Gray Area: Recognizing Substance Abuse in the Aging Population

Recognizing Substance Abuse In Seniors

People frequently picture young individuals struggling with substance use disorder when they think about common issues in life. While it is true that youth have a higher risk of substance usage, there has been very little study on the older population.

Despite the paucity of evidence, it is commonly accepted that substance abuse and addiction among the older adults is a global and American problem.

It is important to look out for these mental health issues, even though nobody likes to think their parents or grandparents could struggle with drug misuse or addiction—especially if they have no history. This article will outline the significance of the problem, how to spot indicators of substance use and misuse, and how to provide assistance.

Defining Substance Abuse 

Substance abuse is the excessive and harmful use of drugs, alcohol, or other psychoactive substances that can have negative physical, psychological, and social consequences. It is often characterized by a persistent pattern of using substances despite the negative consequences and a lack of control over the amount or frequency of use.

Prevalence of Substance Abuse in Older Adults

Substance abuse is rising among people 65 and older, with an estimated 4% prevalence. Alcohol, over-the-counter (OTC) drugs, and prescription pharmaceuticals, including opioids and benzodiazepines (BZD), are the most often misused substances. 

The baby boomer generation, which includes those born between 1946 and 1964, is thought to have contributed to this surge in part because they were exposed to alcohol and drugs heavily while they were younger. 

Although it might be challenging to identify substance abuse in older adults, once it is, there are additional difficulties because only 18% of treatment programs are tailored to this expanding group. Overall, substance abuse may raise the risk of fractures brought on by frequent falls, memory loss, sleep problems, anxiety, and depression

Why It Happens

Later in life, older adults experience major changes. They might experience tension and worry because of the following:

Some people turn to drinking or narcotics to relieve stress and pass the time. Also, the baby boomer generation (between 1946 and 1964) entered adulthood when attitudes about alcohol, marijuana, and other substances were evolving. Some people mature with those opinions.

Warning Signs of Substance Abuse in Older Adults

Substance abuse may be difficult to diagnose in persons of any age, but it is more challenging in the case of the older adults.

The indications of substance abuse are similar to the side effects of aging, which is one of the reasons it might be challenging to identify substance misuse in older individuals. Here are the signs of older adult substance abuse that you need to be mindful of.

A. Physical Signs

Substance abuse can cause some of the most observable physiological and psychological effects. For instance, your body tolerates a drug when used frequently or long enough to become accustomed to the substance’s high levels of presence. As tolerance increases, larger doses or stronger concentrations are needed to produce the same results.

People who use drugs to get high could start taking such high dosages to surpass their tolerance that they put themselves in a higher danger of overdosing, which might be deadly.

Additional indicators of potential substance abuse include changes in appearance, which might include:

  • Glare or eyes that are bloodshot.
  • Pupils that are dilated or constricted.
  • Abrupt fluctuations in weight. 
  • Alterations in hygiene.
  • Dental problems.
  • The skin morphs.
  • Sleep issues or excessive sleep.

Depending on the material and the procedure, different signs will appear.

B. Behavioral Signs

Substance abuse frequently causes a person’s behavior and habits to change drastically. Some medicines might make it difficult for the brain to concentrate and think effectively.

Problematic substance abuse is occasionally connected with behavioral changes like the ones listed below:

  • Heightened hostility or irritation.
  • Depression.
  • Abrupt modifications to a social network.
  • Drastic adjustments to routines or priorities.
  • Participation in illegal activities.
  • Alterations in personality or attitude.
  • Lethargy.

Understanding the physical and behavioral indications of substance abuse might assist in stopping the issue from getting worse.

C. Psychological Signs

Substance abuse also affects a person’s mental health. The person may not be aware of these changes while their addiction enslaves them. The following list is not exhaustive of the psychological symptoms of drug addiction:

  • Anxiousness
  • Inattentiveness
  • a lack of drive
  • irritability or explosive anger
  • personality or attitude changes
  • mental and emotional withdrawal from others
  • abrupt mood changes
  • irrational paranoia     

Getting someone into treatment is frequently made possible by family members and other close friends. Despite potential obstacles to assisting, such as using denial as a coping method, seeing the signs and symptoms of drug use may frequently spur a concerned individual to take action. 

Additionally, by being more knowledgeable about the abused substance, a person can better comprehend it and discover new methods to support a loved one.

Risks and Consequences of Substance Abuse in Older Adults

Older adults may struggle with various issues, including retirement, peer connections, and physical and mental health issues.  In addition, there are repercussions for the community, society, and family members.

A. Physical Health Risks

The health impacts of older adults’ substance abuse include accidental injuries (such as vehicle accidents), physical illnesses and impairments, and the effects of probable overdoses. Youth who use alcohol and other drugs in disproportionately high numbers run a higher risk of dying by suicide, homicide, accident, and disease.

While abusing substances may momentarily improve your mood, they can also reduce your inhibitions and increase your likelihood of taking risks that could result in harm or even legal or criminal repercussions. A drug’s harmful effects might be felt even after a few uses. 

By using a shared needle to inject drugs, you might be engaging in risky behavior that could result in the spread of dangerous diseases like HIV/AIDS or hepatitis. Abuse of drugs significantly raises the chance of developing a viral infection that can spread through blood or body fluids and may be fatal.

All of your body’s systems may be impacted by drug usage regularly. The way your brain transmits chemical signals to your central nervous system, which instructs your body how to operate, is affected by drugs. Substance abuse alters brain chemistry, and continued use alters how your brain functions.

Long-term substance abuse can also harm one’s physical and mental health.

Chronic drug usage increases your chances of:

  • Cancer
  • lung condition
  • Heart condition
  • mentally sick
  • infectious conditions
  • Addiction

Your body may adversely impact your health depending on how you use medicines. 

Specific drug usage techniques can have the following side effects:

  • Ingestion: Drugs can cause stomach ulcers and other gastrointestinal issues when swallowed.
  • Smoking: Burns to the hands and face can result from smoking drugs. You could also experience respiratory problems, including a persistent cough, and perhaps contract respiratory disorders like pneumonia.
  • Using medications intravenously (IV) or by injection: It increases the risk of getting sick from an infectious illness. It also leads to side effects, including cardiovascular problems like infections of the heart’s lining and difficulties like scarring at the injection site (track marks), collapsed veins, and scarring.
  • Snorting: Drugs can harm your sinus and nasal passages, impair your ability to smell, produce recurring nosebleeds, and create a runny nose.

B. Mental Health Risks

There are many various motives for why people take drugs and use alcohol. Whatever your motivation, abusing alcohol or drugs might have a lasting detrimental impact on you. The following are a few potential long-term consequences.

  • Need more to have the same impact.
  • Strokes and high blood pressure.
  • Issues with your pancreas and liver.
  • The emergence of some malignancies, including liver, bowel, and oral cancers.
  • A challenge in getting or keeping an erection.
  • Difficulties with orgasms.
  • Having trouble becoming pregnant.
  • Feeling compelled to utilize alcohol or drugs. This is referred to as dependence.
  • When you stop taking them, withdrawal symptoms might include feeling nauseous, chilly, sweating, or trembling.
  • Experiencing abrupt mood swings.
  • Having a pessimistic perspective on life

Long-term substance abuse can substantially negatively affect your mental health. Drugs may worsen your condition and increase your propensity to damage or end your life.

C. Social and Financial Consequences

Many drug addicts do not become homeless or financially ruinous. Some do, but typically the older adults who misuses drugs have a family who bears that person’s emotional and financial cost.

In families plagued by addiction, financial problems are a constant, even as families try all in their power to maintain a healthy lifestyle. Sometimes money meant for rent or food is spent on drugs instead, which increases food insecurity and the number of people who are homeless.

Other negative repercussions of drug usage on older individuals’ social and economic well-being include:

  • Conflict within the family that may involve physical or emotional abuse and neglect
  • loss of income and employment
  • family members are more likely to suffer from emotional and mental illnesses (such as anxiety and sadness)
  • Divorce and family separation, including the removal of children from their families

Prevention and Treatment of Substance Abuse in Older Adults

It hurts to suspect a loved one is struggling with addiction. However, admitting they have a problem might be the first step in assisting them in solving it. Caregivers and medical professionals can play critical roles in helping someone with a drug use disorder obtain help.

A. Prevention Strategies

Although there is not a single or certain strategy to stop someone from taking drugs or alcohol, there are things that everyone can do.

The top five strategies to stop substance abuse are as follows:

1. Recognize the progression of substance abuse. It begins by:

  • Using addictive substances, whether illicit or prescription, for fun
  • attempting to become drunk whenever you use
  • taking prescribed drugs illicitly

2. For mental illness, get treatment. Substance abuse and mental disorders frequently coexist. 

You should get professional assistance from a qualified therapist or counselor if you are struggling with a mental ailment like anxiety, depression, or post-traumatic stress disorder. A professional can teach you effective coping mechanisms to manage your symptoms without abusing alcohol or drugs.

3. Examine the danger signs. Examine your family’s history of addiction and mental illness. These conditions tend to run in families, but they may be avoided. Your chances of overcoming your biological, environmental, and physical risk factors increase as you become more aware.

4. Maintain a balanced lifestyle. When something is missing or not functioning in their lives, people frequently turn to drugs and alcohol. You may overcome these challenges and have a balanced, healthy life by developing stress management abilities.

B. Treatment Options

Whether an older adult qualifies for an inpatient or outpatient treatment program depends on the degree of the misuse or addiction or the length of time a person has used drugs or alcohol. If the issue is not handled properly, the consequences might be damaging or fatal.

1. Detoxification

Just like a young person with a substance addiction issue, older adults will benefit substantially from detox. Older adults who struggle with substance abuse can get the support they require from various addiction treatment methods, including detoxification. (detox).

This covers continuous care, outpatient drug abuse therapy, and inpatient addiction treatment, among other things. However, older adults and the specific detox and drug abuse treatment programs can assist in addressing some of the distinctive distinctions between older and younger substance abuse.

Detox is the first step in the recovery process for many senior citizens and others in their golden years who struggle with substance abuse. A detox may occur in an inpatient drug abuse treatment or through an outpatient substance abuse program, depending on the physical side effects of withdrawal and other factors in the patient’s home life or financial situation. 

The following may be included in general detox regimens for substance abuse  in older adults:

  • Stabilization: Stabilization is the phase after detoxification. The detoxification process starts and is carried out at this point. As the substance is removed from the body at this stage of substance abuse therapy, older adult patients and the older adult will get assistance and, in some cases, detoxification medicines to help lessen withdrawal symptoms.
  • Fostering into treatment: Older adults will get aid and expert advice to help transition into an outpatient treatment program during the last and third stages of detoxification.
  • Evaluation: The initial phase of a detox program involves an assessment. Patients thoroughly examine to determine the right degree of therapy based on the severity of the substance abuse. Additionally, older persons will be evaluated for co-occurring conditions, including depression, concerns connected to loss, and unresolved grief.

2. Rehabilitation

By providing patients with the self-management techniques and assistive devices they need or addressing pain or other problems, rehabilitation aims to eliminate or slow down the incapacitating effects of chronic health disorders, including cardiovascular disease, cancer, and diabetes. 

The purpose of therapy in the rehabilitation process is to assist patients in altering their attitudes, beliefs, and actions around substance misuse and to urge them to participate in treatment and lead healthy lives.

3. Medication-Assisted Treatment

Medication-assisted treatment (MAT) uses pharmaceuticals, counseling, and behavioral treatments to treat substance abuse on a “whole-patient” basis. MAT is primarily used to treat opioid addiction, including that heroin and opiate-containing prescription painkillers. 

The recommended prescription works to restore normal brain chemistry, stop alcohol’s and opioids’ euphoric effects, ease physiological cravings, and restore normal body functioning without the harmful side effects of the abused substance. 

Although MAT may be an effective treatment for certain people, it is only one tool in treating drug use disorders, and the most suitable therapy should be selected after consulting with a qualified healthcare professional.

4. Support Groups

Older adults can discuss their personal experiences in addiction support groups. Anyone with any addiction can benefit from joining certain organizations. Support groups might benefit addicts who also suffer from co-occurring mental illnesses like depression.

When cravings occur, support groups can offer addicts emotional direction and support.

The following advantages of substance abuse support groups:

  • interacting with new individuals that desire a sober lifestyle
  • acquiring knowledge to combat urges
  • obtaining assistance through challenging emotional circumstances
  • having others hold you responsible
  • Recognizing your support system

Must Read: Mental Health and Social Support Resources for Older Adults


Substance abuse is a significant social problem. Today, substance abuse is a problem in every region of the world. Substance abuse significantly impacts human resources and encourages the illegal manufacture and sale of narcotics.

Talk to your elderly loved ones if you are concerned about their drug or alcohol usage. Be honest yet compassionate and nonjudgmental. They may not be aware that they require assistance. They could claim they are okay. However, urge them to consult their physician. Consider getting their doctor, preacher, or a close friend to contact them instead if that does not work.