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Substance abuse among adults over 60, particularly of alcohol and prescription drugs, is one of the fastest-growing health problems in the United States. The National Center for Equitable Care for Elders (ECE) at Harvard estimates that some 5.7 million older people needed treatment for substance use disorders in 2020, about triple that in 2000.
Prescription drug abuse affects up to 17% of older adults, according to The National Institute on Alcohol Abuse and Alcoholism (NIAAA). However, this problem remains underestimated, underidentified, underdiagnosed, and undertreated, aging experts say. Substance use disorders or addictions may be mistaken for other age-related conditions or fall completely off a clinician’s radar as they manage other age-related conditions like diabetes, heart disease, frailty, or cognitive decline. Journalists may be missing out on important story coverage as states and communities readjust their health care priorities in the wake of COVID-19 budget shortfalls.
Older people are more vulnerable to substance abuse or misuse because many may take more medications than necessary to treat their conditions. Medications metabolize more slowly, and older brains may be more sensitive to drugs, according to the National Institute on Drug Abuse. For some, cognitive decline can contribute to confusion about what, when, and how much medication needs to be taken. Risk factors may vary considerably by substance and the specific clinical presentation of a patient (e.g., age, medical comorbidities, current medications, and health history), according to a 2014 study.
