One can help an elderly parent or grandparent do so by asking if they are taking any medicines that could cause drug interaction and communicating the symptoms of prescription drug misuse or abuse to them. If they are taking several prescription drugs for different health conditions at once, it would be very helpful to write down the doses and administration times in big letters https://ecosoberhouse.com/article/abuse-in-older-adults-a-growing-threat/ on a sheet and put it up where they will see it, like on the fridge. Let them know they should always turn to their loved ones and a doctor if they feel like they’ve become dependent on a particular medicine or other substance. This article presents an overview of epidemiology, service use, and clinical considerations on SUD in older adults and suggests future directions.
Current predictions state that more than 1 million individuals over the age of 65 were reported to have a problematic substance use disorder in 2014 in the United States and it appears this number is expected to increase considerably in upcoming years, perhaps double by 2020 (Mattson, Lipari, Hays, & Van Horn, 2017). Due to the difficulties in assessing substance use disorders in older adults, there are no current projected estimates in Canada (Canadian Centre on Substance Use & Addiction, 2018), implying that more attention needs to be paid to this https://ecosoberhouse.com/ problem of substance use in the ageing population. Older adults and seniors who abuse alcohol or prescription drugs face a higher risk of developing illnesses like osteoporosis, ulcers, diabetes II, irritable colon, varicose veins, conditions of the small or large intestine, and chronic bladder inflammation. In particular, irritable colon and bladder inflammation have been linked to colon cancer in persons over 60. In addition, elder substance abuse causes an increased risk of household-related accidents, like falls, bone fractures, and burns.
Helping a Senior Recognize Risk
Rather, health care providers should presume that there may be an underlying cause, such as substance use, that may need to be addressed. In these ways, health care providers can challenge and question societal assumptions about ageing, substance use, and the connections between them. They should also question the language they are using when addressing older adults who are living with problematic substance use issues. Questioning of one’s own practice is a significant and important step in helping move health care practice towards being equity based and holistic. This alarming trend is due to a combination of factors, including an increase in access to prescription drugs and alcohol and a decrease in family support and social interaction, especially during the Covid-19 pandemic.
- As a philosophy, harm reduction shifts the focus from stigma and discrimination to a focus on moral worth—and by promoting a view of older people as deserving of care versus a potential drain on resources.
- In this article, we will review the signs and symptoms, risk factors, screening tools, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria, and challenges of treating substance abuse in the older adults.
- But the pronounced uptick — another data point in the long list of pandemic miseries — surprised government researchers.
- Addressing the social context of substance use can help nurses and other health care providers better understand the complex context of older people experiencing substance use issues.
This tool has many of the advantages of the CAGE, such as ease of administration and low cost. Although useful as an indicator of lifetime problem use, it lacks information about frequency, quantity, and current problems important for intervention. Brief screening instruments can assess the level of risk caused by alcohol and drugs. Some screening tools are adaptations of instruments created for younger adults, and others have been designed for older adults. Interview screening tools or global selfreport measures are less intrusive or burdensome to the older adult than blood or urine tests. Furthermore, the use of biologic screening (ie, laboratory tests) has limited utility and can be problematic in older adults, as isolating impaired bodily functions (ie, liver function) as the result of alcohol or other substances versus prescribed medications may be difficult.
Aging baby boomers — the Woodstock generation — had more exposure to alcohol and drugs than previous generations, who viewed the use of such substances as a moral weakness and were much less familiar with marijuana, Dr. Blow said. He has now been sober for four years and has become a recovery peer advocate at Senior Hope, an outpatient clinic in Albany that caters to people aged 50 and older who are struggling with substance abuse. In the pandemic’s first year, death rates linked to alcohol and drugs climbed among seniors as lockdowns and isolation spread. Cannabis can interact with certain medications, like warfarin, a drug used to treat blood clots. And seniors who take sedative-hypnotics like Ambien or benzodiazepines like Xanax — or who drink alcohol — should consider avoiding cannabis, Dr. Solomon said, because when paired with those drugs, it can cause dizziness and confusion and make seniors more susceptible to falls and injuries. “It’s important to talk with a clinician or health provider, especially if you’re using it for medical reasons to treat chronic disease or chronic symptoms,” Dr. Han said.
- Experts recommend that older people have no more than seven alcoholic drinks per week.
- As the world’s population continues to get older, there is a growing need for assessments, treatments, and services that target older adults with substance use issues.
- 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.
- Cannabis can interact with certain medications, like warfarin, a drug used to treat blood clots.
- SAMHSA’s mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.
Among those admitted, 38.8 percent were for alcohol, 33 percent for opioids, and 5 percent for cocaine (TEDS-2017, 2017). Sex can be a risk factor for substance abuse, especially alcohol abuse, in older adults. Studies have shown that older women are more prone to the harmful effects of alcohol than older men due to their lower body mass and certain biological factors. Additionally, women may drink less often than men, but the same amount of alcohol will, on average, affect a woman more severely than a man.
Addiction Therapy Programs
Many older adults may begin to have problems with substances during transitional times in their lives such as retirement, loss of loved ones, new health concerns, and loss of independence (National Initiative for the Care of the Elderly, n.d.). Because older populations are more likely to experience stigmatization and thus be less likely to seek treatment or services, a non‐judgemental, harm reduction approach is necessary. Harm reduction is a helpful stance in practice because it can encourage rather than dissuade people, including older adults, to seek adequate care, facilitate access to medical and social services, and encourage care providers to be non‐judgmental in their care (Pauly et al., 2018). As a philosophy, harm reduction shifts the focus from stigma and discrimination to a focus on moral worth—and by promoting a view of older people as deserving of care versus a potential drain on resources. Using a harm reduction lens emphasizes that problematic substance use is better understood as a complex, relapsing, long‐term condition (Pauly et al., 2015) and shifts the culture of health care from one where resources may be rationed on the basis of deservedness to one where everyone is seen as deserving of care. A growing body of research demonstrates that in practice, harm reduction approaches build trust, avoid stigmatization and judgements, (Smye et al., 2011) and improve health overall (Pauly et al., 2018).
The strongly held societal view of substance use as primarily a “choice” often diverts attention from the underlying causes and factors that influence substance use; rather, it increases blaming and stigmatizing of people who use substances (Varcoe et al., 2018). In the context of this paper, stigma stems from interrelated social processes and negative societal attitudes towards the behaviour of people experiencing problematic substance use. Stigma is the disqualification from social acceptance and marginalization encountered by individuals who use substances, resulting in social exclusion, discrimination, ill health, and social suffering (Browne et al., 2012; Room, 2005).
The fraying of social networks and shutdowns during the first part of the pandemic exacerbated substance abuse, just as access to cannabis and alcohol increased — one could order drinks or cannabis over the phone and have them delivered to one’s home, Dr. Blow said. Alcohol and opioids can interact poorly with prescription medications that many older adults take for common conditions like hypertension, diabetes and mood disorders. Misuse can lead to falls and injuries, exacerbate underlying medical conditions and worsen declines in cognition. Physiological changes that occur with aging leave older adults more vulnerable to the ill effects of alcohol and drugs, as metabolism and excretion of substances slow down, increasing the risk of toxicity. It can impact any family, no matter how insulated you think your loved ones are from the risks and pressures of substance abuse. After recognizing a substance abuse issue, the first step is to connect your loved one with professional help.
Though alcohol and drug use typically subside with age, nearly a million adults aged 65 and older have a substance use disorder, according to government data. Some 3 percent use marijuana, and one in 10 binge-drink, which is defined for men as having five or more drinks on a single occasion, and for women as having four or more. Issues about stigma are particularly relevant for health care providers to consider when working with older adults who may be at risk for substance use. The terms substance use, substance abuse, addiction, and dependence are sometimes wrongfully used interchangeably.