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Addiction

Addiction in the Elderly

The latest on how it may be far more prevalent than realized.

Key points

  • Nearly a million people 65 and older are estimated to be battling addiction in the U.S.
  • For those over 65, there are added hesitations about getting help, which keeps thousands of seniors from getting the treatment they need.
  • Despite some challenges, especially early in recovery, treatment is still the best way forward for older people with drug or alcohol issues.

While the incidence of substance use disorder (SUD) is lower in older than in younger people, nearly a million people 65 and older are estimated to be battling addiction in the U.S. That’s a lot of addiction.

Many experts think that number may be significantly lower than the reality because of underreporting—often because older Americans don’t want to admit they have a “young person’s disease.” As I will explain in this blog post, seniors face several other addiction issues and barriers unique to their age.

"I’m Not Addicted. I’m Just Getting Old."

The signs of addiction in an older person are sometimes hard to identify because they can mimic certain characteristics of normal aging. These may include:

  • More falls than usual
  • Memory slips
  • Increased clumsiness
  • More frequent medical issues
  • Frequent bruising
  • Poor hygiene and/or grooming

If you or a loved one is experiencing any of these signs, it may be time to take action. At a minimum, a conversation about it with a doctor.

Overcoming Fear, Shame, or Mistrust of Addiction Treatment

Everyone has hesitations about seeking addiction treatment. It’s a big and sometimes scary step to take, and most people would prefer to skip it altogether if they could get sober independently. Since most people can’t, treatment is usually the answer, and it’s almost always the correct answer.

For those over 65, there are added hesitations about getting help, which keeps thousands of seniors from getting the treatment they need.

Many think they’re too old to have an addiction and believe something else must be going on. Others are stuck in outmoded thinking from decades ago when there was more social stigma around addiction and treatment than today. These seniors think that having an addiction means they have a character flaw, a personality defect, or are socially deviant in some way.

None of those things are true about addiction—and never have been. Addiction, or SUD, is a brain disease, it’s treatable, and it has nothing to do with a person’s moral character. The problem is, many seniors won’t believe that. Which, again, is simply going to keep them from admitting they or a loved one has a problem and stop them from getting treatment.

The Scary Part for Elders With SUD

Consider these troubling facts:

  • According to a recent report by the National Institute on Drug Abuse, older people typically take longer to metabolize (break down) the drugs or alcohol they take in, and their brains may be more sensitive to these substances.
  • Older adults are also more likely than younger adults to suffer from depression and other mood disorders, heart and lung problems, and memory issues. Drug use can worsen all those conditions.
  • Many drugs also impair judgment, coordination, and reaction time. This increases the risk of accidents such as falls or car crashes. Further, the injuries suffered in those accidents tend to require longer recoveries in older adults.
  • Finally, older adults are more likely to live with cancer, heart disease, arthritis, and other chronic illnesses. Many take prescription opioid medications to help with the associated pain of those conditions. Some people get hooked on those prescription medications, then switch to heroin because it can be cheaper and easier to obtain. Result? They become hooked on both.

Treatment Is the Best Path

At the addiction treatment center where I am chief medical officer, the older adults we see typically take longer to get through detox. They also tend to be more prone to delirium and even hallucinations than younger patients.

However, treatment centers with medically assisted detox capability can provide older patients with medications to make detox far more bearable. Many centers also offer tailored therapy, support, and expertise to make a recovery go more smoothly.

Bottom line: Despite these challenges, especially early in recovery, treatment is still the best way forward for older people with drug or alcohol issues.

What to Look for in a Treatment Center

If you or a loved one needs treatment for drug or alcohol problems, and you’re researching facilities, consider this checklist of questions to ask the admissions person:

  • What is the age range of your patients?
  • Does your medical team have expertise with older patients?
  • Is your center fully wheelchair accessible, and do you have wheelchairs onsite?
  • Do you have a chronic pain program? (Older patients sometimes have pain issues.)
  • Do you have expertise in fall prevention?
  • Do you offer step-down care (IOP, standard outpatient, halfway house, etc.) tailored to older adults?
  • Do you provide a detailed aftercare plan that is tailored to older adults?

Also, when looking for treatment, keep in mind that not a lot is known about the best models of care for elderly patients. That said, research shows that older patients see better results with longer durations of care.1

What Family Members and Caregivers Can Do

Older adults usually turn to drugs or alcohol—and get addicted to them—for the same reasons as their younger peers: As a way to self-medicate, to reduce their pain (mental and physical), or to “fix” their depression, anxiety, trauma, or other mental illness.

To help head off this path to addiction, family members and caregivers need to know if their older adult is getting needed social services, is connected to a nearby senior care center, has in-home care or social worker support if needed, and has other social supports in place.

As a family member or caregiver, if you believe that things have progressed to addiction, be determined to take action. Let your loved one know you’re concerned and ask how you can help. Try your best to be kind, patient, supportive—but also direct. That’s always the best way.

Once you have that conversation, you may need to suggest addiction treatment. Make it clear to your loved one that you fully support the move and that it could be a great option. Your support for it could be a significant deciding factor in his or her decision to go.

To find a therapist, visit the Psychology Today Therapy Directory.

References

[1] Substance Use in Older Adults DrugFacts. (July 2020) National Institute on Drug Abuse.

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