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As a group, elderly individuals have historically had relatively low rates of alcohol and other illicit drug use when compared to other age groups; however, as the Baby Boomer generation grows older, rates of use of these substances in aging adults are climbing.
Rates of illicit substance use in the past year has nearly doubled in each of the age brackets above 55 that are tracked annually by the National Survey on Drug Use and Health. Past year illicit drug use in adults aged 65 or older climbed from 3.0% in 2013 to 5.7% in 2018.1,2 For adults aged 60–64, past year illicit drug use was 6.5% in 2013 and hit 13.0% in 2018.1,2 For adults aged 55–59, drug use in the past year was 8.6% in 2013 and hit 15.2% in 2018.1,2
The number of older Americans with a substance use disorder is expected to rise from 2.8 million in 2002–2006 to 5.7 million by 2020.3
Getting older results in various changes, such as changes in life obligations, changes in health, and even changes in one’s circle of family and friends. Some of the major risks associated with an increased probability of developing a substance use disorder in elderly individuals include:4
Factors associated with prescription medication abuse in older adults include a history of a substance use disorder and medical exposure to prescription drugs with abuse potential.4 Being a smoker increases the risk of having problems with alcohol.5
The probability of substance use, specifically alcohol, is high for older adults suffering from depression and other affective disorders.4 At the same time, at-risk and problem drinking among the elderly are likely to exacerbate depressive disorders.6 At-risk drinking and co-occurring depression are associated with suicide ideation and completed suicides.6
Although the formal diagnosis of any substance use disorder is made according to criteria applied to all age groups as published in the Diagnostic and Statistical Manual of Mental Disorders (DSM),7 evidence points to some signs that may indicate there is a substance use disorder include physical, psychiatric and social signs and symptoms.
Physical signs or potential indicators include:4
Psychiatric symptoms or potential indicators include:4
Social symptoms or potential indicators include:4
Research and surveys, such as those sponsored by the Substance Abuse and Mental Health Services Administration and the National Institute on Drug Abuse, provide data on the use, misuse, and abuse of drugs by the elderly. The data indicates the following:
Elderly individuals respond just as well to standard treatment protocols for substance use disorders as other groups. When seeking treatment for an elderly individual, keep the following in mind:
Overall, there are several major considerations that apply to increasing the effectiveness of treatment protocols focused on elderly individuals. These include: