Addiction In The Elderly | Prevalence, Signs, & How To Help

Some people think drug addiction, also called substance use disorder, mainly affects younger adults. However, the disease is also common among the elderly (individuals aged 65 and older).  

With proper treatment, elderly people can recover from substance use disorder and lead healthy lives. 

How Common Is Addiction In The Elderly?

The National Institute on Drug Abuse states that almost 1 million adults aged 65 and older have a substance use disorder.

Substance use disorder starts with substance abuse. Many people abuse substances to cope with painful situations or emotions that damage their quality of life (also known as “triggers”). 

Common triggers for elderly people include:

• social isolation
• relocation to a nursing home
• death of a loved one  
• physical health problems like arthritis, diabetes, cancer, and heart disease
• mental health problems like depression, anxiety, memory loss, and insomnia
• financial problems
• family conflict

According to the University of Pennsylvania, between 6-11% of elderly hospital admissions involve substance abuse problems. 

Common Addictions In The Elderly

Just like younger people, older people can become addicted to a variety of substances, including prescription drugs, legal drugs like nicotine, and illegal drugs like cocaine. However, elderly people are most likely to become addicted to alcohol, opioids, and benzodiazepines. 

Alcohol Use Disorder

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends that men have no more than 2 alcoholic drinks a day and women have no more than 1 alcoholic drink a day. About 65% of elderly people exceed these guidelines at least once a week.

Similarly, over a tenth of elderly people engage in binge drinking. The NIAAA defines binge drinking as having five or more drinks on one occasion for men and having four or more drinks on one occasion for women. 

Over time, this type of alcohol abuse can lead to alcohol use disorder. This disease can cause or worsen various health problems in elderly people, such as mood disorders, high blood pressure, congestive heart failure, diabetes, liver and bone problems, and memory problems.

Opioid Use Disorder

Many doctors use prescription opioids (such as OxyContin, Percocet, and Vicodin) to treat chronic pain and pain from cancer or surgery. 

Since senior citizens are more likely to experience these types of pain than other age groups, they’re more likely to be prescribed opioids. In fact, between 4-9% of people aged 65 and older use opioid pain medications. 

Many people who are addicted to prescription opioid painkillers eventually turn to heroin. As an opioid itself, heroin has similar effects as prescription opioids, but it’s usually much cheaper. 

No matter which opioid you or your loved one uses, opioid addiction poses serious health risks, including fatal overdose.

Benzodiazepine Use Disorder

Benzodiazepines are prescription tranquilizers that can help treat health conditions like anxiety, insomnia, and seizures. Popular benzodiazepines include clonazepam (Klonopin), alprazolam (Xanax), and lorazepam (Ativan). 

Like opioids, benzodiazepines are frequently prescribed for elderly people, and they pose a high risk of addiction if you take them for a long time or abuse them. 

Along with causing addiction, benzodiazepines may increase an older person’s risk of both hip fractures and Alzheimer’s disease. In addition, a 2019 study found that 25% of people over 50 who abuse benzodiazepines experience suicidal ideation. 

Signs Of Addiction In The Elderly

The most common signs of addiction in the elderly are tolerance and physical dependency. 

Tolerance & Physical Dependence

Tolerance means that over time, a person needs an increasingly larger or more frequent amount of a drug to feel the desired effects. 

Physical dependency means that a person relies on a drug to function normally. If they stop taking it, they may experience withdrawal symptoms like anxiety, sweating, or shaking.

Physical, Psychological, & Behavioral Signs

Addiction can also cause other physical, psychological, and behavioral signs.

Common physical signs of addiction include:

• sudden weight loss or gain
• strange smells on the breath, body, or clothes
• unwashed hair, dirty clothes, or other signs of declining personal hygiene
• slurred speech or increased talkativeness 
• bloodshot eyes and/or change in pupil size
• sniffling or runny nose
• unexplained aches or pains
• unexplained bruises 

Common psychological signs of addiction include:

• trouble concentrating
• loss of interest in activities once enjoyed
• irritability
• mood swings
• memory loss
• anxiety
• paranoia 
• feeling unable to stop using drugs despite wanting to

Common behavioral signs of addiction include:

• avoidance of friends and family members
• avoidance of daily tasks, such as cleaning and cooking
• frequently borrowing or stealing money
• visiting multiple doctors to get multiple prescriptions of the same prescription medication (also called “doctor shopping”)

How To Help An Elderly Person Recover From Addiction 

If an elderly person in your life shows the above signs, talk to them. Gently explain why you think they may need addiction treatment. If they deny they have a problem, ask a doctor, therapist, or interventionist to help you plan a more effective conversation with your loved one. 

Help Them Find A Treatment Program

When your loved one admits they have an addiction, help them find a treatment program. 

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), elderly people often have unique needs that should be addressed during addiction treatment, such as:

• co-occurring medical conditions
• side effects from medications used to treat co-occurring medical conditions
• nutritional deficits 
• reluctance to discuss substance use disorder and other mental health problems

Not all addiction treatment programs are designed to address these challenges. Thus, you should help your loved one find a treatment center with health care providers who have experience working with older patients. 

Decide On Inpatient Or Outpatient Care

You’ll also need to decide whether your loved one needs inpatient or outpatient care. Inpatient care is best for people with moderate-to-severe addictions, while outpatient care may work for people with mild addictions and strong support systems at home.  

Whether inpatient or outpatient, the right treatment program will provide services such as:

• medical detox, where doctors will help your loved one slowly and safely cease drug or alcohol consumption
• behavioral therapy, where your loved one can learn coping skills to manage drug cravings and improve their overall mental health
• psychiatry, where your loved one can receive medications to treat any underlying mental illnesses that contribute to their drug use

In addition, some treatment facilities offer support groups designed specifically for older adults. In these groups, your loved one can connect with other people who are managing addiction along with the usual struggles that accompany old age.

To learn more about substance abuse treatment options for elderly people, please reach out to an Ark Behavioral Health specialist.