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Signs of Substance Abuse in Older Adults

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Medically Reviewed By: Diana Vo, LMFT

August 14, 2023

Table of Contents

Learning how to pick up on the signs of substance abuse in older adults could mean you are able to help parents, grandparents, and other seniors who run into issues with alcohol or drugs in their golden years.

Most people instinctively think of young adults when they think about addiction and substance abuse. Teens and young adults are at heightened risk of substance abuse, and frequently binge drink – especially in a college environment – but substance abuse in the elderly is a growing concern.

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At the same time, there is very little research into substance abuse senior citizens, so the more you learn about the association between the elderly and substance abuse, the better placed you will be to ensure any senior loved ones in your life embrace sober living rather than falling prey to addiction.

Older Adults and Addiction

According to the most recent data from SAMHSA’s NSDUH (National Survey on Drug Use and Health):

  • 5.1% of all alcohol use disorders occur in the over-65s
  • 1.5% of all substance use disorders occur in the over-65s

While researchers still know little about the way alcohol and drugs impact aging brains, studies show that seniors metabolize substances at a slower rate. Equally, senior brains feel the effects of drugs more acutely.

Some research suggests that cocaine use in youth could increase susceptibility to negative outcomes from cocaine use in later life. This occurs due to a decline in gray matter in the brain.

According to SAMHSA (the Substance Abuse and Mental Health Service Administration), older adults are more likely to experience the following:

  • Lung problems
  • Heart problems
  • Memory issues
  • Mood disorders

Consuming alcohol or drugs can inflame all these conditions, compounding the negative health consequences.

Beyond this, some substances lead to slowed reaction times, impaired coordination and poor judgment. Accidents like falls and motor vehicle collisions both pose a stronger health risk to seniors than younger adults. Recovery times are also typically lengthier among older adults.

With anywhere from 5% to 9% of over-65s in the US prescribed opioid medications for pain management, research shows that opioid prescriptions increased ninefold over the course of the US opioid epidemic.

What Drug is Most Commonly Abused by OIder Adults

Legal and socially acceptable, alcohol can also be remarkably damaging when abused. Alcohol is the most abused substance among seniors.

Opioids and benzodiazepines are also heavily abused among the older demographic, with regular prescription use often snowballing into dependence, tolerance, and addiction.

Substance Abuse in the Elderly: Statistics

  • Alcohol abuse: Roughly 65% of seniors report high-risk drinking (drinking more than CDC guidelines) at least once a week over the past year. Studies also show that more than 10% of seniors report binge drinking (men consuming 5 or more alcoholic drinks within 2 hours, or women consuming 4 alcoholic drinks in the same period). Additionally, increases in alcohol consumption in 2020 were greater among those aged 50+ then among younger adults.
  • Opioid abuse: Between 4% and 9% of adults aged 65+ use opioid painkillers, according to this study. From 2013 to 2015, the number of adults aged 55+ increased by 6%, while there was a 54% increase in over-55s seeking treatment for opioid use disorder. During the same period, the number of seniors using heroin more than doubled, per the same data. In many cases, seniors start by misusing prescription opioids and then switch to heroin if they are unable to refill prescriptions, or unable to afford prescription opioids.
  • Marijuana abuse: This study illustrates that 9% of adults in the US aged 50 to 64 reported using marijuana during the previous year. While in 2006, only 0.4% of seniors used marijuana, by 2015, this rose to 2.9% of seniors using marijuana.
An image of an old man on a bench | Signs of Substance Abuse in Older Adults

Signs of Substance Abuse in Senior Citizens

If you are concerned about an elderly loved one abusing alcohol or drugs, the signs and symptoms will vary depending on the substance being abused.

That said, there are some common signs of substance abuse in older adults, including:

  • Losing interest in hobbies and activities
  • Depression
  • Anxiety
  • Spending more time alone
  • Hostility
  • Aggression
  • Forgetfulness
  • Confusion
  • Memory loss
  • Secretive behaviors
  • Losing prescriptions
  • Doctor shopping
  • Drastic changes to appearance
  • Drop in personal hygiene
  • Chronic health complaints
  • Excessive sleepiness

How Does Substance Abuse Affect the Elderly

Aging brings with it a battery of challenges to both physical and mental health. Abusing substances can further inflame these adverse outcomes.

NIDA (the National Institute on Drug Abuse) reports that seniors metabolize substances like alcohol, medications, and illicit drugs more slowly than younger adults, increasing their sensitivity to addictive substances.

Mental health issues also become more problematic in later life, again exacerbated by any underpinning substance use. The misuse of both benzodiazepines and opioids is associated with increased suicidal ideation in seniors.

Also, impairments triggered by substance use increases the risk of seniors falling or having accidents, both detrimental to older adults.

Effects of Alcohol Addiction in Elderly

Older adults metabolize alcohol more slowly, leading to higher BAC (blood alcohol concentration) levels.

In addition to being impaired more quickly than younger adults, seniors who drink heavily (more than three standard drinks daily) can accelerate the onset of cognitive decline, while at the same time increasing the risk of dementia.

For older adults taking medications that interact with alcohol, these dangers are amplified.

Effects of Drug Use in Elderly

Substance use disorder – the clinical descriptor for drug addiction – can increase the risk of the following in seniors:

  • Mood disorders
  • Memory problems
  • Falling
  • Car accidents

Fortunately, even if you have a severe substance use disorder, help is at hand.

Senior Drug Abuse Treatment Center at Renaissance Recovery

Regardless of age, we can help you unchain yourself from addiction here at Renaissance Recovery. If you are noticing signs of substance abuse in older adults in your life, don’t hesitate to reach out.

If you are concerned about needing to relocate to an inpatient facility for treatment, you needn’t be. Engage with one of our outpatient programs for addiction, or with our virtual IOP if you cannot attend a treatment center at all.

Whatever level of intensity makes the best fit for your addiction, you’ll benefit from evidence-based therapies here at Renaissance, including:

  • Medications: MAT (medication-assisted treatment) works well for both alcohol use disorder and opioid use disorder, streamlining both detox and ongoing recovery.
  • Psychotherapies: Talk therapies like CBT or DBT effectively complement MAT, helping you tackle the psychological component of addiction. Learn what triggers you to use alcohol or drugs and discover how to cope with life’s everyday stressors more healthily.
  • Counseling: Individual and group counseling will both help you to learn more about yourself and more about addiction.

Life’s too short to let substance abuse issues hold you back. Take action today and start embracing life substance-free by calling 866.330.9449.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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