Early vs. Late Onset Drug and Alcohol Use

For some, the use of substances began in their youth; with marijuana and alcohol as the entry point that continued to have a negative impact on the quality of their lives. For others, being prescribed medication for post-surgical pain control opened the door to physical and psychological habituation.

According to a report from the Substance Abuse and Mental Health Services Administration (SAMHSA), “An estimated 4.3 million adults aged 50 or older, or 4.7 percent of adults in that age range, had used an illicit drug in the past year, based on data from the 2006 to 2008 National Survey On Drug Use and Health (NSDUH) surveys.”

An article by E. D’Archangelo titled, “Substance Abuse in Later Life,” Canadian Family Physician 39: 1986-1993, states that, “Older patients are prescribed benzodiazepines more than any other age group, and North American studies demonstrate that 17% to 23% of drugs prescribed to older adults are benzodiazepines.”

Get Out of the Cage

The American Psychiatric Association designed a simple four-question test called CAGE to determine potential problems with drinking or drug use.

C — Have you ever felt you should Cut down?

A — Does others’ criticism of your drinking (or drug use) Anger you?

G — Have you ever felt Guilty about your drinking (or drug use)?

E — Have you ever had an Eye-opener or to rid yourself of a hangover in the morning?

A score of one indicates concern, while a score of two or greater is considered clinically significant.

Factors That Contribute to Addiction Among Older Adults

  • Loneliness and isolation
  • Chronic illness
  • Injury
  • Retirement
  • Depression and anxiety
  • Inability to provide self-care
  • Ageism that becomes self-perpetuating and accompanying fear of aging
  • Difficulty metabolizing alcohol
  • Receiving multiple prescriptions from various medical professionals without continuity of care and communication between them
  • Widowhood
  • Empty nest syndrome
  • Taking care of grandchildren and aging parents

Dangers of Substance Abuse for Seniors

Symptoms of impairment may be mistaken for age-related memory loss. An elder’s regular cocktail — or several, may be accepted as normal behavior that makes them happy. Depression might be deemed an expectation as one ages. The unregulated use of prescribed medications and alcohol contributes to a greater fall risk. Since many seniors live alone, there may be no one to check on their safety.

Barriers to Treatment

Paul Quigley, MBChB, FACEM, of Wellington Hospital in New Zealand, refers to elders as “invisible addicts,” and attributes some of the challenges they face to minimal or lack of thorough screening in medical settings.

Others include:

  • Limited awareness in the medical community
  • Need for education among family members
  • Shame within the individual that he or she has a problem
  • Focus on medical conditions takes precedence over psycho-social needs
  • Inability to get to therapy or 12-step meetings if there is no access to transportation
  • Financial limitations on a fixed income

Treatment Options

Since the aging population has unique physiological and psychological needs that are not present in younger clientele, it is essential that the treatment facility has staff who are experienced and trained to meet them. A medical doctor who is an addictions specialist would be of benefit as well.

The golden years need not be tarnished by addiction.

By Edie Weinstein, LSW Follow Edie on Twitter at @EdieWeinstein1


Choose a better life. Choose recovery.