Senior substance abuse is one of the fastest growing health problems the country is facing at the moment. The number of adults 60 years and older at high risk from alcohol and prescription drug abuse is continuing to climb, yet the situation remains under-identified, underestimated, under-diagnosed and under-treated.
Alcohol and prescription drug misuse affects 17% of our senior population, yet we are only just beginning to talk about it in the open. Health care providers often overlook substance misuse among senior adults because they do not have enough information about it. It is difficult to diagnose because the symptoms of substance abuse in the elderly are often the same as the symptoms of other medical and behavioral disorders among this age group, namely dementia, diabetes, depression, etc.
Drug trials hardly ever include older subjects. Consequently, clinicians do not establish their side effects (adverse or otherwise), nor do they get the opportunity to find out about psychoactive effects on older people (if any).
At the heart of the problem are the senior individuals themselves. They are reluctant to seek professional help because they consider substance use and abuse a very personal (shameful) matter. They think if they ignore it, it doesn’t exist. Their family and relatives are also guilty of what is called “ageism”, or the dismissive attitude towards older people, giving them too much leeway with their lifestyle, their drinking habits or their “cocktail” of pills. Others would go so far as saying “give them what makes them happy, they won’t be here for much longer”. It is an unspoken yet pervasive assumption that treating substance abuse in older people is a waste of resources.
This attitude is appalling and callous, born out of ignorance or misinformation. The majority of our adult population is self-sufficient. Only 4.6% of adults over 65 are in nursing homes or cared for by home care providers. Contrary to what some would choose to think, giving in to older people’s excessive drinking or pill-popping doesn’t “make them happy”. They do it because they are either depressed after losing a spouse or because they are suffering from actual physical pain from injuries. Allowing older people to over-indulge takes a greater toll on their aging bodies.
A Growing Senior Population
In 1994, the senior population in the United States was at 33 million. Census estimates this number to reach 80 million by 2050, with most of the growth happening between 2010 and 2030. It is happening right now, growing at an average rate of 2.8% annually. Life expectancy in the US was at 68 years back in the 1950s. In 1991, it was 79 years for women and 72 years for men. This means that not only are we living longer, it also means that substance abusers are also living longer even with chronic, limiting conditions like diabetes, arthritis, osteoporosis and senile dementia. The problem with substance abuse among seniors cannot be ignored anymore in light of these staggering statistics.
Prescription Drugs of Abuse
More than any other age groups, senior patients are often prescribed benzodiazepines (Xanax, Valium). They are also getting more opioid painkillers. These prescription drugs are associated with age-related problems with drug metabolism, interaction with other prescriptions and with alcohol. Older adults experience longer daytime sedation, lack of muscle coordination and cognitive impairment. Drug-related delirium or dementia can be mistaken or misdiagnosed as Alzheimer’s disease.
Signs of Senior Substance Abuse
We may have a senior family member or know of someone taking care of an older adult. By paying attention to the number and kinds of medications they are taking, and watching out for certain behavior, we may be able to spot prescription drug misuse.
Getting/filling a prescription for the same medicine from 2 different doctors/pharmacies
Taking more pills than they used to, more than what is indicated on the label or taking pills at different times when they’re not supposed to and making excuses why they need it
Becoming more withdrawn or angry or displaying uncharacteristic behavior
Becoming too anxious to go anywhere without their meds and storing “extra” pills in their purse or clothing
Thinking or talking about their meds all the time
Becoming defensive or uncomfortable when asked about their meds
Hiding or sneaking medicine
What to Do
If you have reason to believe that a senior family member or friend may be misusing a prescription drug, you might want to discuss your concerns with the doctor who prescribed it. The doctor will be able to determine drug misuse and/or addiction and initiate treatment. This may begin with a simple drug test, followed by counseling and other meds or both. The important thing here is to get your loved one the help they need.