Substance use disorders don’t discriminate by age

May 3 2004

Substance use disorders don’t discriminate. In fact, anyone can have a problem with prescription medication, alcohol, or illicit drugs—including adults aged 55 and older. Although alcohol and illicit drug use generally decline as people grow older, age-related stresses such as the loss of a spouse, retirement, or loneliness can sometimes trigger substance use problems. In 2000, more than 5 million adults aged 60 and older were problem alcohol users, according to the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) 2000 National Household Survey on Drug Abuse.

Recognizing a substance use problem in older adults is often difficult because symptoms sometimes mimic the signs of other problems common among older adults such as diabetes, dementia, and depression. As people age, their ability to absorb, metabolize, and dispose of drugs changes, making them more at risk for harmful reactions. Cues that an older adult may be having problems with alcohol, illicit drugs, or their medications include the following:

• Changes in sleeping and eating patterns

• Confusion or disorientation

• Malnutrition

• Poor hygiene

• Neglecting one's appearance

• Slurred speech

• Incontinence or difficulty urinating

• Blurred vision or dry mouth

• Tremors

• Shakiness

• Frequent falls and bruising.

Older adults also are more likely to experience harmful drug interactions when they mix their medications with alcohol or take their medicine in a way that differs from their doctor’s prescribed dose or instruction. It’s important for doctors and family members to monitor older adults, especially since many older adults take several medications at once in addition to over-the-counter medicines and herbal remedies.

To help older adults keep track of which medications to take and when, SAMHSA created a brochure, As You Age…A Guide to Aging, Medicine, and Alcohol, that includes a chart where medicines can be listed along with the dose prescribed and the time the medicine should be taken. To order this free brochure or to ask questions about how medications, alcohol, and illicit drugs affect older adults, contact SAMHSA’s National Clearinghouse for Alcohol and Drug Information by writing to P.O. Box 2345, Rockville, MD 20847-2345; calling (800) 729-6686; or visiting https://www.samhsa.gov/.