Substance Misuse In Older Adults

As social distancing during the COVID-19 pandemic has eased and families have begun to reunite, some have noticed signs that older relatives might be drinking too much, misusing prescription medications, or even bringing home products from the local cannabis dispensary. The Centers for Disease Control and Prevention (CDC) reports that the fear, anxiety, loneliness, loss and trauma people have experienced during the pandemic have contributed to a steep increase in substance misuse, most notably among older adults.

Even before the pandemic, experts warned of a steady increase in the abuse of drugs and alcohol among older adults. Some (most notably the baby boomers) had used drugs in their earlier years, and then took it up again or increased their intake. Others only began using in later life.

Some older adults may attempt to self-medicate as they deal with chronic pain, sleep problems, physical disabilities or mental health problems. Others may be trying to cope with challenges life has brought their way, such as the loss of a spouse, a sense of purposelessness, financial worries or social isolation. They might be misusing:

Prescription medications. Most older adults who misuse prescription drugs began with a prescription from their doctor for an opioid medication to treat pain. (Opioids include hydrocodone, oxycodone, morphine, codeine and fentanyl.) Not so long ago, many doctors thought that patients who took opioid drugs for pain control were not at risk for developing an addiction. The opioid crisis showed that this was not true. Today the pain control trend has moved from drugs toward alternate therapies, but a certain percentage of older patients are still misusing opioids. Other prescription drugs commonly misused include barbiturates, stimulants, sedatives, and anti-anxiety and sleep medications.

Alcohol. In June 2021, 25% of older adults interviewed told University of Michigan researchers that they were drinking more alcohol during the pandemic. Even before 2020, heavy and risky drinking was increasing fastest among people older than 65. Alcohol is the most commonly misused drug among this age group. As with prescription drug misuse, the beginning is usually benign—a cocktail at parties, a beer at barbecues, or a glass of wine each night with dinner. Then, some seniors go on to drink more than is safe, putting themselves at risk of a host of social and health problems.

Cannabis. Marijuana, now legal in many states, has grown in popularity among older adults. Just as with prescription opioids, cannabis is sometimes recommended for medical uses, such as pain relief and improved sleep. But a recent study published in JAMA Internal Medicine also shows that many people older than 65 are using cannabis for recreational purposes. The National Institutes of Health cautions that marijuana can complicate existing health conditions among older users, interact with other medications, and affect breathing, memory and mood.

As we grow older, our bodies take longer to process and break down substances. Misuse of drugs can have serious consequences for our:

Health. Today, 10% of hospital admissions among older patients are related to unhealthy drug or alcohol use. Substance misuse can weaken the immune system, increase depression, hasten dementia, raise blood pressure and worsen diabetes. And the CDC reports that each year, many thousands of people die by overdosing on drugs.

Safety. Consuming too much alcohol, opioid medications or cannabis can affect judgment, balance and coordination, which raises the risk of falls, car accidents and other injuries. Families also should be aware that many people who overdose on drugs, including young children, accessed the drug from a grandparent’s medicine chest or purse.

Relationships. Substance misuse can affect an older adult’s entire family, as well as their friendship network. Conflict, loss of trust and the senior’s fixation with their habit can seem to overrule the value of relationships. Families also are impacted when an older relative’s financial security is damaged.

How can family help?

If you suspect an older loved one is misusing drugs or alcohol, it’s time for a conversation. You might not be certain—there can be a thin line between social drinking and alcoholism, or between the proper use of pain medications and abuse. Sometimes families attribute the signs of substance misuse to “just the changes of aging”—for example, confusion, falls, or a lapse in hygiene and keeping up the house. Your loved one may seem more private and withdrawn, and less interested in their normal activities. They could be keeping their excessive alcohol or drug use secret, to protect their habit or fearing stigma.

With kindness, and without judgment, talk to your loved one. They may tell you it’s none of your business, and you might feel that way yourself. But concerns about substance misuse should be approached like any other illness. Encourage your loved one to have a candid discussion with their doctor. Assure them that treatment is available and has a higher success rate in older patients. Interdisciplinary teams provide treatments, including:

• Behavioral therapies
• Medications
• Group and individual counseling
• Medically supervised withdrawal (detox) programs
• Evaluation of mental and physical health
• Family interventions

Experts also say older adults benefit from lifestyle improvements, such as increased engagement and social connection. Professional in-home caregivers can be an important resource in warding off anxiety and loneliness, two factors shown to lead to substance misuse. Professional caregivers provide companionship and mental stimulation, which can help your loved one find joy and peace. They also help with hygiene, safety, nutrition, medication reminders and supervision.

Right at Home’s screened, supervised and trained caregivers provide invaluable support. Find your local Right at Home and ask for a care consultation today.