Addiction has become a much more relevant subject as the nation is engulfed in a drug epidemic. Most people understand that addiction is classified as a disease process and that it can affect people from all walks of life. It does not discriminate. But we rarely consider the impact of addiction on older people like America’s senior citizens.
It’s almost as though we consider them “addiction proof.” According to the National Institute on Drug Abuse, young adults age 18-25 are the biggest abusers of prescription opioid pain relievers, ADHD stimulant drugs, and anti-anxiety medications. And while statistics like these tend to support the stereotypes, they obscure certain truths as well.
Between 2002 and 2014, opioid abuse nearly doubled for those who are 50 and older yet declined in younger age groups. Among people age 65 and older, opioid-related emergency room visits were up 74% from 2010-2015, with 124,300 hospital admissions in 2015. So, addiction among seniors is no small problem. But how, and why does this happen?
Let’s face the harsh truth that people in the grips of addiction don’t survive long, certainly not into their 60s. They usually succumb to health problems or overdose at a young age. So, it’s not exactly that these seniors are lifelong drug abusers who got lucky. Some of them are, but not many. A potential reason for these increases is the baby boomer generation. The explosion in population during that era will be turning 65 or older in a wave set to increase the number of senior citizens in America drastically.
It is projected that the population of older adults will nearly double between 2010 and 2030. The baby boomer generation came of age in the 60s and 70s, a period of growing acceptance of and dependence on drugs. Undoubtedly, the social and cultural influences of those times have shaped an individual’s attitudes toward drugs, which may be playing out in a late-life addiction. A growing acceptance of drugs wouldn’t be surprising, considering we are in the middle of a national drug epidemic.
But is it that there’s more addiction than ever in seniors, or that we’re now just starting to pay attention to it?
Before a national spotlight on the addiction crisis, nobody seemed to care. A brutal truth may be that because older people are perceived to have “less to live for,” it just doesn’t get the same attention. It’s this kind of stigma that pervades society, even to the degree that older people may begin to feel that way themselves and act accordingly. People in late life, already more plagued by illness and chronic pain, could wind up using a similar mentality as a justification why it doesn’t matter if they use drugs or alcohol.
Alcohol is the most commonly abused substance by those age 65 and older. Because of this, most of the research on senior substance abuse focus on alcohol use disorder. For seniors in healthcare settings, the rate for alcohol use disorder goes up to 22%. Rates for binge drinking are also up among seniors, with nearly 20% of older males participating in consuming five or more standard drinks in one drinking episode. Guidelines for seniors recommend keeping consumption to no more than 7 drinks per week.
Illicit drug use is more common among older adults in America than in almost any other country in the world. Rates for illegal substances abuse doubled on average between 2002 and 2012 for Americans age 50 to 65. Again, this is influenced by the baby boomer generation. In 2012, 19.3% of adults age 65 and older reported ever using illicit drugs in their lifetime. Compare this to the 47.6% of adults between the ages of 60 and 64 who answered that poll the same year, and you can see the stark difference statistically of the surging baby boomer generation. But sometimes, people wind up dependent on drugs without knowing or meaning to.
As our culture becomes more saturated in drugs as the solution to all that ails, older people are put on more and more prescription drugs.
Indeed, older people have more medical conditions, but this doesn’t account for the overprescribing of psychiatric medications. And seniors consume more benzodiazepines than any other psychotropic drug. Benzos are an older class of drugs that have been proven to be very addictive and only used for short periods. Yet about one-third of seniors placed on them by non-psychiatric clinicians, such as primary care doctors, are on these drugs long term. With this comes dependence, and a situation where the person doesn’t want to be on the drug but can’t stop taking it due to withdrawal symptoms.
We also see a phenomenon that is particularly common in seniors. It’s known as the prescribing cascade. This event occurs when a medication causes unwanted side effects. These side effects are misidentified as a separate ailment and treated with yet another prescription. Unnecessary prescriptions can go on and on to where a person has several unneeded medications.
To illustrate this, a person who started on a blood pressure medication may develop issues with sleep. To help with this, a doctor prescribes a sleeping pill, which causes depression. The depression is, of course, treated with antidepressants that have a myriad of unusual side effects. Because older people are so much more likely to be on medications, the “prescribing cascade” can be observed most among them. TO give an example, in the United States, 57% of women age 65 and older take five or more prescription drugs, and 12% take more than 9 of them.
Without a doubt, America’s seniors are part of the drug epidemic, and they can’t be forgotten. The baby boomer wave is coming, and with it, unprecedented levels of addiction among older adults. So long as overprescribing of narcotic medications like benzos continues, this combined with a surging population of seniors with more liberal attitudes may cause a perfect storm scenario. It’s time to pay attention to this issue before that happens because no one’s life is less valuable than another’s.
