Drug abuse in older people used to be rare, but not today. In 2014, over a million adults over 65 had a substance abuse disorder. By 2020, researchers say that number will hit 5.7 million!

Almost 98% of those are alcohol abuse cases while the remaining 2% are illicit drugs.

Because it’s a silent epidemic, the media focuses on younger drug users instead of older adults. It’s no surprise if you haven’t heard about substance abuse in older people even though it’s so common.

The number of older adults abusing drugs will keep rising every year without action. You can’t fight what you don’t understand, so read on to learn more about the drug epidemic in adults over 65.

How Do Substance Use Disorders Affect Older Adults?

Substance abuse disorder affects older adults in the same way it affects everyone else. The signs and symptoms can include:

  • Cravings
  • Drug-seeking behavior
  • Financial problems
  • Mental health changes
  • Mood changes
  • Secretive behavior
  • Social problems
  • Trouble with responsibilities

Older people abuse drugs for many reasons, including to deal with stress and depression.

What Drugs Are Most Commonly Abused by Older Adults?

Alcohol is the most common drug abused by older adults. In fact, it makes up nearly all substance abuse in this age group at 98%.

The next most common drugs are opioids, such as:

  • Hydrocodone
  • Morphine
  • Oxycodone
  • Tramadol

Why opioids? Older adults are more likely than younger people to:

  • Have chronic health issues
  • Take prescription drugs

Because over one-fifth of all drugs prescribed to older adults are opioids, that puts this age group at risk for drug abuse.

Opioids are powerful painkillers that are used to treat many kinds of pain, including:

  • Acute pain
  • Cancer pain
  • Chronic pain
  • Labor pain
  • Post-childbirth pain
  • Surgical pain

With the exception of labor and childbirth, older adults are more likely to experience all of these types of pain. Half of all aging adults have pain on a daily basis.

The problem is, opioids are effective at treating pain, but they’re also dangerous. Even using opioid drugs as directed can cause addiction.

Source: Ameriglide via SlideShare

Alcohol Addiction in Seniors

Alcohol abuse disorder (AUD) is the most common kind of drug abuse in older people. In fact, 1.5% of adults over 65 have alcohol abuse disorder. If you include adults over 50, then the number rises to almost 3%.

You can have a problem with drinking even if you don’t have AUD yet. Around 16% of older men are at risk and 10% of women are too.

You’re considered at risk for AUD if you binge drink. That means drinking more than five drinks in a night for a man or four drinks for a woman.

AUD is one of the most dangerous forms of substance abuse disorder. When you drink excessively, the effects on your health can be very bad.

The main signs of AUD are:

  • Cravings
  • Not being able to stop drinking
  • Mood changes when you aren’t drinking

The health effects of AUD can include:

  • Brain damage
  • Dementia
  • Fatty liver disease
  • Increased risk of death from accidents or suicide
  • Liver damage
  • Nerve damage
  • Seizures

You can avoid getting AUD by following guidelines by the American Geriatrics Society. Older adults should limit their drinking to one standard drink per day.

One standard drink equals:

  • 12 ounces of beer
  • 5 ounces of wine
  • 1.5 ounces of liquor

How to Address an Older Adult’s Substance Abuse Problem

It’s important to be delicate when you talk to an older adult about drug abuse. Most people with substance abuse disorder (SAD) don’t think that they have a problem.

It’s common for loved ones to get defensive when you say you’re worried about their drug use. So take some time to think about the way you’re going to handle the conversation.

It’s very important to plan out what you’re going to say and avoid getting distracted by emotions in the heat of the moment.

Some tips include:

  • Say “I noticed…” If you can be specific about the behavior that worries you, it’s easier for your loved one to understand and open up a conversation. For instance, try saying “I noticed that you’re staying in and drinking more. Are you feeling okay lately?”
  • Use “When you… I feel” statements: This structure shows your loved one how their behavior affects you. It’s also neutral and doesn’t lay blame. For instance, try saying “When you miss family events to use opioids, I feel like I’m not important to you.”
  • Know when to stop: If your loved one gets defensive and upset, then it’s not the right time. Persisting for too long can make your loved one put up walls. Say what you need to say, then let the conversation end without turning into a fight. You’ve planted the idea of getting help, and that’s enough until the next time you can talk about it.

You’ll probably need to have this conversation more than once. That’s true even if you handle it perfectly. It’s not your fault or your loved one’s fault —it’s just part of the disease. Substance abuse disorder causes denial, so if you’re affected, it can be hard to know that you have a problem.

That’s okay because there’s a solution. Plan to have the conversation more than once and be patient with your loved one. It may take a few tries for them to come around and that’s normal.

How Caregivers Can Help Seniors With Drug Abuse

It’s common for caregivers to pull away from older people when they see that there’s a drug problem. But that’s the worst approach to take. Right now, this person needs your help more than they ever did.

You might be scared of talking about it because you’re worried it won’t go well. But you can do more damage by ignoring the issue. It’s important to talk about it and keep it in your mind as you interact.

If you’re a loved one or a caretaker, you can help by:

  • Being supportive: Ask how you can help and if they aren’t sure, offer ideas. Use the right language when you talk about drug abuse. Don’t call them an addict or an abuser; these words blame your loved one instead of blaming their disease. Be thoughtful and open when you talk with your loved one about drug abuse. Your loved one might not know how to ask for support, so it’s your role to offer it.
  • Not enabling: If you know your loved one has a problem with alcohol, then don’t buy any. If they ask for money to buy drugs, say that you can’t do it. It can be hard to stay strong, but it’s important not to give in. “Helping” your loved one to get drugs (even indirectly) isn’t helping at all.
  • Providing options: It’s common for older people to avoid getting help because they’re worried about insurance or cost. If you can do some of the legwork and bring your loved one care options, it can make the idea of treatment less overwhelming. Services such as Medicaid might be able to help.
  • Be ready to move: You have to move fast if your loved one agrees to go to treatment. It’s common to agree to get help in the heat of the moment, then change their mind when they’ve had time to think about the challenge of recovery. Pack a bag before you have the treatment conversation and have the phone ready to dial.
  • Still being their loved one: At the end of the day, you’re still the child, grandkid, or caretaker that your loved one needs. While you have to look out for their welfare, you don’t have to be their jailkeeper. Make time to spend with your loved one and assure them that the relationship is still there. Social support is a big part of recovery.

Drug and Alcohol Treatment Resources for Senior Citizens

Older people often put off treatment because they’re worried about the logistics. You might worry about not having insurance or finding the right place.

There’s a public perception that detox and rehab centers are for younger people, but that’s not true. Treatment centers can help anyone, no matter what your age is.

Without treatment, you’re more likely to relapse and less likely to stay in recovery.

Getting treatment can:

  • Help you function better
  • Improve your relationships
  • Protect your health
  • Reduce your drug use by 60%
  • Help you achieve remission or recovery

How to Pay for Substance Abuse Treatment

The cost of treatment shouldn’t be one of the factors you consider when choosing treatment centers. There are resources available to help you pay.

Options include:

  • Medicaid: Some adults qualify for Medicaid based on their income. If you qualify, then you may have some of your treatment covered or all of it.
  • Medicare: All Americans over age 65 qualify for Medicare, which is government-sponsored insurance that may cover your treatment cost.
  • Supplemental insurance: A private insurance plan, temporary disability insurance, healthcare marketplace insurance, or job-related supplemental insurance might help pay for a portion of your treatment.

If you’re a caretaker or a loved one, then you should research payment options before talking to your loved one about recovery. Treatment is scary when you have no idea how you’re going to pay. Come to them ready with ideas so your loved one doesn’t shut the idea down right away.

To get insurance to cover any amount of treatment, you should get help so you can get a diagnosis. Your care provider will recommend or prescribe treatment, which can help in having your insurance company pay for treatment.

Treatment for Substance Abuse

It’s common for treatment to include:

  • Cognitive-behavioral therapy (CBT): This is the most common kind of therapy for substance abuse. It helps you learn why you abuse drugs so you can change the way you think and act.
  • Group therapy: Social support can be in the form of a 12 Step group or a support group. It’s important to connect with other people having the same experience. This can help you or your loved one feel less alone.
  • Medication-assisted treatment: This kind of treatment uses Suboxone or methadone to treat alcohol or opioid cravings. It’s the most effective kind of treatment for those types of substance abuse when combined with CBT.

Don’t be part of the growing statistic for substance abuse in older adults. Right now is the perfect time to get help. Call Rehab Adviser today!


  1. https://medlineplus.gov/alcoholusedisorderaud.html
  2. Kuerbis, A. (2015). Substance abuse among older adults: A targeted response initiative. Clinical Geriatric Medicine, 30(3), 629–654. doi: 10.1037/e416182008-001
  3. https://www.samhsa.gov/data/sites/default/files/report_2792/ShortReport-2792.html.
  4. https://www.drugabuse.gov
  5. Patel, K. V., Guralnik, J. M., Dansie, E. J., & Turk, D. C. (2013). Prevalence and impact of pain among older adults in the United States: Findings from the 2011 National Health and Aging Trends Study. Pain, 154(12), 2649–2657. doi: 10.1016/j.pain.2013.07.029

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