How to Help Older Adults with Substance Use Disorder

How to Help Older Adults with Substance Use Disorder

Kent Runyon, Novus VPRecently, Kent Runyon, Novus Vice President was asked by two different groups to do a presentation on "Older Adults and Substance Use Disorder." Since this subject is being much discussed, we'd like to share with you some highlights of the presentation.

Kent pointed out that there remains an underlying belief, including among healthcare professionals, that older adults are not susceptible to SUD. The truth is that there are 2.5 million older adults with an alcohol or drug problem.

Here are some of the facts:

  • Widowers over the age of 75 have the highest rate of alcoholism in the U.S
  • Nearly 50 percent of nursing home residents have alcohol related problems.
  • Older adults are hospitalized as often for alcohol related problems as for heart attacks.
  • Approximately 70% of all hospitalized older adults have alcohol related problems.
  • Although people 65 years of age and older comprise only 13% of the population, they account for almost 30% of all medications prescribed in the United States.
  • 2014 data showed that people age 65 + had the largest increases in opioid related hospital stays and ER visits.

In 2016 overdose cases where levels of the following drugs were found to be the cause of death, persons age 50+ led any other age group:

  • Diazepam (Valium): Benzodiazepine
  • Oxycodone: Opioid
  • Morphine: Opiate
  • Cocaine: Stimulant

(Source: FL Dept. of Law Enforcement)

The Perfect Storm

Kent presented that there are a number of additional points that make the situation with our older population one that more people should be aware of. These include the fact that the size of the older population is increasing in proportion to the rest of the population and people are living longer, which puts increased pressure on the healthcare system to address age-related ailments.

Additionally, since almost 50% of adults age 55 to 75 experimented with drugs earlier in their lives, members of this new generation of older adults are far more likely to use and overuse alcohol and drugs. And the very process of aging makes our bodies more susceptible to the effects of all substances. As we age we have more body fat, less muscle mass, and less total body water. This results in slower metabolism meaning that a glass of wine or an opiate pill will have a greater impact on someone at 70 then it would at 30.

Then there remains an underlying belief, including among healthcare professionals, that older adults are not susceptible to SUD, while at the same time chronic pain affects many older adults and can be truly debilitating if not properly addressed, so many older adults end up dependent on pain medications.

In hurried office visits, health care providers often overlook alcohol and drug misuse and abuse among older adults. Diagnosis may be difficult because the symptoms of alcoholism and drug dependency in older individuals sometimes mimic symptoms of other medical and behavioral disorders common among this population, such as diabetes, dementia, and depression. Additionally, many patients are not adequately screened due either to lack of training on the part of physicians or bias that alcoholism and addiction are not worth treating in this population.

Wrong Beliefs and Attitudes

There can be a biased view of older adults and how we treat their substance abuse disorders:

  • "Grandmother's cocktails are the only thing that makes her happy," or "What difference does it make; he won't be around much longer anyway."
  • Family secrets - handle the issue quietly.
  • Family shame - help is second to protecting the image.
  • Our society assigns a different quality of life standard to older adults.

Plus there are many reasons that we might not see the problem. Many older adults are living alone, they are widowed and/or separated from family, out of the workforce, or retired. They hide in our midst.

How can we make a difference?

Less than 7% of service providers design services specifically for older adults. Programs need to be developed that take into consideration amenities for older adults, longer detox protocols need to take into consideration co-occurring medical conditions, with an emphasis on older adult risk factors.

More attention needs to be brought to this issue, talking to family and friends about it, talking to local organizations and at professional conferences, and publishing information in organization publications.

Meanwhile, check on the older adults in your life, in your neighborhood, at your church. You can help an adult you are concerned about by identifying all their prescription medications, their doctors and specialists, their trusted relationships with friends and faith leaders, so that you and they know who they can turn to for help.

If you find yourself in a situation where intervention is called for, identify the best, most trusted person to talk to them. Identify a time when they will not be using or under the influence of alcohol or drugs. Be empathetic, gentle and respectful, but direct. Do not use labels such as alcoholic or addict because shame is the enemy. Consider possible cognitive impairments. Use simple and clear conversation that is non-confrontational. Share with them the reasons you are concerned including how it is harming family and relationships. Do not expect one conversation to result in change. Plan on it requiring a series of engagements.

Remember: It's Never Too Late

To Develop a Substance Use Disorder.
To Intervene.
To get Sober.

Start Your New Path to Sobriety Today!

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