Alcohol and drug addiction in older adults has been steadily rising since the early 2000s1. This is believed to be, in part, due to the ‘baby boomer generation, most of whom reached legal drinking age in the 1960s and 1970s, now reaching retirement age2.
The ‘60s and ‘70s saw a change in attitude towards drugs and alcohol and an increase in drinking and drug-taking at parties.
This means that today’s seniors are more likely to have experimented with drugs and alcohol when they were young, and so they might be more prone to addiction later in life.
The most common substance use disorder among older adults and the elderly is alcohol addiction, closely followed by addiction to prescription drugs3.
Generally, seniors are less likely than young people to abuse recreational drugs, but this doesn’t make their addictions any less serious. As we age, our bodies’ defences weaken, and so we can become more susceptible to the addicting compounds in certain substances.
Approximately 1.6% of seniors have been classified as having an alcohol abuse disorder, but more than 10%3 admit to regularly binge drinking, and so there may be a high proportion who experience alcoholism but have not yet been diagnosed.
Rather than abusing drugs and alcohol out of curiosity or for an escape, as a younger person might, older people are more likely to use substances in order to self-medicate for physical or psychological ailments.
In cases such as these, it might not be obvious that an addiction is developing, as the symptoms can be similar to those of the illness that they are trying to treat.
Common signs of addiction in the elderly include:
These can also be the symptoms of many serious health issues related to ageing, such as dementia and strokes, and so if you notice any of these changes in a family member or loved one, seek expert advice.
More obvious social signs that an elderly person may be experiencing a substance addiction include:
Because the incidence of addiction in the elderly has seen a major rise only in the last 20 or so years, substance use is not often the first thing doctors will look for when making a diagnosis.
If you are looking to refer an elderly person because you suspect they are suffering from an addiction, give as much information as possible on any changes in their behaviour.
This information can be crucial in helping a GP to recognise that the issue is drug or alcohol-related, rather than linked to any other type of illness.
Memory problems, whether caused by the addiction or by ageing, can make it difficult for older people to manage their addiction recovery on their own.
Therefore, if an elderly person is struggling with substance abuse, entering a rehabilitation centre is often the best course of action for them.
There are centres that specialise in rehab for the elderly and are well-equipped to support users through their addictions while also overseeing their general health and wellbeing.
As we age, our lives begin to slow down. Many people look forward to the days of retirement and having an empty nest, but big life changes such as these can be triggers for addiction in older adults.
Leaving work might mean losing a routine that you have had for decades, and even if you try to structure your days, they won’t be the same. A lot of our socialisation occurs at work, and so retirement can be lonely and boring, especially if your partner or your friends are not also retired.
It’s not uncommon for people to have the odd drink after a long day of work. If you’re someone who has done that throughout 40 or more years of employment, it can be a hard habit to break.
After retirement, you’re likely to be home more, and so you might be tempted to have that drink earlier in the day, or have more than one. This can easily spiral into a reliance or addiction to alcohol, especially as memory problems relating to age can make it difficult to keep track of how much you are drinking.
The recommended drinking guideline for a healthy adult over the age of 65 is up to 7 drinks in a week, with no more than 1 or 2 in any given day4.
These limits are lower for people who are on prescribed medications, as the alcohol can impact on their effectiveness, or interact badly with them.
GPs are extremely careful when prescribing multiple drugs to an individual, as they are aware of how different substances interfere with each other. If your GP is not made aware of your drinking, they can inadvertently make your situation worse by prescribing drugs that mix badly with alcohol.
Older people are more likely to need prescribed medications, given that our risk of developing certain illnesses – such as diabetes, heart disease, and cancer – increases as we age.
The elderly can also be at an increased risk of accidentally overdosing on medications because their slowed metabolism means that they might still have higher than normal levels of medication left in their systems when they come to take their next dose.
There are many painful conditions that we can develop as we age, such as arthritis, and so opiates may be prescribed in order to manage the pain. Strong opiates, such as morphine, may also be prescribed following surgery, such as a hip replacement.
The use of opiates must be closely monitored, as they are generally considered to be addictive. That’s why, while heroin addiction is one of the most common opiate addictions in the young, elderly people are much more likely to become addicted to prescribed opiates, such as codeine or tramadol.
Benzodiazepines are a type of sedative which are typically prescribed to treat anxiety and insomnia, both of which are commonly experienced by older people.
They are usually only prescribed in the short term, as our bodies can acclimatise to them quite quickly, causing them to stop being effective.
However, this means that people who take them for a while can feel like they need higher doses in order to feel the effects, and so there is a high risk of abuse. It is also extremely dangerous to drink alcohol while on benzodiazepines, regardless of age.
Even if someone is not taking any prescribed medications, excessive drinking or other substance abuse can still cause many physical and mental issues.
This is true at any age, but the elderly in particular are more susceptible to complications as our ability to process toxins worsens as we get older.
Treatment for substance abuse can be effective no matter how old you are, or how long you have struggled with addiction. What’s important is to reach out as soon as you recognise that there is an issue – whether that is for yourself, or on behalf of a loved one.
Your GP should be your first port of call when seeking help on the road to recovery, but if that isn’t possible, there are many resources available online, or at your local place of worship, to direct you to treatment options.
Age-specific rehabilitation centres are often the best route to take, especially for older people who have general health issues in addition to their addiction.
Rehab centres make sure to focus on the person as a whole, not just on their substance abuse, and age-specific centres have a deeper understanding of the struggles that the elderly face.
Going through detoxification can be physically and emotionally challenging. If an elderly person has become addicted to a substance, they will need a well-structured and carefully monitored detox programme.
This is especially true if the substance in question is a prescribed drug used to manage an illness, as they will most likely still need some form of the medication.
Age-specific rehab centres employ specialists who understand how to rid older people of their addictions without depriving them of any of the treatments they need.
As loneliness and boredom are common triggers for addiction in the elderly, spending time in a residential rehabilitation centre can benefit a senior’s recovery in a number of ways.
It gives them an opportunity to socialise with others, to reintroduce routine they may have lost since retiring, and to enjoy a sense of community.
These centres can also be a helpful transition between living at home and making the move into a retirement home. Additional support is given after you leave rehab to ensure that you are not going to go back to your old ways.
This might mean helping you get set up in a new senior living facility, or arranging for a nurse to visit your home and help you to better manage any prescriptions and health concerns.