Senior Health Substance Use Disorder in Seniors 9/8/2023 | By Terri L. Jones Whether from the flower child influences of their youth or because of a greater awareness by physicians and researchers, it seems that substance use disorder in seniors is on the rise. We look at the problem and solutions. Many baby boomers came of age during the ’60s and ’70s, when many of their peers were smoking pot and using hallucinogenic drugs. As a result, they have a more relaxed attitude about drug use than their parents’ generation. And, as they enter their advanced years, their continued use and abuse of these drugs is becoming more and more apparent. In 2022, a study of Medicare recipients found that 2% of those over the age of 65 (more than 900,000 people) had a substance use disorder or dependence. It seems that substance use among this age group is on the rise, with alcohol the most commonly misused substance. Prescription opioids ranked second, with opioid disorders tripling between 2013 and 2018. Not all senior drug users are created equal However, not all seniors who have a substance use disorder are stereotypical “children of the ’60s” using drugs for years. Dr. Elizabeth Bulat, an addiction medicine specialist at Henry Ford Maplegrove Center, explains that some are “late-onset” users, forming addictions after doctors prescribe a medication to treat pain, anxiety, insomnia, or another medical condition. Seniors may also start drinking or using other substances later in life as a response to loneliness or the stress of health or financial concerns. A carefully guarded secret Regardless of how and when a senior starts, the widespread issue of substance abuse disorder in seniors has remained largely under wraps. Who could even imagine that their sweet, 75-year-old next-door neighbor is abusing painkillers? Another reason many seniors are able to keep their behavior a carefully guarded secret is that they’re not going into a workplace anymore, where drug use can interfere with jobs, and many are spending a lot of time alone. Plus, some signs of substance abuse mimic normal signs of aging (like poor balance and confusion). Until recently, even medical professionals didn’t delve deeply into drug use with their older patients. Why change now? After decades of using a substance safely, seniors are lulled into a false sense of security. But the fact is that the body changes with age. These physiological changes impact how the body absorbs, distributes, metabolizes and eliminates drugs, sometimes resulting in the drugs staying in the body longer. According to Dr. Benjamin Han, a geriatrician and addiction medicine specialist at the School of Medicine at the University of California, San Diego, misuse of drugs can exacerbate seniors’ cognitive impairment as well as heart problems and liver disease, among other conditions. Drugs and alcohol can also lead to falls, car accidents, and other dangerous situations. And even when drugs are prescribed, overdoses can happen when too much medication is taken accidentally or mixed with other medications or alcohol. Related: Five reasons why binge drinking is especially dangerous for seniors Long-term marijuana users may even develop a condition called cannabinoid hyperemesis syndrome, which starts with morning nausea and abdominal discomfort. Over time, the condition evolves into intense and repeated vomiting. The only way to resolve this condition is complete abstinence from cannabis. Red flags If someone you love is taking an increasing number of painkillers or other addictive medications, frequently sneaking away to vape or smoke, or binge drinking, they may have a substance use disorder. Other signs to look for include: Memory loss or confusion Sleep issues Mood swings Anxiety or depression Loss of interest in favorite activities Poor hygiene Reduced contact with friends and family Slurred speech Unexplained injuries and bruises Never too late to make a change Unfortunately, few seniors who have substance use problems seek treatment (only 6% of Medicare recipients over the age of 65 compared with 17% of younger recipients). Adults who have a high comfort level with drugs may have difficulty believing that their social or medical use has turned into an addiction. Cost can also keep older substance users from obtaining treatment, as there are treatment limitations on Medicare coverage. There’s also the shame. “We see higher rates of stigma concerns, things like worrying about what their neighbors would think,” Dr. William Parish, the lead author and a health economist at RTI International, a nonprofit research institute, told the New York Times. Another barrier to treatment is not knowing how or where to find it. The best place to start is with the senior’s primary care physician, who may refer them to a senior-specific treatment program. These programs often involve support groups, which ensure that seniors don’t feel alone with their challenges. Bottom line, the most important first step is for a person with a substance use disorder to admit that they have a problem, then reach out to someone – a doctor, family member, friend, or spiritual leader – and be motivated to make a change. You’re never too old to break a habit! Read More Terri L. Jones Terri L. Jones has been writing educational and informative topics for the senior industry for over ten years, and is a frequent and longtime contributor to Seniors Guide.