Studies conducted over the past 10 years indicate drug use rising in middle-age and older adults. Researchers found the opioid epidemic is partially behind this spike in cases. In addition to prescription opioids and heroin misuse, increased alcohol, marijuana and poly drug misuse in older adults also is on the rise.
Although many perceive substance use disorders as a condition of the young, addiction and substance use are becoming increasing threats to middle-aged and older adults. The National Institute of Drug Abuse (NIDA) recently conducted studies highlighting the importance of screening older adults for substance use disorder (SUD).
Why Are Older Adults at Increased Risk for SUD?
Chronic health conditions due to the aging process can lead physicians to prescribe the middle-aged and elderly with opiate medications. And opiates are not the only drugs they are taking. Another NIDA study found that 3,000 adults aged 57-85 showed common mixing of prescription medicines, non-prescription drugs and dietary supplements. More than 80 percent of participants in the study used at least one prescription medication daily. Nearly half used more than five medications or supplements. This puts at least one in 25 people in this age group at risk for a significant drug-to-drug interaction. Worse, older adults who mix prescriptions face an increase in suicidal thoughts.
Another complication is that little is known about the effects of drugs on the aging brain. That is why sometimes drug use in older adults is considered a hidden problem. For example, we associate forgetfulness with several ailments that affect the aging. This makes it hard to decipher whether a loved one is misusing substances or has a cognitive condition such as dementia. And in a cruel twist, a person with a cognitive condition may unintentionally take improper amounts of medication, leading to accidental substance use disorder.
Recently, researchers discovered that it’s not just prescription drugs and alcohol affecting this demographic. One study shows that marijuana and medical marijuana could be contributing factors to the increase in SUD among older adults. The data indicates that 9 percent of adults aged 50-64 reported past-year marijuana use in 2015-2016. That’s compared to 7.1 percent in 2012-2013. The same went for adults 65 years and older. Their pot intake increased sharply from 0.4 percent in 2006-2007 to 2.9 percent in 2015-2016.
“My first job as a clinician is to convince these patients to cut back on using,” said Susan Lehman, director of the Geriatric Day Hospital program at Johns Hopkins University
However, this has proved difficult due to a lack of screening for SUD in older adults. According to the University of Buffalo’s Research Institute on Addictions, the drug-use symptoms associated with younger substance users are masked somewhat in older adults. Therefore, the challenge becomes identifying when older adults are using substances, rather than attributing symptoms to the normal aging process.
Also, there is little information on what successful long-term care models look like for this older demographic. Therapy and medication are used successfully in younger substance users. That is why developing proper screening for older adults is essential to determine what methods of therapy and medications are right for them.
Ultimately, developing a better understanding of how we screen middle-aged and older adults for SUD will improve care in the future. With better screening, doctors and treatment professionals will be able to identify SUDs in older Americans. Even more helpful, medical professionals will be able to determine whether an individual has a SUD or is struggling with a pre-existing cognitive condition.