The cultural appeal of craft cocktails, wine-tasting events, and legalized recreational marijuana use, especially on the heels of a global pandemic, has led many people to develop an unhealthy relationship with alcohol and cannabis. But what many healthcare professionals were not prepared for was the growing number of older adults, especially Baby Boomers that came of age when alcohol and pot were part of the social scene, who may have substance abuse issues.
According to a recent New York Times Health report, substance abuse is rising sharply among seniors and yet due to the stigma, older adults may not always honestly report alcohol or drug use to their doctor. A study of opioid use among people over 65 enrolled in Medicare shows a dramatic increase over five years from 4.6 cases per 1,000 patients in 2013 to 15.7 cases per 1,000 patients in 2018. Fatal overdoses have also spiked, quadrupling between 2002 and 2021. These deaths included suicides and accidental death – which resulted from drug interactions and errors.
Aging Baby Boomers often have a long history of alcohol and drug use – but most substance abuse disorders among seniors of this cohort involve prescription medication, not illicit drugs. Because many seniors live with several chronic health conditions, medication regimes can be complicated and leave room for error. Additionally, older adults may be more sensitive to drugs and alcohol with less tolerance to these substances as the body ages. Cognitive changes can also influence the ability to properly manage medications and chronic diseases.
Drug interactions, mixing substances, and overdoses can not only lead to death, but many seniors suffer falls and accidents that can lead to loss of physical function and independence. Drug and alcohol abuse can also worsen cognitive decline, and accelerated heart and liver disease, cancers, and kidney failure. Accessing treatment for substance abuse may also be a barrier for seniors who lack transportation, health insurance coverage, or the motivation to begin recovery.
With greater awareness of the growing substance abuse program among older adults, more primary care screening is taking place and insurance coverage for treatment programs and counselling has expanded. Telehealth options have also made it easier for homebound seniors or those living in remote communities to access help.