Substance Use Problems
Many people are not aware of the age related changes that make the human body more vulnerable to the effects of alcohol, drugs, and medications. As we age, our bodies experience changes (i.e. enzyme, metabolic and tissue composition) that impact the absorption, processing and excretion drugs and alcohol.
An estimated 75% of people over the age of 65 take a prescription medication. The average number of medications an older may be using at any given time is five. More than half of medications commonly prescribed to older adults have some sedating side-effects. Given these facts and the knowledge that older body systems are changing, it is easier for us to understand the ease with which an older adult can fall victim to the problems of substance misuse or abuse.
A 2005 report from the National Substance Abuse and Mental Health Services Administration claims that substance abuse treatment for older adults increased by 32% from 1995 to 2002. Problematic use of opiates (found in prescription pain medications and heroin) rose from 6.8 percent to 12 percent in that same time period. Alcohol, however, remains the primary substance of misuse and abuse among older adults.
Alcohol is a culturally acceptable drug that is commonly overused and misused by adults to cope with difficult life changes. It can be difficult to distinguish between misuse, abuse and addiction but we do know that people who increasingly use alcohol to cope with problems are vulnerable to addition.
Addiction is an illness that can develop at any age. In fact, admissions for drug treatment among those ages 55 and older increased by 106 percent for men and 119 percent for women between 1995 and 2002. Addiction problems can resolve with treatment, and older adults have a high success rate for overcoming addiction and substance abuse problems.
The consequences of substance addiction and abuse in later life are much greater than in younger years, and if the abuse continues, all other problems are likely to become worse.
Whatever the drug, substance misuse/abuse by older adults in our culture goes under-estimated, under-identified, under-diagnosed and under-treated. This happens for a many reasons including; limited research and data, confusion of symptoms with other problems, lack of education, ageism, myths, stigma and denial.
Our most powerful weapon against substance abuse problems is education. Know these facts:
- Addiction is a disease.
- People who are addicted are not “bad” people who need to get “good”, they are sick people who need to get well.
- Denial is a strong force and also a definite symptom of the disease of addiction.
- Intervention, withdrawal and after-care for older adults require a careful plan due to the sensitive physical nature of the older adult, and the need to mobilize effective support.
Substance use becomes problematic abuse when:
- It interferes with a person’s ability to function, perform tasks or carry out responsibilities
- Relationships are disrupted or destroyed
- It causes physical, cognitive, behavioral or mood problems
- It becomes a central activity or part of a daily routine
- It distracts from reality—is used as an escape
- An individual depends on the substance
Symptoms of substance abuse include:
- Bumps and bruises that may have no explanation
- Falls that are unexplained or suspicious
- Slurred speech, impaired balance
- Memory loss, black outs, vague recollections
- Depressed mood, anxiety, hostility
- Behavioral changes
- Empty bottles, multiple medications
- Isolation or withdrawal
- Medical problems — complaints of gastrointestinal disturbances, fatigue, insomnia, malnutrition, hypertension, unstable diabetes
- Drinking in spite of warning labels on prescription drugs
- Smell of liquor or mouthwash on breath
- Neglect of personal appearance
The good news is that older adults have a high recovery rate from substance use problems. If you have the opportunity to talk with an older adult about substance abuse, assure them that there is ample evidence that they can recover to a healthier and more productive way of life. Suggest that they talk to their health care provider and contact a support group to obtain information, assistance and support.