Substance abuse, specifically alcohol and prescription drug use, is one of the most rapidly growing healthcare problem for older adults, 60 years of age and older in Canada and the United States. Researchers project a 3-fold increase in substance abuse in adults aged 50 and older by 2020. Consequently, an estimated 5 million older adults will require treatment for substance abuse problems in the near future. Researchers are only beginning to recognize the prevalence of substance abuse among people age 60 years of age and older as alcohol and prescription drug use in older adults was seldom discussed until recently.
Substance use and misuse place older adults at risk for a variety of possible clinical dangers, contributing to increased use of healthcare resources and a need for age-specific interventions with the increased proportion of older adults living in North American society. Presently, the misuse of prescription and over-the-counter medications is recognized as a problem.
However, baby boomers are expected to have had more contact with illicit substances (ie. marijuana, hashish, cocaine (including crack), inhalants, hallucinogens, heroin and prescription-type drugs used non-medically) than past and present cohorts of older adults. Illicit drugs may also be increasing in a small percentage of older adults.
The National Survey on Drug Use and Health reported that illicit drug use by adults 55 to 59 has increased from 1.9% in 2002 to 5.0% in 2008, which depicts the potential for growth in illicit drug use in the baby boomer cohort. However, illicit drug use in older adults is typically linked to individuals who are lifelong drug users.
In addition, approximately 15% of individuals 65 years of age and older living in the community are at risk for alcohol abuse or dependence and 50% of individuals living in personal care homes drink moderately or are dependent on alcohol. However, only 90% of individuals who are at risk for alcohol abuse or dependence do not receive alcohol treatment services.
Therefore substance abuse services in the future will need to anticipate and acknowledge problems with the use and misuse of both licit and illicit substances in older adulthood. However, due to insufficient knowledge, limited research data, and limited and rushed healthcare visits and appointments, healthcare providers often overlook substance abuse and misuse among older adults. Therefore, despite the number of older adults experiencing problems related to substance use, the situation remains underestimated, underidentified, underdiagnosed and undertreated.
The reasons for the inability to acknowledge substance use problems in older adults are due to many factors. First, healthcare providers often overlook substance abuse and misuse among older individuals, as their symptoms are often mistaken for depression, dementia and health problems common to old age such as falling, infections or digestive difficulties. Second, older adults may also hide their substance use and are less likely to seek help for their problems with substance use. Third, many family members of older adults with substance use, particularly adult children, are often embarrassed of their family members’ problems which often results in their inability to seek treatment.
As a result, thousands of older adults who need treatment never go, and the number of substance abusers among older adults continue to rise. Healthcare professionals must acknowledge that older adults’ struggles with substance abuse are becoming a prevalent issue and the stigma associated with these issues must be addressed as well.
Healthcare professionals must acknowledge that older adults’ struggles with substance abuse are becoming a prevalent issue and the stigma associated with these issues must be addressed as well. Mental health practitioners should also receive specific training and education to develop sensitivity towards these issues.
