Therapy

Find A Drug And Alcohol Rehab Center For Senior Citizens Today

If one of your loved ones is struggling with substance abuse or addiction, contact us today to get them the help they need. Recovery is always possible and finding the right program is often key to long-term success.