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Substance Abuse or Misuse in the Elderly: How to Know the Difference

Because drug and alcohol abuse by seniors can often be mistaken for normal symptoms of aging, substance addiction in that demographic has been called “an invisible epidemic.” Today, 60% of substance abuse is identified in people younger than 60, while only 37% is spotted among seniors over the age of 60 according to the Center for Applied Research Solutions.

Meanwhile, according to an article published in the American Journal on Addictions, research has revealed that adults aged 65 and older:

Consume one-third of all prescription drugs in the UnitedStates. Are more likely to be prescribed opiates, stimulants, and/or benzodiazepines.

Are likely to have more than one prescription for these most commonly abused drugs.

Comprise a fast-growing proportion of the substance abuse treatment population in this country. Add to this the massive number of baby boomers approaching retirement, and this new medical reality makes knowing the signs of prescription drug abuse in the elderly of urgent importance. Below is essential information to help family members and caregivers recognize the signs and find the help they need.

Drug Misuse and Drug Abuse

To identify problems with prescription and over-the-counter drug use in the elderly, first it’s important to know the differences between misuse and abuse.

Misuse, which can be willful or accidental, occurs when a person takes a drug:

For a purpose other than that for which the drug was originally prescribed.

That was prescribed to someone else. At a dose or in a manner that is not in accordance with the directions on the packaging.

Abuse of a drug, on the other hand, can be distinguished from misuse by at least two characteristics:

A compulsive or willful intent to “get high” (as opposed to taking more of a drug to increase its therapeutic effects). A pattern of behavior rather than an isolated occurrence. The type of intervention chosen will also depend on whether the problem is determined to be misuse or abuse.

Know the Signs of Drug Problems in the Elderly

Drug abuse and misuse in the elderly can mirror some of the same symptoms of aging, such as memory loss, disorientation, mood swings, andthat a doctor won’t prescribe any more of a controlled substance. depression. If these symptoms accompany any of the following changes in behavior, it is time to seek treatment for a potential drug use disorder:

Concerns that the drug(s) is “not working” as well.


Frequent requests for refills of a particular medicine. Rapid increases in the amount of medication being taken. “Doctor shopping” (moving from provider to provider in order to get more of the same prescription). False or forged prescriptions. A person not seeming like themselves (extremely energetic or unusually bored with life).

How to Help a Senior Who May Be Misusing Drugs

Seniors can be especially vulnerable to misuse of drugs. Many are on multiple medications, and taking a medicine as directed can be made difficult by factors related to aging such as forgetfulness and eyesight issues.

In cases where an elderly person is misusing drugs, he or she may benefit from help through:

Education about the purposes of each medication and the dangers of not taking medication(s) as directed.

A written review of the correct dosage and dosing intervals. Supervision of the use of medication(s) via safe storage and scheduled reminders (MedCoach and MediSafe are just a couple of the many handy phone apps that are now available to help track and monitor medications, and automated prescription pill dispensers can prevent overdoses).

How to Get Help for an Older Adult with a Drug Abuse Problem

If drug abuse is the problem, professional treatment is the best course of action. A good starting place for treatment referrals is the National Helpline, a free, 24/7, 365-day-a-year treatment referral and information service of the Substance Abuse and Mental Health Services Administration.

If getting an older adult into treatment is the next step, an honest, direct, and non-confrontational discussion—at a time when the loved one is not under the influence of drugs—is a good place to start.

Avoid talking down to older adults. Using a tone of positive respect and emphasizing the ways that he or she is loved and admired will be more effective in convincing them to accept help.

When offers to assist are met with deaf ears, an intervention may be necessary. This guide from the Mayo Clinic can help.





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