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Addiction in the Elderly

Addiction in the Elderly: A Growing Crisis

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Substance abuse and addiction is often something we typically only think about affecting adolescents and young adults. It’s easy to lose sight that addiction does not discriminate race, sex, status, or age. Addiction in the elderly is a growing concern that often gets overlooked because so much energy is being spent focusing on drug or alcohol abuse in young adults.

Drug addiction in the elderly people often stems from being given highly addictive prescription drugs, like opioids. Co-occurring disorders, like depression, are also typical factors of addiction rates of people aged 65 and up in the United States. When a person is in pain and prescribed medication while also suffering from untreated depression or other mental disorders, they are more likely to self-medicate with alcohol or drugs or abuse their access to prescription medications.

Family members often overlook the signs of substance abuse and mental health issues in the elderly, but this article may shine some light on the situation.


Opioid Addiction in Elderly: The Opioid Epidemic

The opioid epidemic has left no group unaffected, including older people.

Opioids include natural, semi-synthetic, and synthetic substances like the illicit drug heroin and prescription pain medicines. Prescription opioids have been a significant driver of the opioid epidemic as a whole.

Opioid addiction in the elderly has been a growing problem for years. It can be especially dangerous since older people are at a higher risk of overdose and other types of accidental death.

From 1999 through 2019, almost 500,000 people died because of an overdose in the U.S. Drug overdose deaths have quadrupled since 1999. From 2018 to 2019, opioid-involved death rates went up by more than 6%.


Prescription Painkillers

Prescription opioids, including hydrocodone and oxycodone, affect the user’s brain and body in many of the same ways as heroin. There is a slowdown in central nervous system (CNS) functionality. This reduces vital functions controlled by the CNS, like breathing and heart rate, contributing to the potential for an overdose.

While prescription opioids are high-risk for overdose and addiction, they are often given to patients to manage chronic pain. Chronic pain is a significant source of opioid addiction in the elderly. As we age, we’re more prone to the conditions that can lead to chronic pain, including musculoskeletal disorders and arthritic conditions. Around 80% of people with advanced cancer deal with severe pain, like 77% of patients with heart disease — Up to 40% of outpatients who are 65 and older report experiencing pain.

Between 1995 and 2010, the prescribing of opioids for older adults during regular doctor’s office visits increased 9x. The proportion of older people in the U.S. using heroin more than doubled between 2013 and 2015.

Of course, coping with chronic pain through prescription opioids is only one contributing factor to addiction in the elderly. Other factors include loneliness and isolation and having multiple doctors who might inadvertently prescribe medicines that interact with one another.


How Common Is Substance Abuse In Older People?

Around one million adults who are 65 and older are believed to have a substance use disorder in the U.S. From 2000 to 2012, the proportion of admissions to treatment programs among older adults went up from 3.4% to 7%.

Due to chronic health conditions, older people have more prescribed medicines than any other age group. For example, one study of 3,000 adults between the ages of 57 and 85 found more than 80% used at least one prescription medication daily, and almost half used more than five medicines or supplements.

While opioids are one class of drugs given particular attention, many older adults report misusing other substances as well. For example, from 2001 to 2013, there was a 107% increase in alcohol use disorder among people 65 and older—around 65% of people in this same age group report high-risk drinking. Research published in 2020 found that people aged 50 and older have shown the most significant increases in alcohol consumption compared to other age groups.


The Risks of Drug Addiction in the Elderly

While the use of drugs is dangerous for someone in any age group, it’s even riskier for older people. It’s a problem that is often overlooked since addiction is most frequently associated with younger people. Many of the signs of addiction in the elderly can also be wrongly attributed to other co-morbidities or signs of aging.

The risks of addiction in the elderly include:

  1. Older people, especially with comorbidities, tend to process drugs more slowly. Anything, including prescription medications, can stay in their system for longer. Substances can also build up if they take a dose too close to another. This increases side effects like drowsiness or lack of coordination and also makes an overdose more likely.
  2. If an older person is using opioids and they combine them with alcohol or benzodiazepines, like Xanax, it can amplify the effects of both. That can lead to further respiratory depression and a higher chance of an overdose occurring. An older person may mix up their medicines or forget when they took their last dose, which also creates more likelihood of an overdose.
  3. The effects of medication can speed up cognitive decline and may make symptoms like memory loss more apparent. An older person using substances may have difficulties with problem-solving and decision-making. Substances can also affect motor skills, attention, mood, and mental health.
  4. When older people use drugs, they’re at an even more considerable risk of falling or accidentally hurting themselves. That’s already a significant problem in this age group.


Signs and Symptoms of Substance Abuse in the Elderly

It’s common, even among medical professionals, to misdiagnose drug abuse or addiction in the elderly. The signs and symptoms can be confused with other conditions, and it’s upsetting to envision addiction happening in the elderly population as much as it does.

addiction in the elderly

Some of the possible signs and symptoms of drug use or addiction in older people include:

  • Emotional changes
  • Reduced energy
  • Changes in memory or mental state
  • Depression or sadness
  • Differences in sleeping or eating patterns
  • More isolation
  • Less social engagement
  • Hygiene changes
  • Weight loss or gain
  • Less family contact
  • Missing appointments or commitment
  • Irritability

Addiction is different from physical dependence, although the two often occur together. Addiction is a psychological disorder affecting mental and physical health. Dependence means that if you stop taking a substance you’ve been regularly using, you may have symptoms of withdrawal and may require a medically assisted detoxification.


Treating Addiction in the Elderly

If you have a loved one who you believe is showing signs or symptoms of addiction, resources are available. You might want to first speak to their primary care doctor and possibly go to an appointment with them to check on the medicines they’re taking.

It’s always a good idea to regularly inventory any prescription and over-the-counter medicines and supplements that your loved one is taking and the doses. You can then speak to their doctor to make sure there aren’t interactions.

Addiction, no matter how old you are, is a disease affecting the brain. When you take a psychoactive substance like opioids, it triggers a dopamine response in the brain. That pleasant response is rewarding. The brain is wired to want to keep seeking out a rewarding experience, and that’s how addiction can occur.

Dependence occurs when the brain and body grow accustomed to the presence of drugs or other substances. Your loved one can become ill with withdrawal symptoms if they’re dependent on opioids or other substances.

There are programs available to treat addiction in the elderly. These can combat the physical and mental symptoms and effects of addiction. Treatment options include behavioral therapy and counseling as well as medication-assisted options.

The most important takeaway is that drug addiction in the elderly is a real and growing problem. Regardless of how it starts, watching for the signs can save your loved one’s life.


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