Ann certainly did not expect life to look like this.
At 72, she was grieving the loss of her mother three years on while simultaneously fighting bouts of anxiety and overwhelming sadness. To make things worse, she had a taken fall the year before, fracturing her hip. The doctor had prescribed her pain medication to help manage the ongoing discomfort she was still having. But she also noticed that they helped her zone out and relax, especially when combined with a few glasses of chardonnay each night.
To help with her floating anxiety, her doctor had also prescribed her a benzodiazepine. This really helped her disconnect, but it also increasingly caused her to disconnect from activities she loved. Going to lunch with her friends. Playing with her grandkids. Dinner out with her husband. A round of golf on a sunny day. These were all activities that she just did not seem to have the energy or desire for anymore.
Her family and friends became more and more concerned for her as time went on. She just wanted herself. She needed help—and more help than her primary care physician could do at this point.
Addiction in the Elderly – A Growing Problem
Unfortunately, Ann’s story is not completely unique. Many older adults find themselves using opiates, benzodiazepines, or other substances to medicate their anxiety, pain, or other discomforts that life has brought their way. In fact, some are even dying from the very medications prescribed to make their pain more manageable and their lives more enjoyable.
Between May 2020 and April 2021, drug overdoses caused more than 100,000 deaths in the U.S. (National Center for Health Statistics). A closer look suggests that many of these deaths are from a somewhat surprising group: older Americans.
What age defines an “older adult”?
“Older adults” refers to adults aged 55 and older. It is estimated that by the year 2030, well over one-fifth of the U.S. population will be over the age of 55.
The Risk of Opioid Addiction in Older Adults
In older adults, opioid overdose deaths rose between 1999 and 2019 (JAMA Network Open, 2022). In 2019, nearly 10,300 people ages 55 and older died from opioid overdoses, compared to just over 500 in 1999.
As individuals get older, they are more likely to have an opioid prescription (U.S. Centers for Disease Control and Prevention, 2020). Substance misuse is rising among older adults. Emergency department visits for opioid misuse rose 220% between 2006 and 2014 in people ages 65 and older (Innovation in Aging, 2019). This could be in part to older people’s bodies being physically less able to metabolize opioids, thus making them more vulnerable to overdoses than younger people are.
Why is Substance Abuse in Older Adults A Growing Risk?
Like Ann, many older adults have more access to medications with misuse potential, such as benzodiazepines, which are commonly prescribed to combat symptoms associated with aging. With multiple prescriptions for mood-altering medications, older adults are potentially at higher risk of being confused about dosages and interactions. And if they are social drinkers, they can be at use for greater potential harm as alcohol will worsen the effect of any narcotic in the system.
Recognizing the Signs of Substance Use in Older Adults
Problems with substance use are not uncommon among older adults, but they are less likely to be recognized, particularly by medical professionals, due in part to the physiological changes of aging. This can mean that alcohol and other substances can have a greater impact on the body, resulting in a longer healing process.
Treating Substance Abuse in Older Adults
Due to the unique medial needs of aging, it is important to go slower when treating substance misuse in older adults. A medical detox may take longer. Therefore, it is important to seek out providers who understand the interaction aging, medications, and other current diagnoses.
Many older adults often experience chronic pain and believe that opioid pain killers are essential to manage their pain. However, these medications can actually make pain worse, resulting in hyperalgesia, an oversensitivity to pain. So, some form of talk therapy is essential for added support in the treatment and recovery process.
Individuals engage better in treatment and recovery when surrounded by people who share their lived experience. So, when seeking out treatment options, it is important to ask if the treatment providers have experience in treating older adults for substance misuse. As well, it is important to ensure that the actual physical facility is equipped for individuals with mobility issues or hearing, vision, or other impairments.
There is Hope for Substance Use Recovery at Any Age
There’s good news for older adults. When personally motivated, some may respond better than younger people to substance use treatment because they possess more life wisdom, complex decision-making skills, a greater capacity for emotional regulation, and a more-developed ability for self-reflection and insight. Recovery for older adults is indeed possible and can result in a much-improved quality of life through appropriate treatment interventions.
The good news for Ann is that her family was able to find medically appropriate treatment. She detoxed from opioids and benzodiazepines, safely under medical supervision. Combined with psychotherapy to address her grief and loss issues, Ann found new meaning and purpose, surrounded by her husband, children, grandchildren, and friends. She discovered that recovery is possible, no matter one’s age, no matter what one has experienced.
Note: Ann’s name and certain identifiers have been changed to protect her anonymity.