Substance Use in Older Adults DrugFacts National Institute on Drug Abuse NIDA

Sometimes, people notice but ignore it, thinking it’s best for older people to keep doing what makes them happy. Naloxone does not treat OUD or pain by itself, but it can reverse potentially fatal opioid overdoses. It is so effective that WHO lists it as “an essential medication.”166 Older adults are at increased risk of opioid overdose. Bodily changes that occur normally in aging cause older adults to experience a higher concentration of opioid metabolites than younger adults when the same dose is consumed.167
Low-dose naloxone is safe and effective in older adults in case of opioid overdose.

  • “When developing cannabis legislation, unintended consequences should be considered, including increased risk of cannabis use disorder in large vulnerable subgroups of the population such as patients with chronic pain,” the authors write.
  • Older adults also often take more than one medication, which increases their odds of being exposed to harmful drug interactions.
  • Blood flow can decrease, and relationships between neurons can change, influencing cognitive function.
  • For some, this creates a desire to get more pain medication than prescribed, because of tolerance.

The data are featured in two new reports released today by CDC’s National Center for Health Statistics (NCHS). 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 substance abuse in older adults for ED visits occurring in calendar year 2011 in 233 hospitals. In fact, most seniors experience reduced tolerance due to age-related physiologic changes that augment the effects of alcohol and other drugs. According to a study by Moore and Endo, the results of which were published in the Journal of the American Geriatric Society, the higher rate of comorbid physical and psychiatric conditions and the prescription medications used to treat them render older adults extremely vulnerable to the impact of alcohol.

Diagnostic Issues in Working With Older Adults

Here at, where we consult with the families of elders, we hear all too often that Mom or Dad drinks heavily every day. The adult children get overwhelmed by the compounded effects of alcohol on their parents’ care needs. Different years of NSDUH, TEDS, and DAWN data were used in this analysis because they are the latest years of data available. All NSDUH estimates in this report are annual averages based on combined 2007 to 2014 NSDUH data.

Also, for disulfiram to be useful, clients must stick to strict medication protocols.141 Doing so may be hard for older adults who have cognitive impairment or live alone and have no one to support them in taking medication as prescribed. A meta-analysis suggests that when compliance with disulfiram is not monitored, its efficacy is no different from that of control conditions.142
Monitoring for adherence is essential for disulfiram to be effective. People taking disulfiram may also need to be observed, as some may stop taking it on a day during which they want to drink. Chapter 3 of this TIP offers further information about substance misuse screening measures and how to follow up with clients who screen positive as well as those who screen negative.

Prescription Drug Abuse​

Asking for guidance on safety is crucial when taking multiple OTC medications or using them in combination with alcohol or a prescribed medication. Therefore, the discussion surrounding alcohol and other substance use should take place in the context of an older adult’s overall assessment with the goals of improving health, maintaining function and independence, and improving quality of life. Indeed, recent projections show that by 2020, substance use disorders among adults over age 50 will increase to 5.7 million, up from 2.8 million in 2006. The rise in use of alcohol and drugs, says Lehmann, is in large part attributed to baby boomers — those born between 1946 and 1964. Many, she says, came of age during an era of substance experimentation and have been “using” for decades. On an average day during the past month, 132,000 older adults used marijuana and 4,300 used cocaine (Figure 1).

All three methods are reliable and valid.120 Any positive responses should lead to further questions constituting full assessment (or referral for full assessment by a qualified provider). 2.9 percent for individuals with less than a high school education, 3.1 percent for individuals with a high school education, and 4.5 percent for those with at least some college.

Overview and Scope of the Substance Misuse Problem

Warren no longer had the capacity to change his will or trust, which was the protection he had put on his house. Despite its deteriorated condition, it was in an expensive area and had considerable worth. Would she take Warren to a lawyer and have the lawyer change the beneficiary of the trust from Rikki to herself? At the very least, he seemed happy to be returning to the town of his birthplace and to be in contact with his sister. What was his sister’s motivation to suddenly show up and assume responsibility for the care of Warren when she had not done so over the years of his slow decline from his former independence? Between his military pension, a veteran’s benefit (Aid and Attendance) Social Security, and the rental income, Warren could just meet the cost of the assisted living home.

substance abuse in older adults

One can help an elderly parent or grandparent do so by asking if they are taking any medicines that could cause drug interaction and communicating the symptoms of prescription drug misuse or abuse to them. If they are taking several prescription drugs for different health conditions at once, it would be very helpful to write down the doses and administration times in big letters on a sheet and put it up where they will see it, like on the fridge. Let them know they should always turn to their loved ones and a doctor if they feel like they’ve become dependent on a particular medicine or other substance. Older adults have unique risk factors that increase their vulnerability to substance misuse, but signs and symptoms of SUDs often resemble those of other health issues, making detection difficult.

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