Why Is Alcohol and Drug Misuse on the Rise in Older Adults?

Four Major Factors Contribute

Four major factors contribute to the large number of older adults now having problems with alcohol and other drugs.

1. Silver Tsunami

The number of people reaching retirement age is growing by leaps and bounds. In 2011, the first of the 76 million baby boomers turned 65. In what's been dubbed the "silver tsunami," every day for the next 20 years, 8,000-to-10,000 boomers in the United States will reach age 65, and many will retire—with time on their hands.

2. Life Changes

About 50 percent of those who make up the boomer generation grew up experimenting with illegal drugs, even if only briefly. When careers and raising a family took precedence, most of this generation gave up their attachment to mood-altering substances. But in retirement, or as empty nesters, a growing number of boomers are reverting to using drugs as a means of dealing with the stressors that can accompany aging—including boredom, health issues, and financial worries, as well as loss of a spouse, loss of identity, and, in some cases, loss of a certain degree of freedom. A 2011 Substance Abuse and Mental Health Services Administration study found that the rate of current illicit drug use among people in their fifties jumped by about 3.5 percent, from 2.7 percent in 2002 to 6.3 percent in 2011, indicating that the baby boomer generation is more likely than previous generations to turn to drugs as older adults.

3. Pain Management

Since the late 1990s, when the medical community began monitoring pain as a fifth vital sign (in addition to temperature, heartbeat, breathing rate, and blood pressure), prescription painkiller use has experienced a dramatic rise in the United States. Worldwide, Americans take the lead, consuming about 80 percent of all prescription painkillers. Painkillers such as Oxycontin and Vicodin fall into a highly addictive class of drugs called opioids, which also includes heroin. Since 2002, use of prescription painkillers has doubled. The result: From 1998 to 2008 the number of people being treated for opioid abuse increased 400 percent. And those who can no longer manage to get their drugs via prescription are turning to the street, where dealers have these pills readily available as well as very pure heroin—which is stronger and often cheaper than pills—creating an epidemic of frequently fatal overdoses across the country.

4. Environmental and Social Norms

Older adults have been conditioned to turn to drugs for relief, whether taking a couple of ibuprofen to soothe an inflamed joint or an opioid painkiller for major back pain. According to a U.S. Census report, as many as 92 percent of U.S. adults live with at least one chronic condition; 41 percent have three or more conditions. Each year, doctors write 17 million tranquilizer prescriptions for older adults, including for benzodiazepines (think Valium, Xanax, and Ativan), the most widely misused class of drugs among that age group. In 2014, Americans filled over 4 billion prescriptions at retail pharmacies alone; and adults over sixty- five fill more than twice as many prescriptions as those younger than sixty-five. This is for a nation of 290 million people.

Older adults may have been comfortable using drugs in their youth, they trust their doctors to prescribe only medication that's good for them, and they trust the television commercials promoting prescription drugs. And who can blame them? Pharmaceuticals have their place in the world. They reduce suffering for millions of people every day. The problem starts when the drugs stop helping and start hurting instead. In some cases, the drug combination (whether mood-altering or not) is the culprit. In these situations, addiction is not the issue—toxic drug combinations, some of which produce dementia-like symptoms, are the problem. But when people cross the line from normal use to misuse and then dependence, addiction starts running the show. And when addiction takes over, the negative consequences start piling up.

Few older adults start out with a hedonistic urge to get high. Most are following doctor's orders, taking medications as prescribed. Others have been victimized by polypharmacy (taking multiple medications to help with various health issues), the result of seeing multiple doctors who don't talk to each other, coupled with a lack of patient advocacy to protect them. Others begin drinking or smoking marijuana to numb feelings of loneliness or depression that can be common in older adults for a variety of reasons. The effects of the recent decriminalization and legalization of medical marijuana in some states are, as of this writing, still largely unknown.

Regardless of intentions or age, the results of addiction are the same: Addiction destroys lives and families. Recovery from addiction can reverse these damages by promoting a fulfilling life that heals relationships.

Excerpted AARP's book, Not As Prescribed: Recognizing and Facing Alcohol and Drug Misuse in Older Adults—A Guide for Families and Caregivers, by Harry Haroutunian, MD, Physician Director, Licensed Health Professional Program at the Betty Ford Center in Rancho Mirage, California. In this book, Dr. Haroutunian provides you with the information needed to understand the dynamics of addiction in older adults. You'll learn to:

  • clearly distinguish between the signs of aging and the signs of addiction, many of which overlap
  • identify the indications of drug misuse and its progression to addiction
  • understand the unique treatment needs of older adults
  • get the help you—as a caregiver or loved one—need to cope with your loved one's addiction

This essential guide can help you transform stress and chaos into understanding and compassion.

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