Substance use can complicate the course and management of existing illnesses and they, in turn, can worsen the consequences of substance use and SUD. Societal norms tend to reinforce the perception that older adults do not have SUD (Kuerbis https://ecosoberhouse.com/ and Sacco, 2013). This belief can be internalized by older adults, leading them to avoid treatment. On the positive side, because individuals ages 65 and older are eligible for Medicare, insurance is less often a barrier to care.

After graduation, he became a substance abuse counselor, providing individual, group, and family counseling for those who strive to achieve and maintain sobriety and recovery goals. Communication should be as clear and straightforward as possible, taking into account age-related brain changes, both normal and abnormal. It is easy to get frustrated with an older person abusing substances, sometimes more so than with one in another age group, because they’re very defensive and set in their ways. Interruption in social and occupation roles or other repercussions of elderly drug abuse may be less noticeable or likely to occur at this stage of life. With age, one departs from these roles naturally in the vast majority of cases, such as through social isolation due to age-group peer mortality or retirement.

Drugs Mentioned In This Article

For example, older adults may be more likely to disclose depressive symptoms and present to primary care settings rather than mental health or substance abuse treatment settings. Although this was not the chief cause of drug-related ED visits for this age group, use of illicit drugs, use of drugs combined with alcohol, and nonmedical use of pharmaceuticals resulted in nearly 300 ED visits each day. The increasing number of older adults in the United States, due in part to the Baby Boomer substance abuse in older adults generation, means that there is also an increase in the number of older adults dealing with substance abuse problems. With the average older adult legally using 17 medications from nine different medical professionals, the physical effects of substance abuse might easily go unnoticed. Older adults have unique risk factors that increase their vulnerability to substance misuse, but signs and symptoms of SUDs often resemble those of other health issues, making detection difficult.

• Family members should communicate with the elderly in a respectful, empathic way.
• Although the rates of SUD and use of drugs and alcohol are generally lower among older adults than the general population, aging itself presents specific risks for harm when considering even minimal amounts of substance use among older adults.
• Chapter 1 will help you understand the current situation and trends to gain an overall, broad understanding of this critical issue.
• These sections give overviews of basic information on screening, diagnosis, and treatment as they apply to older clients from the provider’s point of view.
• Participants wore the WatchPAT™ device to measure sleep that night, and on the following morning participants returned to the laboratory to complete another cognitive assessment.

Treatment options for elderly alcohol abuse or drug addiction vary depending on the level of medical care needed. They may include educational and preventative services and support, medical detox, and outpatient or inpatient treatment. Admittedly, studies on the effects of treatment of substance abuse in older adults are few and far between, which is why it is crucial to find specific ways to engage the senior. There is a well-established link between habitual physical activity (bodily movement resulting in energy expenditure; Caspersen et al., 1985) and preservation of cognition in aging (Sofi et al., 2011; Blondell et al., 2014; Yoneda et al., 2021; Sewell et al., 2023a). However, evidence for the efficacy of exercise (i.e., structured/planned physical activity) interventions to improve cognitive function in older adults is inconsistent (Sink et al., 2015; Young et al., 2015). Lifestyle and genetic factors may affect individual cognitive response to exercise, contributing to inconsistencies in the literature (Erickson et al., 2022).

Who Is Most at Risk?

2.9 percent for individuals with less than a high school education, 3.1 percent for individuals with a high school education, and 4.5 percent for those with at least some college. 11 percent of older adults with any mental illness in the past year also had an SUD. 37 percent with a past-year SUD also had any mental illness; 13 percent, an SMI. Solving the problem of inappropriate drug use in older adults requires more than avoiding a short list of drugs and noting drug categories of concern. A patient’s entire drug regimen should also be assessed regularly to determine continued need for a drug, as well as potential benefit versus harm. In older patients, prescribers should always consider the possibility that a new symptom or sign is due to existing drug therapy.

Among comorbid SUD, alcohol and tobacco are used commonly together among older adults10; being a smoker increases the likelihood of being an at-risk drinker.71 Little else is known about the use patterns among older adults and the use of multiple substances simultaneously. Also, there is a need to improve the integration of mental health and general health services. This would lead to more person-centered care and decrease the need for multiple appointments, which can be particularly challenging for older adults. Collaborative models of care can achieve this goal either in-person or with the use of digital technologies (Ramuji et al., 2019). SUD can be difficult to recognize in older adults and lead to treatment delays due to medical comorbidity, neurocognitive impairment, and functional decline (Seim et al., 2020). A key consideration in the treatment of older adults with SUD is that they often have co-occurring general medical illnesses (Wu and Blazer, 2014).

Conditions

Figures 3–5 show individual participant change in episodic memory, executive function and attention cognitive composite scores, respectively, from baseline to immediately post-intervention, compared to their individual meaningful change threshold, calculated using the SDCind. Across a total of 60 assessments (one post-exercise, one post-control for each participant), participants showed meaningful change from baseline to immediately post-intervention for both episodic memory and executive function 15% of the time, and for attention 42% of the time. Table 4 details these frequencies by intervention condition and categorized as “positive” or “negative” score change. Supplementary Figures S1–S3 and Supplementary Table S1 detail these same analyses for cognitive score change from baseline to 24-h post-intervention.

• They may include educational and preventative services and support, medical detox, and outpatient or inpatient treatment.
• The reasons for this type of addiction involve tolerant attitudes toward substance use, family conflict, and financial troubles.
• Treatment options remain generally limited, as few programs or health care settings offer tailored interventions for older adults.
• Drug reconciliation refers to a formal process of reviewing all prescribed drugs at each transition of care and can help eliminate errors and omissions.
• On the positive side, because individuals ages 65 and older are eligible for Medicare, insurance is less often a barrier to care.
• This report did not provide comparable information on frequency of prescription drug misuse.