We often ignore troubling behavior in older people, letting these behaviors slide as signs of aging. Forgetfulness, falls or an inability to live alone may come with age, but they don’t have to. They can also be symptoms of substance abuse. Many, many of our aging and elderly family members and friends need help with substance abuse and misuse. The problem of substance abuse among the elderly is only expected to grow in the coming years.
Consider some disturbing conclusions from one study:
Due to the large population size and high substance use rate of the baby-boom cohort, the number of adults aged 50 or older with substance use disorder is projected to double from 2.8 million (annual average) in 2002–06 to 5.7 million in 2020. Increases are projected for all examined gender, race/ethnicity and age groups.
Why does substance abuse become a problem as people get older? As people age, our bodies metabolize substances differently. An individual that has had a nightly glass of wine for years will eventually not be able to tolerate the same amount of wine because our aging organs have increasing difficulty metabolizing the alcohol. This can be dangerous because the process is slow and we may not recognize that a change is occurring. Yet with time, we will realize that a change has happened. For example, one glass of wine that was previously enjoyed with impunity could after time have the same effect as three or more glasses of wine, with falls resulting. The problem is, instead of recognizing a changing metabolism and an issue with drinking, the falls will likely be blamed on old age and no help will be given to the elderly person.
Is it retirement and perhaps boredom that causes higher rates of substance abuse among the aging? The issue is more complicated than being able to identify a single source of the problem. Peter A. Bamberger and Samuel B. Bacharach, coauthors of “Retirement and the Hidden Epidemic,” conducted a ten year study funded by the National Institutes of Health on substance abuse in older adults. Mr. Bamberger stated:
“The impact of retirement on substance abuse was anything but clear cut, with the conditions leading to retirement, and the economic and social nature of the retirement itself, having a far greater impact on substance use than simple retirement itself.”
A number of circumstances can encourage substance abuse in later life. The home may feel too large and quiet after retirement. Loneliness and depression can occur due to loss of a spouse or friends, the end of a career, fewer social interactions, limited mobility, and children living at a distance. Boredom and loss of purpose in life are also triggers for substance abuse.
What are some of the signs we might be missing? Disorientation and memory loss are usually associated with growing older. Very often chemical dependency has similar side effects to dementia. Some medications for diabetes, blood pressure, sleep, pain and anxiety can all affect aging patients more than younger patients. As we grow older and need to take medications for various conditions, these medications in combination with one another, over the counter drugs, nutritional supplements, and/or alcohol, can cause interactions that put a person’s health at risk. All substance use needs to be closely monitored as we age. This means that medical professionals need to ask probing questions about all substance use, particularly with older patients.
For more information on the aging population and substance abuse, watch a lecture I gave at the Jewish Theological Seminary in New York this past June to learn the latest information on addiction in the elderly.