Drug and Alcohol Abuse in Seniors
With the increase in abuse and misuse of prescription drugs and alcohol in the elderly, it’s critical for caregivers to take steps to prevent and treat these conditions.
People over 65 don’t fit the typical drug or alcohol abuser stereotype so you may not consider it an issue for your elderly parent. Surprisingly, an alcohol and drug problem, particularly prescription drug abuse, is one of the fastest growing health problems in the U.S. among older adults. (SAMHSA.gov, n.d.)
Prescription drug addiction occurs when a person takes a drug differently than was prescribed by a doctor. Taking a larger dose of a medication or mixing it with alcohol, can cause the person to become addicted. Abuse can happen by accident especially if your parent is taking a number of different drugs for common ailments such as arthritis, chronic pain, anxiety, or sleep issues. They may also be taking over the counter medications or dietary supplements which could cause an adverse reaction when mixed with prescription medications or alcohol.
According to the National Institute on Drug Abuse, more than 80 percent of older patients aged 57 to 85 years old take at least one prescription medication on a daily basis. Over half of the senior population takes more than five medications or supplements daily with women taking more than men and using them for longer periods of time. (drugabuse.gov, n.d.)
Because of the number and variety of drugs they take, the most common reason for seniors to become addicted is the misuse of drugs. As people get older, their minds aren’t as sharp and memory loss is common which could cause them to take the wrong dosage or take a dose twice.
Hospital admissions associated with prescription medications and illicit drug use rose by 96 percent among people ages 65 and 84 between 1997 and 2008. The percentage of people 85 and older was even higher, making abuse or misuse of prescription drugs second only to alcohol abuse in the over 65 demographic. (SAMHSA.gov, n.d.)
Studies show that half of the drugs most commonly taken by older adults are potentially addictive substances. Three types of medications frequently prescribed to seniors are highly addictive and susceptible to abuse (familydoctor.org. n.d.):
- Opioids which are used to control pain. Major surgery, joint pain, and chronic pain from old injuries are usually treated with Opioids. Examples of Opioids are Percocet, Vicodin, Fentanyl and OxyContin.
- Benzodiazepines which are used to treat anxiety and insomnia. These symptoms can be brought on by the loss of a family member, friend or pet. Examples of Benzodiazepines are Valium, Ativan and
- Stimulants which are used to increase alertness, elevate blood pressure, or increase heart rate. Examples of stimulants are Adderall, Dexedrine and
Not only do people take more medications as they age, but the body’s ability to absorb and filter them is also greatly reduced. This increased sensitivity to drugs and alcohol puts a senior at risk for addiction even if they consume the products in much lower quantities than younger adults. Older adults may use these substances as they always have not realizing that their risks have increased.
To compound the issue, there may be limited coordination between doctors and the senior may be taking over the counter medications and supplements that weren’t disclosed to their doctor. This means that the total medication profile and potential risks aren’t documented. The older adult and their caretakers may not be aware of the risk of mixing different drugs or combining prescription drug use with alcohol or other supplements. (Burke, Victoria 2017)
While most drug abuse in seniors is unintentional, they could deliberately turn to alcohol to cope with emotional pain. Life changing events which could trigger alcohol abuse are:
- Coping with the death of a loved one whether that’s a spouse, close friend, or pet
- Downsizing and moving to a smaller home
- Failing health such as vision or hearing loss
- Inability to perform daily activities the way they used to
- Lack of a social circle to keep them occupied
- Empty Nest Syndrome when adult children move away
Seniors may not be aware they have an alcohol problem. If they’re used to having a couple of drinks after dinner they may not realize that their aging body is more sensitive to alcohol and it can have a much greater effect on them. They may find themselves with a problem even though their drinking habits haven’t changed.
Another big issue for seniors is caused when prescription drugs or over the counter drugs are combined with alcohol use. For example, some doctors recommend a senior take an aspirin each day to prevent heart issues. Aspirin can cause stomach or intestinal bleeding. This risk increases if alcohol is consumed as well. Some cough syrups and laxatives have a high dose of alcohol in them and drinking even a small additional amount of alcohol could cause increased drowsiness or potential liver damage.
Alcohol abuse can contribute to health issues an aging parent may already be experiencing such as:
- age-related mobility problems
- heart problems
- judgment problems
- anxiety and depression
Substance Abuse can be difficult to diagnose in older adults because the symptoms are similar to those of other health issues common in the elderly. For example, alcohol abuse causes memory loss which can be similar to dementia (Basca, Belinda 2008).These warning signs may signal substance abuse:
- A lack of interest in personal hygiene
- Changes in eating and sleeping habits
- Having a prescription for the same medication from two different doctors or two different pharmacies
- Irritability or agitation
- Giving up a hobby or other fun activities
- Sharing medications with family members or friends who are trying to help them avoid drug costs
- Memory loss or confusion
- Balance problems
- Slurred speech, empty alcohol bottles, or smelling alcohol on their breath
Seniors who realize they have a problem with alcohol may feel ashamed to admit it due to the stigma associated with alcoholism. Adult children may also ignore potential alcohol abuse because they feel it’s the only pleasure Mom or Dad has and they want to preserve their parent’s quality of life. The reality is that substance abuse will shorten their lifespan even further.
If your elderly parent displays any of the symptoms mentioned above, it ’s important to get a doctor’s evaluation because those same symptoms could be age-related issues, not substance abuse. Other illnesses which may be causing the symptoms such as diabetes or dementia need to be ruled out.
If it’s determined that treatment is needed, seniors and their caregivers have some options including:
- Twelve- Step programs
- In-patient and out-patient programs
- Group counseling
- Prescription medications to prevent relapse.
Medicare can help pay for treatment if certain conditions are met such as services being provided by a Medicare-approved physician or treatment facility. (Burke, Victoria 2017)
Treatment usually starts with a medically supervised detox program followed by individual or group therapy as part of a short term or long term rehabilitation program. Look for treatment centers with age-specific programs and staff trained in the needs of seniors. These include not only addressing the individual’s physical needs but their emotional needs as well. It’s also important to address any underlying mental health issues. No one treatment plan will work for everyone, so it’s vital that you investigate alternatives to find the best fit for your parent.
Anyone recovering from addiction will have a high risk of relapse. Senior adults who live alone are at particularly high risk. Keep in mind that your elderly parent may still need access to prescription medications to treat a chronic illness. Ensure you set up support services or extended care services to minimize the relapse risk.
It’s important for seniors to be educated about the symptoms and risks of drug and alcohol abuse. Some strategies for preventing abuse are:
- When potentially addictive drugs are prescribed by a doctor, request they start with a lower than normal dose. A smaller dose may be just as effective due to the senior’s metabolism
- Always ask if alcohol can be used safely while taking the medication
- Ensure the senior is monitored closely by their physician for adverse effects
- Read all pharmacy instructions carefully making a note of drug interaction issues
- Caregivers and family members should monitor the senior’s behavior and look for warning signs
If the senior does become addicted, a detoxification plan combined with a strong rehabilitation plan and support services will ensure seniors can successfully combat addiction while managing other health issues.
- SAMHSA.gov (n.d.) Specific Populations and Prescription Drug Misuse and Abuse. Retrieved from https://www.samhsa.gov/prescription-drug-misuse-abuse/specific-populations
- Drugabuse.gov (n.d.) Misuse of Prescription Drugs. Retrieved from https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/what-scope-prescription-drug-misuse
- Familydoctor.org (n.d.) Retrieved from https://familydoctor.org/condition/prescription-drug-abuse-in-the-elderly/
- Agingcare.com (n.d.) Retrieved from https://www.agingcare.com/articles/alcohol-abuse-elderly-parents-133827.htm
- Burke, Victoria 2017 Prescription Drug Abuse Among Older Adults. Retrieved from https://medicare.com/health/prescription-drug-abuse-among-older-adults/
- ncadd.org (n.d.) Alcohol ,Drug Dependence and Seniors. Retrieved from https://www.ncadd.org/about-addiction/seniors/alcohol-drug-dependence-and-seniors
- Basca, Belinda (2008) The Elderly and Prescription Drug Misuse and Abuse. Retrieved from http://www.cars-rp.org/wp-content/uploads/2014/06/Prevention-Tactics-Vol09-No02-2008.pdf