How to spot, and address, substance misuse in older adults
Substance misuse among older adults hasn’t typically been thought of as a pressing issue in past generations. However, current and upcoming older adult populations are becoming increasingly at risk for misuse of substances. In 2006, 2.8 million older adults identified as having an SUD (substance use disorder). In 2020, it is predicted that the number of older adults with an SUD will hit the 5.7 million mark, more than double the number in 2006.
There are many factors that put adults over 50 at risk for developing an SUD. Some signs may be difficult to identify as they can be confused with signs of aging or simply overlooked. However, here are a few things you can look for if you believe that someone in your life may be dealing with or at risk for an SUD, as well as ways to provide help and resources to those misusing a substance.
To begin with, let’s look at some of the most commonly misused substances:
Alcohol is the most widely misused drug in the US. Older adults may be more at risk for alcohol misuse due to the decrease in metabolism which reduces the ability to process alcohol (resulting in a higher average BAC compared to younger populations), drug interactions with medications, or using the substance to self-medicate for physical pain or grief.
Tobacco is another substance commonly misused by older adults. Older generations may have grown up during times where the public perception of cigarettes and other tobacco products was more normalized and there was less public health education surrounding the harms of cigarettes. A past history of tobacco use can also be a risk factor.
Adults over 50 may also be at risk for misuse of prescription medications. Older adults are more likely than any other group to have health issues that require medication, allowing easier access to prescription medication. Additionally, there is also a risk for drug interactions between different medications that may be taken. When prescribing medications, typically a person is asked to list other medications being taken to ensure less risk of interaction, but if a patient forgets a medication they are on or switches between current and past prescriptions without consulting their medical professional first, then the risk is increased. There may also be an issue of forgetting when a medication was taken, accidentally taking too much of a medication, or not following directions willfully.
Signs to look out for
Hangovers, memory loss, or irritability can indicate overuse of alcohol.
Refilling medications more often than needed, either due to forgetting how much medication has been taken or intentionally over-using a medication, may be a sign of misuse.
Lack of interest or participation in usual activities
Decrease in mental health (signs of depression, anxiety, grief)
Declined communication with friends and family with no identifiable cause
Additionally, because addiction can be genetic, if there is a family history of addiction or substance misuse, you may see generational traits passed down.
Further Help
One of the first steps you can take is having a conversation with your loved one about their use of substances. This can be a good way to check in, call attention to the behavior, and offer to help provide resources. Above all, this is a way to express your concern of their well-being and not a way to attack or accuse.
It is important that during this conversation all involved parties be sober and that you use this as an opportunity to express specific situations you may have witnessed. The goal is not to judge, but to provide support. It can also be helpful to bring in other concerned parties for follow-up conversations so your parent or other relative has more perspective on the issue.
There are many different organizations that help those dealing with a substance use disorder of any age, as well as organizations that may better cater to an older population. The following are a few resources you may find helpful.
SAMHSA combines substance recovery and mental health care to help those suffering from an SUD
Addiction Center, which can help you browse for rehabilitation centers as well as learn more about different substance addictions
National Council on Aging, a source which can provide more information on steps you can take as well as common substance misuse public health issues for seniors
National Institute of Alcohol Abuse and Alcoholism, a place to generally find out more about substance misuse
Counseling for underlying mental health issues contributing to substance use, which can be arrange privately