Substance Abuse & Seniors: How Addiction Impacts Older Adults Differently

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Addiction in people over the age of 60 is skyrocketing. Even before the COVID-19 pandemic hit in 2020, a growing number of older Americans were misusing alcohol and prescription drugs. Add social isolation to the mix, and fears about contracting a deadly virus, and substance use among seniors is at an all-time high.

Also known as substance use disorder, addiction is a serious medical condition that requires professional care to treat. It can be caused by alcohol, opioids, or other drugs. In older adults, the signs of addiction can be harder to spot.

"Substance use disorder among senior citizens is often overlooked,” says Elizabeth Bulat, M.D., an addiction medicine specialist at Henry Ford Maplegrove Center. “Additionally, they may have medical or behavioral conditions such as depression or dementia that can mask the signs of addiction."

Substance Abuse After 60

According to the National Institute on Alcohol and Drug Abuse (NIAAA), alcohol and prescription drug abuse affects up to 17% of adults over the age of 60. Many of these people are using potentially harmful substances to manage chronic psychiatric or health conditions.

In general, substance use among seniors falls into one of two categories, according to Dr. Bulat:

  • The “hardy survivor,” who has been abusing substances (heavily drinking or using other drugs) for many years and has now reached age 65.
  • The "late-onset" user, who forms addictions later in life or after retirement.

Late-onset alcohol or drug abuse often begins with medications doctors prescribed to manage a specific condition. In fact, one of the first-line treatments for pain, anxiety and insomnia is a class of drugs called benzodiazepines, such as Valium or Xanax. "Benzos" are among the most dangerous prescription medications because they're highly addictive.

To make matters more complicated, many older adults take multiple medications to treat different conditions. They also may have difficulty keeping track of — and following — dosing instructions.

"That type of polypharmacy (or taking many medications at the same time) not only creates the potential for addiction, it's also dangerous," Dr. Bulat says. "As we get older, our bodies are not as efficient at metabolizing drugs and the risk of overdose is higher. Senior citizens are already at risk of falls and memory impairment and certain medications can lead to foggy thinking and spatial awareness difficulties."

Why Are Seniors Vulnerable To Addiction?

People often think of addiction as a disease that strikes younger people, but it can happen to anyone at any time during their life. During our senior years, a number of factors converge that increase the risk of substance abuse issues.

"The aging process is complicated and many people struggle with health-related concerns that take an emotional and physical toll," Dr. Bulat says. "Seniors may be retired and feeling isolated. They may also be struggling with the loss of a spouse or loved one."

Add financial concerns to the mix, and the threat of relocating to an assisted living facility or nursing home, and it makes sense that the golden years are often fraught with stress and anxiety.

How To Spot Addiction In Seniors

Health problems, both mental and physical, tend to increase with age. The older we get, the more likely we are to experience health-related concerns such as cognitive impairment, heart disease, cancer, depression and diabetes.

Unfortunately, since people expect seniors to struggle with memory and lack of energy or focus, substance use problems can be tough to spot. So how do you know if a family member or loved one has an addiction problem? Dr. Bulat suggests watching for these warning signs:

  • Changes in sleeping or eating habits
  • Mood changes and irritability
  • Erratic behavior
  • Poor hygiene
  • Unexplained bruises

No matter when the addiction began, there are treatment options available to help seniors overcome addiction. Of course, the first step is recognizing there's a problem.

Then, talk to your primary care provider, suggests Dr. Bulat. There are a number of assessments doctors can do in the office to determine whether someone is suffering from an addiction, or whether their symptoms are just a normal byproduct of aging.

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To find a doctor or addiction medicine specialist at Henry Ford, visit henryford.com or call 1-800-436-7936.

Dr. Elizabeth Bulat is Service Chief of Addiction Medicine at Henry Ford’s Maplegrove Center in West Bloomfield.

Categories: FeelWell