A Day in the Life of Older Adults: Substance Use Facts CBHSQ Data

Psychometric properties of the CAGE-AID have not been reported, yet the CAGE has been extensively studied. Because of the brief nature of the CAGE-AID, it can be a useful screening tool; but it should not be a substitute for a more thorough assessment, such as consumption levels, consequences of use, and functional deficits. Trained Drug Abuse Warning Network (DAWN) staff reviewed medical records (charts) of emergency department (ED) visits on an ongoing basis at a nationally representative sample of hospitals to find drug-related ED visits that met the DAWN case criteria. The estimates presented in this report were based on the drug-related visits made by patients aged 65 or older found through a review of 5.2 million charts for ED visits occurring in calendar year 2011 in 233 hospitals. On an average day during the past month, 132,000 older adults used marijuana and 4,300 used cocaine (Figure 1).

substance abuse in older adults

It’s essential for family members and physicians alike to educate seniors on proper medication usage and side effects so they can avoid any potential misuse down the line. Mental health conditions such as depression or anxiety can affect how a person perceives https://ecosoberhouse.com/article/abuse-in-older-adults-a-growing-threat/ and responds to stimuli, making them more vulnerable to risky behaviors like substance misuse. Seniors with co-occurring psychiatric disorders may be more likely to try drugs or alcohol as a means of self-medicating to cope with their symptoms.

Substance Use in Older Adults DrugFacts

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It’s essential for family members and healthcare providers alike to be aware of this risk factor so they can take steps to prevent it in their loved ones. According to Harvard University, older adults metabolize alcohol more slowly than younger people. This means that drugs can stay in their system longer and have a more significant effect. Additionally, their brains can be more sensitive to substances due to aging-related physical changes, such as decreased neurotransmitter levels or slowed metabolism.

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Treatment options remain generally limited, as few programs or health care settings offer tailored interventions for older adults. Health care professionals need to continue to do as thorough of assessments as possible and enlist the help of formal measures, Web-based assessment, and build in the questions outlined earlier as routine. As the baby boom generation ages, the health care system will be challenged to provide culturally competent services to this group, as they are a unique generation of older adults. Knowledge about older-adult substance use and the issues that contribute to late onset or maintained addiction in late life will need to be continually updated as we learn how and why this generation of adults uses substances. Furthermore, the advancement and development of interventions that may be more useful for, effective for, and desired by this incoming generation of older adults than previous generation, such as mobile interventions, will be crucial to alleviating the projected pressures on the health care system.

For example, some people with alcohol use disorders may occasionally binge drink, while others drink daily. Seniors are frequently unaware of the risks they are taking by misusing or abusing psychotropic substances. They may be taking these substances in the same doses or amounts they always did without realizing they now face a higher risk. That is why objective information about the dangers of alcohol or prescription drug use can be helpful.

Why Do Seniors Abuse Drugs and Alcohol?​

This type of disorder is particularly concerning when it affects seniors, as they can be especially vulnerable to the consequences of drug addiction. Isaak learned addiction psychology at Aspen University and got a Master’s Degree in Arts in Psychology and Addiction Counseling. 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. Physicians rely on the criteria outlined by the DSM to diagnose substance abuse disorder in the general population. That is perhaps the main reason for misdiagnosis and lack of treatment of seniors – these criteria are less relevant to them. Moreover, they can unknowingly become addicted to these medications, making it another cause of substance abuse in the elderly.

substance abuse in older adults

The Michigan Alcohol Screening Test-Geriatric Version (MAST-G)101 is an instrument designed to identify drinking problems and was developed specifically for the elderly by modifying the Michigan Alcohol Screening Test. This screening tool contains 24 questions with yes/no responses; 5 or more positive responses indicate problematic use. The MAST is highly sensitive and specific and generally has strong psychometric properties.102 It is also administered in a short form, the SMAST-G, which has 10 questions, with 2 positive responses indicating a problem with alcohol.

Co-Occurring Psychiatric Disorders

Because of the diagnostic challenges outlined earlier, the MAST-G focuses more on potential stressors and behaviors relevant to alcohol use in late life, as opposed to questions toward family, vocational, and legal consequences of use. 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. The questions can be adapted to a specific substance, such as a prescription medication, and they can be asked either in the context of an interview or self-administered.

substance abuse in older adults

Additionally, the effects of some drugs—like impaired judgment, coordination, or reaction time—can result in accidents, such as falls and motor vehicle crashes. These sorts of injuries can pose a greater risk to health than in younger adults and coincide with a possible longer recovery time. NSDUH is an annual survey that collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.

Prescription Drug Abuse

We may be paid a fee for marketing or advertising by organizations that can assist with treating people with substance use disorders. Lehmann hopes further research on older adults with substance use disorders will lead to better-targeted screening methods and new models of care. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) is another instrument developed by the WHO to screen across substances for potential problem use.106 It is an interview-based tool that consists of 8 questions that help identify the level of risk to help guide decisions for intervention. The ASSIST has yet to be validated among older adults, and there is at least anecdotal evidence that it underperforms in this population in part because of the same limitations with a formal DSM diagnosis; the criteria do not apply in the same way for older adults as they do with younger adults. Family, friends, and doctors often don’t know when older people have a problem with alcohol and drugs. Sometimes, people notice but ignore it, thinking it’s best for older people to keep doing what makes them happy.

  • TEDS data are reported to SAMHSA by state substance abuse agencies and include information on admissions aged 12 and older to facilities that receive some public funding.
  • Because comorbid psychiatric disorders, such as anxiety, depression, and personality disorders, are common and recognized among younger adults, it is assumed that these comorbidities also continue into late life.
  • When assessing or speaking to older adults about substance use, some general considerations should apply.
  • Older adults may not easily relate to or feel uncomfortable discussing their problems with younger persons.
  • Hand-in-hand with prescription drug misuse is the prevalence of chronic pain in aging populations.
  • “My first job as a clinician,” says Lehmann, “is to convince these patients to cut back on using.” Involving the family is critical, she adds, because a spouse or partner may also be drinking heavily and could be sharing opioids with loved ones.

The National Institute on Drug Abuse reported in 2019 that rates of substance use had climbed in adults between 50 and 64 years old and in those 65 years and older in the previous decade. It’s been called the “invisible epidemic.”  But knowing what to look out for can help you protect yourself or a loved one. Combined 2007 to 2014 NSDUH data indicate that, on an average day, 6.0 million older adults used alcohol (Figure 1).5 Older adults who used alcohol in the past month drank an average of 1.8 drinks per day on the days they drank. NSDUH data indicate that older adults who used alcohol in the past month drank on an average of 11.1 days per month. This trend concerns family members of older Americans, as well as healthcare providers and social workers who work with this vulnerable population. It’s essential to understand why seniors are increasingly suffering from addiction so we can better prevent it in older adults.