Substance Abuse

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 composition) that impact the absorption, processing and excretion of drugs and alcohol.

Over 75% of people over the age of 65 take a prescription medication. The average number of medications an older adult may be using at any given time is seven. More than half of these prescriptions have some sedating side effects. Given these facts and the knowledge that older adult's 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 and abuse.

Consider too, the 1993 report in the Journal of the American Medical Association that 77% of all hospitalized older persons and up to 50% of nursing home residents have alcohol related problems. A 2005 report form 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 heroine) rose from 6.8 percent to 12 percent in that same time period. Alcohol, however, remains the primary substance of 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 addiction. Addiction is a disease. It is not a sign of weakness or a condition that can be willed away. Addiction is an illness that can develop at any age. It is wrong to assume that older adults cannot develop alcoholism or drug addiction. 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 more acute.

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 multitude of 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, bruises, 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
Drinks in spite of warning labels on prescription drugs
Often has the smell of liquor or mouthwash on his/her breath
Neglect of personal appearance and dramatic weight fluctuations

The good news is that older adults have a higher recovery rate from substance abuse than any other population. 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.