Patient Daily Living

Taking A Proactive Approach Against Substance Abuse in Older Adults

A Comprehensive Guide to Senior Substance Abuse

When it comes to alcoholism and other types of substance abuse, most people tend to associate these negative lifestyle choices with teenagers and young adults. However, the truth is that young people aren’t the only ones who are at risk from substance abuse: the aging and the elderly are also at risk! Unfortunately, since common perception dictates that substance abuse is a younger-person problem, senior citizens who are suffering from a substance abuse issue are often ignored, overlooked, and left untreated.

In this article, we hope to tackle some of the main issues revolving around senior substance abuse, from common misconceptions and public perception down to the actual influential factors that put senior citizens at risk. Our population is aging every day, and as more individuals are reaching their golden years, senior substance abuse is showing no signs of slowing down. In fact, it’s quite the opposite: the number of hospital admissions as a result of senior substance abuse has risen by 3.6% in recent years!

This silent epidemic is steadily becoming more commonplace in nursing homes, assisted living facilities, and households across the United States. Does its rapid growth stem from willful ignorance of the problem, or rather, is it a result of our inability to accurately diagnose & treat these afflicted seniors? Perhaps both situations have their own truths. Let’s take a closer look to find out.

Warning Signs of Substance Abuse & Addiction in Older Adults

Many warning signs of substance abuse & addiction are universal. Regardless of age, these signs are nearly always present, but since many of these signs mirror normal senior issues, it’s extremely easy for both family & medical staff to overlook them. Here are a few universal signs of substance abuse and addiction.

  • Memory Loss - Our memory worsens naturally as we age, which is why this common sign of substance abuse is so easy to overlook. In many cases, memory loss is a legitimate issue, stemming from a decrease in blood flow to the brain, or something more severe like Alzheimer's Disease. However, an increase in substance consumption can also have a negative effect on one’s mental capacities, causing them to forget small details or even entire events! You should try to observe these behaviors, using any patterns to identify potential issues.
  • A General Lack of Interest - With age comes declining health, which—for many—means enjoying favorite pastimes like traveling or partaking in sports are no longer realistic. The inability to partake in the pastimes is sure to take a toll on one’s mood; other common senior issues include the loss of a loved one, drastic living changes, or chronic pain. While a general lack of interest could be a sign of depression, it may also be a sign of substance abuse. Much like their younger counterparts, senior citizens often turn to substances when their day-to-day lives feel uncomfortable or unbearable.
  • Trouble Sleeping - Senior citizens often suffer from insomnia and other sleeping issues, making it hard to differentiate age-related issues from substance-induced ones. Depending on the medication your loved one is taking, they may struggle to fall asleep or they may even struggle to stay awake! While these may be normal side effects from the medication, these signs can also indicate potential substance abuse. When in doubt, it’s best to investigate.
  • Sudden Mood Changes - Major life changes (such as the death of a spouse or a change in lifestyle) often result in major mood swings. Some may be positive; some may be negative. This is normal, but if there doesn’t appear to be a reason behind the sudden mood change, it may be a result of substance abuse.
  • Withdrawal Symptoms - Out of all the common signs of substance abuse in this list, withdrawal symptoms are the only one that’s relatively easy to identify. Although sudden mood changes can definitely be one of the many withdrawal symptoms, in this section, we are referring specifically to physical withdrawal symptoms. These include the “shakes”, elevated blood pressure, sweating, diarrhea, goosebumps, and other noticeable symptoms. In more severe withdrawal cases, victims may even have a seizure or—in the case of alcohol withdrawals—DTS (Delirium Tremens). If you notice a loved one experiencing any withdrawal symptoms then it’s vital that you take them to a healthcare facility right away.

Statistics of Drug and Alcohol Abuse in Seniors

  • Up to 17% of adults over the age of 60 suffer from some type of substance abuse disorder.
  • Over 80% of adults ages 57-85 take at least one prescription medication.
  • Nearly 40% of adults ages 57-85 take five or more prescription medications.
  • Seniors over the age of 64 use 34% of the prescription medications in the United States (and 30% of the OTC medications).
  • Approximately 65% of American seniors (age 65 or older) drink more than the recommended amount.
  • Widowers (75 or older) currently have the highest rate of alcoholism in the United States.
  • Seniors over the age of 65 are recommended to have only one drink per day, yet more than 10% of U.S. seniors consume more than four or five drinks in a single sitting!

Alcohol Abuse in Senior Citizens

Although more controversial substances like marijuana, MDMA, and ketamine are steadily working their back way into the medical field, the biggest issue that seniors face often doesn’t come from “illicit street drugs”. Instead, it comes from a substance that’s readily available and easy to consume: alcohol!

Overconsumption of alcohol can have negative health effects at any age, but for those above the age of 65, the results can be even more drastic. The effects of impairment are augmented by age, with vision, hearing, and reaction times all taking a turn for the worse. Since senior citizens generally have a slow metabolism, their inebriation will last for longer, and they’ll likely get intoxicated quicker than their younger counterparts.

Alcohol consumption in itself can pose a great risk for seniors, but more problems can occur if alcohol is mixed with medication. Mixing some medication with alcohol can have fatal results, so it’s always best to make sure that your loved one isn’t going against the doctor’s recommendations. If a prescription says it can’t be consumed with alcohol, then it’s important to abstain from drinking!

Of course, there isn’t a unique reason that seniors can fall into alcohol dependency or even addiction: it’s simply another form of self-medication. Unfortunately, alcohol often worsens the symptoms your loved one may be trying to treat. Since alcohol is a depressant, heavy use will actually promote depression, anxiety, and sleeping issues. Long-term use can also have negative physical health effects, leading to ulcers, high blood pressure, and liver disease. When in doubt, it’s always best to consult with a doctor about the safe level of drinking for your loved one.

Prescription Drug Abuse in the Elderly

Alcohol abuse is very common, but perhaps even more common among the elderly is prescription drug abuse. Prescription drug abuse is when a senior citizen takes more of a prescribed drug than is recommended by their doctor, often on purpose but sometimes even by mistake! In some cases, the individual may be seeking a “high”.However, most seniors simply have developed a tolerance, which means they may simply need more of the drug to achieve the same result (this is especially common with opioid pain medication).

Let’s take a look at intentional prescription drug abuse first. When a senior abuses prescription drugs, their primary goal will be to consume more of the drug in question. Naturally, if they take more than prescribed, they will quickly run out of medication, which may cause them to change their daily behavior. If you suspect that your loved one is abusing prescription drugs, here are a few things to look out for.

  • Obtaining Duplicate Prescriptions - Elderly persons will often attempt to skirt the limitations of their prescriptions by visiting multiple doctors to receive multiple prescriptions for the same medicine. You should watch out for this tell-tale sign of prescription drug abuse in your loved one.
  • Filling Prescriptions At Multiple Locations - A senior who has managed to obtain duplicate prescriptions will not be able to fill both of them at the same location without arousing suspicion. Instead, they will visit multiple locations to fill their various prescriptions. While it’s fairly common for seniors to visit a few different pharmacies in order to fill all of their prescriptions, you must make sure that there aren’t any duplicate prescriptions in the mix.
  • Increased Usage - Individuals who suffer from prescription drug abuse will often need more than the recommended dosage to meet their needs. This is especially common with pain medication. Steady usage over time will increase the person’s tolerance to the effects of the drug(s). Unfortunately, this means that they’ll require a higher dosage to achieve the same result. Pay close attention to ensure that your loved one doesn’t exceed the dosage recommended by their doctor.
  • Having a “Backup” Bottle – Many seniors use pill organizers to help them stay on schedule with their medication. However, if your loved one is carrying around an extra bottle of medication “just in case”, that may be a sign of prescription drug abuse.
  • Concealing Medication - If you catch an elderly person attempting to conceal either their overall drug consumption or the quantity of medication that they have in their possession, it’s surely worth investigating. Concealing medication is a red flag when it comes to prescription drug abuse & dependency.

Why Substance Abuse in Older Adults is So Common

It’s easy to label and disregard someone for their substance abuse issues, but things seem much closer to home when it’s a loved one in our lives. While young people may be well-known for their substance-abusive tendencies, many older people face the same (or greater) struggles! Age brings about many changes in life, such as the death of a spouse, the passing of a friend, a change in lifestyle, physical limitations, or an obligatory change in living situation. These factors all weigh heavily on our senior citizens, often causing them to spiral downward into loneliness and depression. They often turn to substance abuse as a way to self-medicate against this depression, but unfortunately, this never solves the root(s) of the issue(s).

Why Senior Substance Abuse is Often Misdiagnosed

With all of the changes going on in their lives, it’s not surprising that so many seniors suffer from loneliness, anxiety, and depression. Many of them don’t turn to substance abuse as a form of self-medication, but even those who don’t make it much harder to diagnose and treat senior substance abuse. The irritability, rapid mood changes, sleep issues, and other side effects of withdrawal are all strikingly similar to those who’ve been diagnosed with depression or anxiety. This can cause both doctors and family members alike to confuse one for the other, delaying much-needed treatment and causing the senior’s situation to worsen over time.

Those who abuse substances are usually very good at hiding them from those around them, often going years before being detected. Even if their secret is discovered, there sadly is no guarantee that they’ll be given the treatment they need. Many people think there’s little point in treating the elderly, so even though their substance abuse may have been noticed, it’s still possible that it will be allowed to continue unhindered by a family member, doctor, or home nurse who thinks they’re “too far gone”.

However, senior substance abuse isn’t always an intentional act. For many elderly citizens, simply remembering to take the right medication at the right time is too big of a task for them to handle. They’ll forget that they’ve already taken their medication, unintentionally double-dosing. Unfortunately, whether done intentionally or unintentionally, this still constitutes substance abuse, and long-term substance abuse can quickly lead to a chemical dependency on your loved ones.

Treatment Options for Elderly Substance Abuse

So far, we’ve discussed two main types of elderly substance abuse: intentional and unintentional. Each one has its own unique treatment options, so let’s compare them below.

  • For intentional substance abusers, the available treatment options are the same regardless of age. Counseling, out-patient treatment, in-patient treatment, and medical detox constitute the main treatment options, but there are also resources such as holistic therapy that may be beneficial to the recovery of a senior. Regardless of which path a person must take, each path begins at the same place: can the senior admit that they have a problem? Without the recognition of an issue and a personal desire to change it, most substance abusers will relapse. This is the hardest truth of elderly substance abuse: You cannot simply will your loved one to change. They just want to do it themselves.
  • For unintentional substance abusers, the suitable treatment options depend on how long they’ve been abusing substances and whether or not they’ve developed a chemical dependency. If they have developed a dependency then treatment measures like the ones discussed above will be the most suitable. However, some individuals may not have progressed long enough to develop a chemical dependency. For them, suitable treatment may be as simple as purchasing a larger pill organizer or hiring in-home help to assist them with their daily medications. The ideal treatment for unintentional substance abusers is entirely dependent on how they’re unintentionally abusing their medication. Once the root of this issue has been resolved, they will be able to avoid future unintentional substance abuse.


Elder substance abuse is an issue that’s rarely talked about, and yet it is so prevalent in the lives around us. Every case is unique, formed from the situational differences, life experiences, and specific circumstances of all those involved. As a society, it is time for us to stop letting seniors suffer in silence and start to take a proactive approach towards senior substance abuse. We can all help prevent abuse by:

  • Ensuring prescriptions are up-to-date. An increased tolerance can stand in the way of a senior’s ability to effectively manage their pain. However, self-medication isn’t the answer. Instead, take your loved one to the doctor on a regular basis, and schedule special appointments if they start to complain about decreased effects.
  • Monitoring drug and alcohol consumption. Without living with a senior, it’s impossible to monitor their overall drug and alcohol intake all the time. However, you should work together with your support system (home aid, nurses, other family members, etc.) to ensure that your loved one isn’t taking more than the prescribed medication, or drinking to excess. If a situation arises, make sure to alert the rest of your support system so that everyone is on the same page.
  • Visiting your loved ones regularly. Loneliness and depression are two common motivators behind senior substance abuse. While it’s impossible to claim that simply visiting them will cure them of their depression, doing so will not only give you a chance to check up on them but will also let them know that they’re not alone.
  • Enabling seniors to succeed. Without the proper resources (such as daily reminders or pill organizers) it can be extremely hard for seniors to manage their medication(s). Make sure you’ve done everything in your power to help your loved ones stay on top of their medication schedule.
  • Providing the necessary treatment resources. Whether through intentional or unintentional substance, there may one day be the need for substance abuse treatment. You should always ensure that these resources are readily available should they be necessary.

Your quality of life shouldn’t spiral downwards simply because you’ve aged. By taking the proper steps and precautions, we can help ourselves and the seniors around us live enjoyable, fulfilling lives. Recovery is always in reach, so don’t wait. Help prevent (and treat) senior substance abuse today for a happier tomorrow.

- Written By

Anastasia Hobbs

Elder Care Expert
With over 20 years of experience in the eldercare industry, Anastasia Hobbs is a true elder care expert. Anastasia is passionate about providing compassionate care for elderly individuals and helping them stay independent.