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Can You Be Too Old For Drug Rehab? Options for Seniors and the Elderly

No one is ever too old to get treatment for a substance use disorder. Because the segment of the population over 65 years old is the fastest-growing proportion of Americans, many rehab facilities are making special arrangements to address issues with addiction in this age group.

A Growing Demographic

According to the United States Census Bureau, the fastest-growing segment of the United States population is the group of individuals over age 65. It is expected that by 2030, people above 65 years old will outnumber those under age 18. As people live longer, many of the demographic factors of people who are over the age of 65 have changed substantially, and the group is no longer homogenous.

Typically, the elderly population is divided into three different age brackets:

  • People between the ages of 65 and 74
  • People between the ages of 75 and 84
  • People over the age of 85

None of these labels are very flattering; however, it is important to designate different levels of people over 65 due to differences in their physical functioning and cultural and life experiences. If you do not like the label, just refer to the age bracket.

Quick Facts About Older People

According to the U.S. Census Bureau and the Substance Abuse and Mental Health Services Administration (SAMHSA):

  • If you are a member of the young-old, you are more likely to be working,
  • The most prevalent physical disability of the elderly is difficulty walking up stairs.
  • If you are over age 65, you are more likely to be female than male.
  • If you are over age 65, you are more likely to be married if male and widowed if female.
  • The poverty rate among elderly individuals is lowest for those 65 to 74 years old

Drug Use in the Elderly

According to the National Institute on Drug Abuse (NIDA), the major drugs of abuse in individuals over age 65 are alcohol and prescription medications. It is estimated that about 70 percent of individuals older than 65 years old have misused a prescription medication at least once.

Although alcohol is the most common substance that older adults abuse, other substances such as narcotic pain relievers are also important to keep in mind. Data from the Drug Abuse Warning Network (DAWN) indicate that there were 2,056 drug-related Emergency Department (ED) visits by older adults on an average day in 2011. Of these, 290 involved illegal drug use, nonmedical use of pharmaceuticals, or use of alcohol mixed with other drugs.

Nonmedical use includes ED visits where the patient misused a medication, took more than the prescribed dose of medication, took a medication prescribed for another individual, or was poisoned by another person.

The substances were involved in the following numbers of visits on an average day in 2011:

  • 118 involved prescription or nonprescription pain relievers, 80 of which involved narcotic pain relievers specified by name (e.g., hydrocodone, oxycodone)
  • 48 involved benzodiazepines
  • 25 involved alcohol in combination with other drugs
  • 23 involved antidepressants or antipsychotics
  • 13 involved cocaine
  • 7 involved heroin
  • 5 involved marijuana and 2 involved illicit amphetamines or methamphetamines

Triggers for Substance Abuse in the Elderly

If you have had any type of substance abuse issue, you are likely to think that certain factors caused your substance abuse. Unfortunately, there is no identified specific cause associated with the development of a substance use disorder. Instead, substance abuse is a result of numerous interacting factors that may differ substantially among different people.

People age 65-plus have their own specific challenges that can contribute to substance abuse in addition to other identified risk factors that occur across all groups, such as genetic associations and stress.

Oder man in wheelchair next to daughter

Some of the things that might affect you if you older than 65 include:

  • Issues with a personal sense of self-worth or identity
  • Changes in physical health
  • Family conflicts
  • Issues with sleeping
  • Being overwhelmed with the rate that information is given to people
  • A decline in cognition or mental health
  • Boredom
  • Increased feelings of isolation or loneliness.

Specific Dangers of Elderly Substance Abuse

If you are older than age 65, you have experienced some significant changes in the way your body works. These changes will continue as you get older.
One of the major changes is that your metabolism works much more slowly than it did when you were younger, and your ability to metabolize complex substances like prescription medications has changed. Less of any particular medication can produce more significant effects in you.
Benzodiazepines are regularly prescribed to individuals older than 65, and these may have a significant effect on you if you use them in doses that are typically prescribed for younger individuals. Alcohol use may also affect you differently.
This can increase your chances of developing issues with abuse and physical dependence.

Signs of Addiction in Elderly Individuals

Even if you are 65-plus, the diagnosis of a substance use disorder will be based on the diagnostic criteria as developed by the American Psychiatric Association. Nonetheless, if you are over 65, some specific indicators may serve as red flags that you have developed a potential substance use disorder. These include the following:

  • You use alcohol secretively,
  • You have a ritual of having alcohol before, during, and after your meals.
  • You regularly consume alcohol with your prescription medications.
  • You frequently use benzodiazepines or pain medications.
  • You find that activities that once gave you pleasure no longer do so.
  • People have commented that you are not paying as much attention to certain aspects of self-care as you used to.
  • You find yourself more irritable, hostile, and depressed than you used to be.
  • People have commented that you seem to be using drugs more often than you used to.

Who Is Most at Risk?

According to NIDA and SAMHSA, the highest rates of alcohol use disorders occur in people over age 75 who lost a partner. Rates of substance use disorders among elderly patients in nursing homes may be extremely high. A large percentage of new hospital admissions in elderly individuals may be related to the abuse of alcohol or other drugs.

Treatment

NIDA specifically states that if you are over the age of 65, you will respond just as well to standard treatment interventions for substance use disorders as younger individuals. However, there may be some adjustments that may make you more comfortable with treatment.

  • Choose a rehab program that has experience or specializes in the treatment of elderly individuals.
  • Attempt to find therapy groups or support groups that have a large number of elderly individuals.
  • Work with therapists and other treatment professionals that are closer in age to you.
  • Have your treatment providers explain the effects if your medications are combined with alcohol.
  • Understand that the use of counseling or therapy does not mean that you are mentally ill.
  • Be aware that medications and therapy do not “cure” a substance use disorder.
  • You may be more comfortable if you integrate your treatment with your primary care program.
  • Undergo a formal assessment for any other psychological issues.
  • Make sure you are heard.