Drug addiction among the elderly: a growing crisis

A worried senior in a cafeDrug addiction and abuse among the elderly has steadily increased over the last decade. This is partly due to the fact that Baby Boomers have always had comparatively high rates of substance use and abuse. As they get older, the use of prescription drugs is becoming more prevalent in this group, increasing the risk of addiction. For example, a person who initially takes a painkiller to treat arthritis pain can quickly become addicted.

A 2015 analysis by the AARP for the Public Policy Institute found that 1.2% of older people admit to prescription painkillers. The actual prevalence rate may be even higher. As with most age groups, however, the main source of addiction in the elderly remains alcohol.

Facts about substance abuse in older adults

According to the United States Census Bureau, in 2012, in the US 43.1 million seniors over 65 years of age. According to 2007-2014 data from the National Survey on Use and Health:

  • It is estimated that 5.7 million seniors will have substance abuse by 2020.
  • On an average day, 6 million seniors use alcohol, while 132,000 use marijuana and 4,300 use cocaine.
  • On an average day in 2011, 2,056 seniors visited the emergency room for drug-related reasons. Prescription and non-prescription analgesics were the main cause of these visits.

USA. have seen a sharp increase in the use and abuse of opioids in the last two decades. Opioid overdoses are now killing more people than breast cancer. The elderly are not the age group most likely to abuse opioids, although they may be more vulnerable to opioid-related health issues than other groups. Older people with health problems may be less physically resistant, increasing the risk of overdose of opioids. When opioids interact with other drugs, the effects can be fatal.

Recognizing the addiction to seniors

Certain risk factors increase the likelihood of an elderly person being abused and addicted to drugs and alcohol. These include:

  • Use prescription painkillers. Addiction is especially likely if the senior has been using multiple painkillers for a long time.
  • A previous history of drug or alcohol abuse. Baby Boomers have higher substance use rates than most generations came before them. As they get older, their substance abuse is projected to escalate.
  • Social isolation. For some seniors, drugs and alcohol are one way to avoid feelings of isolation and boredom. Isolation also allows addiction to reach and pass unnoticed.
  • Mental health issues. There is a significant association between mental health diagnoses and substance abuse, especially in people who have not sought mental health treatment. Some seniors use addictive substances to self-medicate. For example, an elder may use amphetamines to combat the low energy and motives associated with depression.
  • Access to potentially addictive drugs. Elderly who receive many prescriptions can save the remaining medicines. These medications can become a tempting alternative to boredom and other unpleasant emotions, increasing the risk of addiction.

Symptoms of addiction in the elderly may resemble dementia. Loved ones who do not know the elderly are drug abusers may even dismiss the symptoms of addiction as signs of normal aging. In addition, addiction can be a factor in some forms of dementia. For example, Korsakoff syndrome is a dementia that is usually caused by alcoholism.

Lovers should not reject personality or mood swings because they are not part of normal aging. Other warning symptoms of addiction include:

  • Confusion, forgetting and poor decision making.
  • It looks drunk, tall or out of it.
  • Using many prescription pills.
  • Taking Prescription Drugs Without Prescription.
  • Loss of interest in past activities.
  • Mood changes.

If you know a senior with these symptoms, urge your loved one to see their doctor.

Nursing homes and stigma

Addiction is a medical condition, not a personal or moral failure. In some cases, an addiction is the inevitable result of prescribing too many addictive drugs for too long. However, many senior care communities, including some nursing homes, refuse to admit that the elderly receive addiction treatment.

Addiction is a medical condition, not a personal or moral failure.In Ohio, a trade team representing more than 900 skilled care facilities issued a statement saying none of its members accept addicts as elderly. Some legal experts say it is a violation of the Americans with Disabilities Act (ADA). The ADA is a federal law that prohibits discrimination based on disability, including mental health disabilities such as addiction.

For the elderly in need of acute or long-term care, this presents an enigma: it either hides addiction, thus avoiding dependency treatment to get the necessary nursing care, or attending addiction treatment and losing nursing services. These options can let caregivers try to fill the care gaps that are usually filled by specialist nursing facilities.

Even when old people's homes are accepted, the stigma can color the treatment they offer. Staff can host negative views about people with addictions or treat addiction medications such as methadone as unnecessary luxury.

How To Find The Best Senior Rehab Center For Your Needs

Not all seniors need treatment for skilled people. For most seniors, the addiction cycle is the same as that of younger groups. However, some older people may need help managing medication or finding alternatives to managing chronic pain. The elderly (or their carers) can work with their doctor to find a rehabilitation facility or an outside treatment provider that can meet the senior's medical needs.

If you are a carer looking for treatment on behalf of a senior, you should ask some questions before agreeing to a specific treatment:

  • What treatment methods do you use and what is the evidence supporting them?
  • Can you help manage other conditions and if not, will you work with your doctor to manage these conditions?
  • Can you provide a safe environment for vulnerable elderly people, such as those with osteoporosis or dementia?
  • How long does the treatment last and what is your success rate?
  • What to do if there is a medical need?
  • Do you provide treatment, counseling, family support or other services to ensure that older people receive comprehensive help?
  • What is the specific cost of the program and are there additional costs for additional services?

What addiction treatments do Medicare cover?

Federal law defines mental health and substance abuse. This means that Medicare and other insurance plans must offer similar coverage for mental health conditions as for physical health conditions.

Medicare covers outpatient, inpatient, and partial care plans when they consider these treatments "reasonable and necessary". A senior may first be diagnosed with an addictive disorder before Medicare covers the treatment. In most cases, a senior must receive outpatient treatment before Medicare approves coverage for hospital care.

In addition, Medicare does not pay for hospital addiction treatment packages. Instead, it approves the services individually and on a case-by-case basis. Thus, some treatments, such as withdrawal treatment and medication, may be covered, while other treatments – especially experimental and alternative therapies – may not be covered. Medicare will not pay for educational or training services unless they contribute directly to treatment (as opposed to recreation or diversion).

A compassionate counselor can help the elderly manage their addiction. When addiction has affected family members, family therapy can help loved ones sort their choices. There is no shame in seeking help.

Bibliographical references:

  1. Benson, W. F., & Alrich, N. (2017). Rural elderly adults have been hit hard by the opioid epidemic. Aging today. Retrieved from https://www.asaging.org/blog/rural-older-adults-hit-hard-opioid-epidemic
  2. Bond, A. (2018, April 17). Hospital facilities systematically deny people treatment for addiction – something that some experts say is illegal. STAT News. Retrieved from https://www.statnews.com/2018/04/17/nursing-homes-addiction-treatment
  3. Dean, O. (2017). Abuse of prescription drugs in older adults [PDF]. AARP Institute of Public Policy. Retrieved from https://www.aarp.org/content/dam/aarp/ppi/2017/07/prescription-drug-abuse-among-older-adults.pdf
  4. Fueled by the aging Baby Boomers, the nation's elderly population is almost doubling over the next 20 years, according to Bureau of Census reports. (2014, May 06). United States Census Bureau. Retrieved from https://www.census.gov/newsroom/press-releases/2014/cb14-84.html
  5. Korsakoff Syndrome. (n.d.). Retrieved from https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/korsakoff-syndrome
  6. Kuerbis, A., Sacco, P., Blazer, D. G., & Moore, A. (2014). Substance abuse in the elderly. Clinics in Aging Medicine, 30(3), 629-654. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146436
  7. Mattson, M., Lipari, R.N., Hays, C. & Van Horn, S.L. (n.d.). A Day in the Life of Older Adults: Substance Use Facts. Retrieved from https://www.samhsa.gov/data/sites/default/files/report_2792/ShortReport-2792.html
  8. Medicare coverage for substance abuse services [PDF]. (2016, April 28). Department of Health and Human Services Centers for Pharmaceutical and Medical Services. Retrieved from https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnmattersarticles/downloads/se1604.pdf

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