Addiction is an equal opportunity affliction, showing no preference for profession, race, or age. It can impact anyone, including the elderly. Numerous older adults grapple with the challenges of substance dependence and addiction every day. A significant number of senior citizens are battling alcoholism and drug abuse, necessitating professional intervention.
Globally, there is a rising trend of substance abuse among older adults. This issue can manifest as either early or late onset, with some individuals first engaging in substance use during their later years, often triggered by stressors such as health issues or the loss of a partner. The consequences of substance abuse in the elderly are severe, leading to various physical and mental health challenges, strain on social and familial relationships, legal complications, and even fatalities due to overdoses.
Substance abuse treatment in older adults is varied, including both non-pharmacological psychosocial approaches and pharmacological methods. Regrettably, the rate of prescribing approved medications for substance use disorders remains relatively low. Customizing treatment practices for seniors with substance use disorders requires careful consideration of their distinct physical, cognitive, and psychosocial needs.
The dedicated team at Northern Illinois Recovery Center in Crystal Lake, Illinois, recognizes the profound effects of addiction on people across all age groups. At our rehab for seniors, we’re focused on assisting older adults and elderly adults in overcoming substance abuse and addiction.
Current evidence indicates that the ‘Baby Boom’ generation, born between the mid-1940s and mid-1960s, exhibits higher rates of alcohol and psychoactive prescription drug abuse compared to earlier generations. This demographic tends to have more permissive views on substance use and has historically enjoyed greater access to and reliance on prescription medications. As this aging population continues to expand rapidly, recognizing addiction in older adults becomes increasingly complex, due to the ever-changing patterns of substance use.
According to the 2023 United States National Survey on Drug Use and Health (NSDUH):
- Over 4.6 million American adults aged 65 and older (8%) faced substance use disorders in the past year. Within this cohort, approximately 2.3 million (4.6%) were diagnosed with alcohol use disorders, while around 1.8 million (3.9%) had drug use disorders.
- Individuals aged 50 and above who misuse opioids or benzodiazepines exhibit significantly higher rates of suicidal ideation (25%) compared to their counterparts who do not misuse these substances (2%).
- There are 1.5 million older adults with a substance use disorder. Between 2015 to 2050, the proportion of the world’s population over 60 years will nearly double from 12% to 22%. By 2030, 1 in 6 people in the world will be 60 years or older. This current cohort of aging adults will continue to grow at a rapid rate.
The aging process is not linear, and several factors contribute to the decline of someone’s overall health. Aging results from years of molecular and cellular damage over time. It comes with physical and mental changes that can make an older individual more vulnerable and susceptible to addiction.
Addiction is a disease that doesn’t discriminate. Northern Illinois Recovery Center in Crystal Lake, IL, is equipped to provide support to a variety of demographics, with our treatment programs and behavior therapies specifically tailored to address the needs of seniors struggling with drug and alcohol addiction.
Common Substances Of Abuse in the Elderly Population
Alcohol use disorder (AUD) is prevalent among the general adult population in the United States, including seniors. Alcohol ranks as one of the most commonly abused substances. Older adults often face heightened adverse effects from excessive alcohol intake, primarily due to its impact as a depressant on the central nervous system.
Although drinking and alcohol problems reportedly occur less with younger people compared to older adults, alcohol misuse brings specific risks for seniors. The rising rates of both alcohol consumption and misuse among older Americans have significant implications, leading to increased morbidity and mortality rates. Despite this, the National Council on Aging (NCOA) reports that nearly 50% of individuals aged 65 and older still consumed alcohol within the past year.
Widowers over the age of 75 have the highest rate of alcoholism in the United States. Older adults are hospitalized as often for alcohol-related problems as much as heart attacks. Unhealthy drinking patterns can result in a greater likelihood of falls, hazardous interactions with medications, an elevated risk of cancer, and, in severe instances, liver disease.
Excessive alcohol use is a leading preventable cause of death in the United States. Approximately 178,000 fatalities annually are linked to excessive alcohol consumption, encompassing both chronic heavy drinking and binge drinking. This positions alcohol as a major contributor to preventable deaths, following tobacco and unhealthy dietary habits.
Current trends indicate that seniors are increasingly using marijuana and illicit substances compared to earlier generations. Individuals who experimented with drugs in their youth may be more inclined to use similar substances, especially marijuana, to alleviate age-related health issues such as chronic pain. The use of synthetic marijuana is not confined to younger individuals; it contains hazardous chemicals that are more potent than natural cannabis and poses a higher risk of psychiatric side effects.
Additionally, the misuse of heroin and cocaine is rising among the elderly, leading to serious medical and psychiatric issues, including cardiovascular complications and cognitive decline. Regular marijuana use at any age can increase the risk of chronic respiratory conditions such as bronchitis. Marijuana can interact with other medications that the older adult has been prescribed. Memory impairment and depression are risk factors for marijuana use in the elderly.
Prescription drug misuse (PDM) involves consuming medications without a legitimate prescription or contrary to a physician’s intent. The misuse of benzodiazepines and opioids among the elderly is a significant yet often overlooked public health concern. In contrast to the use of alcohol and cannabis, the rate of prescription drug use among older adults is significantly higher, at nearly 8% compared to 4% in the general adult population. Contributing factors include age-related emotional and physical changes, such as isolation, anxiety, chronic pain, and mobility issues.
Older adults are often prescribed medications due to chronic pain and other age-related health concerns. Among the elderly population, opioid use disorders (OUD) affect nearly one million individuals over 65 years old. While illicit drug use is rare for seniors, it still exists. It’s crucial to distinguish between the two main categories of opioids: those prescribed and illicit drugs. In this demographic, opioids are generally obtained through prescriptions intended for themselves or others. Prescribed opioids are utilized for their strong pain-relieving effects; however, their ability to stimulate the brain’s reward pathways raises the risk of developing dependence and addiction.
The consequences of prescription drug abuse can result in severe health risks, including heart attacks and strokes, especially when combined with other substances, leading to potentially fatal overdoses and can worsen existing health issues common in older adults, such as coronary artery disease, diabetes, and neurocognitive decline. Prescription medications commonly lead to lethal overdoses. When alcohol or other substances come into the mix, the harmful reactions can lead to devastating results.
What Causes Substance Abuse in Older Adults?
As we age, the ability to be as active as we once were becomes harder, leading to a more sedentary lifestyle and a decrease in activity. The significant impact of alcohol consumption on older adults is further exacerbated by these age-related changes.
There is also an increase in substance-related injuries. Recent projections have suggested that substance abuse in older adults can be attributed to the slowed metabolism of substances. The following risk factors are influential in causing dependency and addiction in older adults:
- Grief
- Financial loss
- Mental illness
- Social withdrawal
- Chronic pain or illness
- Lack of a support system
- An avoidance coping style
Substance use in the elderly is often used as a coping mechanism or way to self-medicate. Some elderly individuals have been using substances for years, with the long-term effects becoming present with age. Binge drinking can’t be stopped cold turkey. Recovering from alcoholism requires help from medical professionals at an addiction rehab center to effectively assist in the management of withdrawal symptoms. Self-detoxing is highly discouraged to avoid complications.
Signs and Symptoms of Addiction in Seniors
Addiction should be recognized as a behavioral health disorder. Dependence can form over regular use, which is ignited by tolerance to substances. It can become difficult to control cravings for substances after use has stopped. Withdrawal symptoms can prompt a person to lapse if they are not supported.
In standard healthcare environments, detecting substance use disorders among older patients can be particularly challenging, as clinicians may not realize that their geriatric patients are misusing alcohol or other substances, including prescribed medications. Differentiating between typical aging vs an addiction problem is often difficult due to overlapping symptoms, such as neglecting responsibilities, relationship difficulties, memory problems, alterations in sleep patterns, or noticeable declines in physical appearance. A useful guideline is that normal aging tends to be gradual and subtle, while abrupt or significant changes should raise concerns that necessitate further examination.
Identifying a substance abuse issue in elderly individuals can be challenging, as addiction often manifests in ways that resemble the typical physical and mental health issues associated with aging. If you suspect that a senior loved one may be struggling with substance dependence, there are several warning signs to observe, such as:
- Loss of enjoyment of hobbies and activities
- Isolation from family and friends
- Recurring desire to be left alone
- Taking more of their medication than is prescribed
- Changes in eating or sleeping patterns
- Anger, irritability, depression, or sadness
- Other emotional changes
- Consuming more alcohol than usual
- Lack of personal hygiene or self-care
- Abnormal bruises and chronic pain
- Obsession with medication
- Drug-related paraphernalia
- Memory loss
- Poor coordination or loss of balance
- Slurred speech
- Unexplained nausea or vomiting
- Fatigue
- Pupil constriction or dilation
- Bloodshot eyes
If you have an elderly relative exhibiting certain signs, they may have developed a substance dependence issue. Numerous older adults face challenges related to alcohol use disorder and drug misuse. Fortunately, there are various resources and treatment programs available to assist those ensnared by addiction. These indicators may suggest that a senior in your life is struggling with an addiction. If this is indeed the case, it is advisable to take prompt action.
You may consider discussing the need for help with your family member or friend. However, if the individual is resistant, it may be necessary to stage an intervention. Collaborating with loved ones and professionals who can guide you through the intervention process can help bring the addiction issue to your loved one’s awareness, enabling you to secure the assistance they require.
Substance Abuse Treatment
Treatment options for elderly patients with addiction may involve brief interventions, cognitive behavioral therapy, contingency management, motivational enhancement therapy, family and community-based support, mutual aid, 12-step programs, and residential treatment facilities. It is essential for programs to address the unique needs of elderly individuals, including their medical and social service requirements. Challenges to accessing treatment for older adults include a lack of transportation, physical limitations, hesitance to venture out in the evening, and increased reliance on their spouses.
Relapse is a common element in addiction recovery. Research shows that 40-60% of recovering individuals will experience a relapse. This can be discouraging for those seeking substance abuse treatment. It’s necessary to understand that sobriety is a lifelong journey. With the guidance of a strong support system and willingness to learn new coping skills, you’ll be prepped for how to stay on a healthy and sober path.
NIRC’s Drug and Alcohol Rehab for Seniors
- Thorough medical care
- Medication management
- Emotional support and counseling
- Privacy and support
- Nutritional guidance
- Sober support
- Long-term treatment plans
We approach substance abuse in the elderly with care. They may deny their substance abuse disorder. The older adult could have a history of substance use and not recognize the depths of their issues. Research has shown that older patients have better results when they remain in addiction treatment for longer periods. More research is required to determine the best model of care to treat substance abuse in the elderly.
Generally, drug and alcohol detox is the first step in the addiction treatment or rehab process. After an initial evaluation, a patient can expect to spend 7-10 days in drug and alcohol detox. Detoxification is the process of ridding the body of toxic substances to fully embrace the treatment.
Physical withdrawal symptoms can be uncomfortable, even lethal in the most severe cases. Detoxification can be medically supervised, especially for substance abuse in the elderly.
Inpatient treatment programs offer the benefit of 24/7 quality care for admitted patients. These programs are vital for those with moderate to severe cases of addiction. Inpatient rehabilitation can also be beneficial for those with a history of previous attempts at sobriety. Therapy services, such as individual therapy and group counseling, are used to treat the underlying causes of substance abuse in the elderly.
Residential rehab can last up to 30, 60, and 90+ days. The cost of an inpatient treatment program will be determined by a variety of factors. Inpatient care entails a mission to create a safe, trigger-free environment for patients.
Outpatient addiction treatment programs are a flexible and cost-effective approach to addiction recovery. If you can’t commit to an inpatient treatment program, outpatient treatment could be for you. An outpatient treatment program allows people with less severe circumstances to have the flexibility of living at home, going to school, work, and other activities while still attending treatment sessions. With individual and group therapy offered, a patient can use psychotherapy as a gateway to relieve their symptoms. Other amenities, such as holistic, art, and music therapy, could be offered in outpatient treatment programs.
The average length of an outpatient program is 30 days. The reduced medical supervision could be useful for those with mild to moderate cases of addiction. Intensive outpatient programs (IOPs) are more structured yet provide flexibility. Education about addiction and employment training can guide the patient towards healthier coping skills to practice in the real world.
Dual diagnosis treatment can be effective in treating substance abuse in the elderly. Co-occurring disorders are classified as a combination of a substance use disorder and a mental health disorder. Considering that substance use disorders produce mental health symptoms and vice versa, treating both is crucial for the livelihood of the patient.
An alarming portion of recovering individuals have a co-occurring disorder. Dual diagnosis treatment is a fairly recent practice in the healthcare industry. It was previously understood to treat each disorder separately. The change in outlook towards treating both has been a key benefit in maintaining sobriety.
Medication-assisted treatment can be vital in maintaining sobriety in older adults. Older adults are often prescribed medication to treat health issues such as chronic pain or mental health symptoms. Medication-assisted treatment is carried out with trained medical staff to alleviate your symptoms. After an evaluation of your medical history, your medications will be a supportive addition to the other medical services you receive.
Case management is a nuanced approach to receiving assistance for substance abuse in the elderly. This is conducted through a counselor or social worker who provides detailed outlines for recovery, typically by providing resources. A case manager will seek to understand your case and initiate recovery goals for you.
S.M.A.R.T. Goals are an efficient way to project your addiction treatment. Case management has been used to treat mental health cases, but it works well with other behavioral health disorders. Case management can be a discreet option.
Insurance Verification
Paying for Substance Abuse Treatment
Under the Affordable Care Act of 2010, addiction treatment was qualified under expansions in Medicare and Medicaid. These are federal and state-funded programs to provide coverage to low-income, disabled, and elderly individuals (aged 65 or over).
The different parts of Medicare help cover specific services:
- Medicare Part A (Hospital Insurance) Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
- Medicare Part B (Medical Insurance) Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
- Medicare Part D (prescription drug coverage) helps cover the cost of prescription drugs (including many recommended shots or vaccines).
It’s best to discuss with your healthcare provider to determine what’s best for you. Certain facilities have guidelines for what forms of payment or insurance are covered.
