If you have noticed that alcohol or prescription drugs are affecting you differently these days, you’re not overreacting or imagining things. As the body ages, it can also become more susceptible to the various impacts of mood-altering substances. For example, you may experience new adverse symptoms or find yourself self-medicating complex emotions more frequently.
These changes matter because substance misuse in older adults is a growing public health concern. Research shows that one in 11 adults over age 60 has a substance use disorder, a number that is projected to keep rising as the population ages. While alcohol use disorder is most common among older patients, drug-related deaths due to misusing prescription medication have doubled over the past decade.
The reasons behind these trends are complex and rooted in changes in physical health and life circumstances. If you or a loved one has concerns about substance use, here are some gentle considerations to keep in mind:
Older Adult and Elderly Substance Abuse: Why It’s on the Rise
Several trends likely speak to the rise in drug abuse among older adults, and they extend far beyond mere willpower or making “poor choices.” This increase reflects a complex interplay between medical, cultural, and demographic shifts within the aging process, including:
Changing attitudes toward substances: On average, baby boomers grew up in a time with more open attitudes toward drug and alcohol use, which may decrease the perceived stigmas associated with using in later life.
Access to prescription drugs: Primary care physicians and psychiatrists may be more likely to prescribe multiple drugs to their older patients. This may increase the likelihood of misuse, especially if someone isn’t truly aware of the complicated risk factors with each medication.
Gaps in mental health services: Older adults often don’t receive adequate screening or treatment for serious mental health issues, including depression, anxiety, or unresolved trauma. Subsequently, many substance use treatment programs disproportionately cater their services to younger adults, overlooking the needs of other populations.
Understanding Substance Use Disorders Among Older Adults
Substance use in the older age group often looks different than it does for young adults. It’s generally less likely to be about seeking a “high” and more likely to be about self-managing physical discomfort, emotional pain, or life changes. You may be turning to drug use in the following situations:
Managing Pain or Chronic Health Conditions
Chronic illness generally comes with its good days and bad days. But persistent pain, limited mobility, or dealing with long-term physical disabilities can undoubtedly make daily life challenging. At times, substances provide the most accessible and immediate relief. However, the body can build a tolerance unexpectedly, leading to higher doses and possible dependence.
Treating Sleep Disturbances
Aging can coincide with sleep problems like insomnia or poor sleep quality. Alcohol, sedatives, or other substances might be used to “take the edge off” and promote a sense of relaxation. However, over time, they can disrupt natural sleep patterns and increase the risk of grogginess. That said, a vicious cycle may occur, where stopping the substance use causes withdrawal and aggravates sleep issues.
Easing Loneliness or Isolation
It’s no secret that aging is often marked by recurrent loss. Navigating deaths or even changes in your daily routine can cause a sense of internal upheaval. For some, alcohol or other substances temporarily numb feelings of social isolation or make socializing feel easier. But over time, these habits can deepen a profound sense of disconnection rather than heal it.
Navigating Mental Health Concerns
Mental health problems among older adults are often undiagnosed or misunderstood. Drug use can become its own form of self-treatment, particularly if you lack adequate support. Unfortunately, this usually creates a problematic pattern. Turning to drugs or alcohol often does provide some relief, but these effects tend to be short-lived and can perpetuate more mental health issues.
Sensitivity to Substance Use in Later Life
As you age, your body processes substances differently and often less efficiently than it did in earlier years. What once may have felt like a ‘small dose’ may now result in significant changes in your mood or overall health. Here are some more specific adverse reactions older adults may experience:
Slower Metabolism and Liver Function
The liver plays a key part in breaking down alcohol and other substances. Over time, liver function naturally declines, causing substances to stay in the bloodstream longer. This effect can increase the risk of prolonged sedation and disorientation. People may be at an increased risk for accidental overdose, even when taking ‘normal’ amounts. Furthermore, binge drinking or heavy drinking can both accelerate liver decline, increasing the chance for cirrhosis or cancer.
Changes in Body Composition
Aging tends to correlate with a decrease in lean muscle mass and an increase in body fat. Alcohol is water-soluble, and a body with less water content will react to its effects more intensely and quickly. This may also impact how fat-soluble drugs, including many over-the-counter medications, are stored and released in the body. This can lead to feeling high or intoxicated even when taking routine amounts of a substance.
Higher Risk of Injuries or Falls
Mild intoxication or drowsiness impacts cognitive impairment, which is responsible for balance, reaction time, coordination, and perception. Falls, in particular, can have significant consequences, including fractures and the need for serious medical attention.
Lethal Drug Interactions
It’s not uncommon for older adults to take multiple prescriptions. However, unintentional drug interactions sometimes come with dangerous side effects. The risk of problems increases if you’re also drinking alcohol, using cannabis, or taking illicit drugs along with your prescribed medications.
Substance Types and Specific Risks in Later Life
Drug use and health go hand-in-hand, but not everyone recognizes how certain substances can impact their physical and emotional well-being.
Alcohol
Although alcohol consumption is widely mainstream, older adults are more likely to abuse alcohol than any other substance. Alcohol can worsen medical conditions like high blood pressure, heart disease, and diabetes. Even mild or moderate drinking may impair balance and increase the risk of serious injury.
Prescription Medications
Opioids, benzodiazepines (like Xanax or Valium), and sleep aids are frequently prescribed to older adults. While they can be helpful in the short term, they carry high risks of dependence, sedation, and dangerous interactions with other medications.
Cannabis
With legalization becoming more mainstream, cannabis use among all populations is rising. Some use it for treating chronic pain or anxiety. Others use cannabis to support sleep. However, it can still impair memory, coordination, and reaction time, especially when taken in high doses.
Illicit Drugs
Though they’re used less frequently than legal medications or alcohol, illicit drug use carries an enormous risk. Today’s drugs can be laced with lethal substances, including fentanyl, that can cause a sudden overdose and death.
Therapy for Older Adults in Austin, TX
If you feel concerned about your substance use, you deserve care and support. It’s important to remember that any attempts at self-medication are simply responses to managing real physical or emotional pain. This does not make you “weak” or a “bad person.” It merely speaks to you being a human trying to cope with very human parts of life.
Therapy offers a supportive, nonjudgmental space to learn healthier coping strategies that work with your body’s changing needs. It can also address co-occurring mental health issues underlying substance use. If you’re a caregiver worried about a loved one, you also deserve witnessing and guidance. Caregivers need space to process their feelings and assert their own needs.
If you’re looking for more care or support, I welcome you to reach out. I specialize in treating older adults experiencing depression, anxiety, grief, and other mental health concerns.
Please contact me today to schedule an initial consultation.