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Substance Abuse in the Elderly: Golly, That’s the Dickens!

Our population of Baby Boomers over the age of 60 is not just burgeoning—it has burgeoned so that they make up a significant part of the population. Middle-aged and young adults who interact with their parents and grandparents are often surprised to consider the idea of substance abuse in the elderly. But why wouldn’t there be a higher level of addiction among our senior citizens? Weren’t they the Woodstock generation? Didn’t some of them at one time believe in tuning in, turning on, and dropping out?

That doesn’t mean that anyone who ever danced to Good Golly Miss Molly is a menace to society. There are plenty of Baby Boomers who spent the Sixties and Seventies going to college, fighting in Vietnam, and working hard to raise their families. It’s true, however, that substance abuse in the elderly has risen in proportion to their place in the general population—and so as more people are retiring nowadays, more of them suffer from substance abuse of some kind.

The Dire Statistics

According to the government’s Administration on Aging, the population of those aged 60 or older increased by 31% between the years 2003 and 2013. The number of Americans over the age of 60 now exceeds 62 million people. That means that one-seventh of all Americans are senior citizens. And some of them are abusing alcohol, drugs, or both.

Addiction Professional Online tells us that substance abuse in the elderly has increased at a startling rate. The younger people in their lives are unsuspecting that Grandpa may be chasing down his arthritis pain pills with a shot of whiskey. They blame changes in mental clarity on the aging process and they never suspect it could have some connection to addiction. The family doctor lacks the time to consider signs of substance abuse in the elderly and writes them off to a disorder diagnosed as the person ages: Sleeping a lot could be a sign of opiate addiction, but the doctor figures it may hypothyroidism, the effects of cardiology issues, or just plain aging.

Substance abuse in the elderly patient is even less likely to be diagnosed if that friendly family doctor has been seeing him or her for many years. The harried doctor doesn’t stop to question the person about how their social habits have changed over time. The doctor sees in the elderly patient a person who is much like his own grandparent, merely exhibiting signs of aging and not signs of addiction.

The government’s Substance Abuse and Mental Health Services Administration (SAMHSA) tells us that substance abuse in the elderly represents “a situation that remains under-estimated, under-identified, under-diagnosed, and under-treated.” The people in their lives typically fail to notice behavioral changes. They worry much more about the teens and youngsters they are raising. They think that if their pain pills and cocktails make their elderly parents happy, then who would they be to interfere with that?

The sad truth is that most elderly people who abuse pain pills or alcohol—or both—generally are lonely and bored. It’s just not true that most elderly people go into nursing homes; SAMHSA tells us that only 4.6 of the population over the age of 65 lives in a nursing home or in a personal care home. A huge portion of the elderly population lives independently. When questioned by researchers, adults who abuse alcohol or drugs admit that they feel lonely and unappreciated. Emotional mood disorders escalate in the elderly population, affecting approximately 30 percent of them.

Substance Abuse in the Elderly Happens More Easily Than You Think

Substance abuse in the elderly rarely involves purposeful opiate abuse. However, many senior citizens do take pain pills for arthritis or other painful conditions, or they use much more cough syrup than they should. Their younger family members seldom stop to think of the dangers of taking opiate pain pills or a cough medication containing codeine while they enjoy their nightly cocktail.

While they may not have a prescription for an opiate pain pill, there are far more prescriptions for or sleep aids written for the elderly. Taking benzodiazepines with alcohol is just as deadly as taking them with opiates.

SAMHSA admits that it’s just so hard to define the exact age when you should begin watching your elderly relatives with more care. Some adults function well into their 80s—or beyond—and some lose cognition around the age of 60.

Barriers to Treating Substance Abuse in the Elderly

We’ve already touched on some of the clinical barriers to effective treatment in a general way. Below are those specifically identified by SAMHSA:

Ageism: We’re all guilty of thinking, it’s just their age. It’s nothing to feel bad about, because many middle-aged people may experience health changes and fail to have them checked out simply because they know they’re getting older.

Failure to Recognize: This may be associated with the stigma against addiction. One never wants to think that their grandparent is one of those elderly who are addicted. If they stumble and walk stiffly, we assign it to their aging and never question whether they are having difficulty maneuvering around the house. If they seem confused, we know it’s just old age and not a couple too many OxyContin.

Professional Nonchalance: Medical and mental health professionals alike generally fail to spot substance abuse in the elderly patients they serve. For one, they fall victim to the same stigma-related black-out as family members. And during the intake portion of a visit, they have so many questions to ask—ranging from body function to aches and pains to how are ya doin’ since so-and-so died? They are also quicker to suspect the elderly of alcoholism but not so quick to consider opiate addiction.

Illness. In the medical community, the proper term is comorbidity. It refers to medical conditions, mental health problems, deterioration of mental acuity, difficulty in ambulating, and more. A doctor may fail to recommend that they attend AA or NA because they think they are too old to fit in with the group or to be open to major lifestyle changes.

Other Barriers. Treatment for substance abuse in the elderly often fails to happen because the affected person cannot arrange transportation to treatment, even if they recognize that they need help. They have few friends in whom they can confide. If they are looking after a debilitated spouse or even a grandchild, they may not have the time to seek out treatment. And lack of insurance can pose a barrier. Even with the Affordable Care Act, it’s necessary to find a Medicare-paneled provider at a substance abuse program that offers treatment for substance abuse in the elderly.

Do you have an elderly relative who may be abusing alcohol, drugs, or opiate medications? Are you reading this wondering if you are the elderly person who needs help? Don’t allow age or embarrassment to prevent you from seeking the help you need. At the very least, you can walk into your local methadone treatment center and find out what treatment options are available. You owe it to the people who, after all these years, still need you and love you.

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