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Understanding Drug Abuse Among Older Adults

Drug Abuse Among Older Adults

As the population ages, the complexities of managing health conditions increase, often leading to the use of multiple medications. While prescription medications are necessary for treating various ailments, there’s a growing concern about the abuse of these drugs among older adults.

However, it’s not just prescription medications that pose a risk; alcohol and even some over-the-counter medications also frequently contribute to substance abuse issues in this demographic.

Understanding the scope and impact of these commonly abused substances is crucial for developing effective prevention and management strategies. This understanding helps ensure that older people can enjoy a higher quality of life, free from the constraints of substance abuse.

Commonly Abused Drugs

As older adults age, they often experience a range of health issues that necessitate the use of multiple medications and can lead to substance use disorders. Understanding the most commonly abused drugs in this demographic from the National Institute on Drug Abuse is essential for prevention and management.1


What drug is most commonly abused by older adults? Alcohol. The National Institute on Alcohol Abuse and Alcoholism shows that 20% of the age group 60-64 years and 10% of 65 years and older report binge drinking.2

Alcohol and prescription drugs are commonly used together, which can significantly increase the risk of adverse interactions. Alcohol can exacerbate the effects of medications, increasing sedation and confusion, and complicate the management of chronic conditions.

Prescription Opioids

Opioids are one of the most commonly prescribed medications by healthcare providers for pain management in millions of adults aged 65 years and older, particularly for chronic conditions such as arthritis, cancer pain, and neuropathic pain.1

Drugs like oxycodone, hydrocodone, and fentanyl offer effective pain relief but also pose a high risk of misuse of prescription drugs and overdose. Due to their age-related slower metabolism and organ function, older patients may experience prolonged drug effects and side effects, increasing the risk of dependency.


The legalization and increasing social acceptance of marijuana have led to its rising use among older adults for both medicinal and recreational purposes. While marijuana can provide benefits such as pain relief and reduction in anxiety, it also carries risks, particularly when used in conjunction with other medications.1

For older individuals, the psychoactive effects of THC, the primary active compound in marijuana, can exacerbate cognitive impairments and lead to confusion, disorientation, and memory lapses. Additionally, marijuana in any form from dabs to edibles can interact with prescription medications like blood thinners, antidepressants, and anxiety medications.


Benzodiazepines are frequently prescribed to treat anxiety, insomnia, and even muscle spasms in older patients. Medications like lorazepam (Ativan), diazepam (Valium), and alprazolam (Xanax) are effective for short-term relief but are associated with a high risk of substance use disorders.1

Prolonged use can lead to tolerance, requiring higher doses to achieve the same effects, and can severely impact cognitive function, increasing the risk of falls and accidents.


While generally less addictive, antidepressants for mental health can still be misused by older adults, particularly when they are taken without proper medical supervision or in conjunction with other medications.

SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors) can interact with other drugs, leading to increased side effects or diminished effectiveness of treatment programs.

Over-the-Counter (OTC) Medications

Older adults might also misuse over-the-counter medications, including sleep aids and cold medicines. Products containing antihistamines or cough suppressants can be problematic due to their sedative properties, which can be intensified in older bodies.2

The Risk of Polypharmacy

Polypharmacy refers to the concurrent use of multiple medications by a patient, typically to manage several health conditions simultaneously. This practice is particularly prevalent among aging baby boomers, who often have multiple chronic diseases requiring various treatments. While necessary for managing these conditions, polypharmacy significantly increases the complexity of care, heightening the risk of drug interactions and adverse effects.

The use of numerous medications can lead to a higher likelihood of adverse drug reactions. Each additional medication not only adds a potential for interactions that can diminish the effectiveness of treatments but also increases the risk of severe side effects. These interactions can cause unexpected health issues such as increased blood pressure, kidney damage, or gastrointestinal distress.

The integration of recreational drugs like alcohol and marijuana into an older adult’s regimen compounds the risks associated with polypharmacy. These substances can interact with prescription medications, potentially leading to enhanced sedative effects, altered drug metabolism, and increased cognitive impairment. Such interactions are particularly dangerous for the elderly, whose organ function may already be compromised.

Prescription Medications

Population-Specific Effects

The effects of drug abuse can be more pronounced in older adults due to several age-related physiological changes:

  • Metabolism and Excretion
    As the body ages, liver and kidney functions slow down, affecting how medications are metabolized and excreted. This can lead to drugs staying in the body longer, increasing the risk of side effects and complications.1
  • Increased Sensitivity
    Older adults often exhibit increased sensitivity to medications due to decreased body water, increased fat storage, and changes in the central nervous system. These changes can amplify the effects of drugs, making therapeutic doses potentially harmful.
  • Cognitive and Physical Health
    The impact of drug abuse can exacerbate existing health problems. Cognitive impairments can worsen, leading to poor decision-making and difficulties with daily living activities. Physically, the risk of falls and other injuries increases, potentially leading to a cycle of increased medication use to manage pain from such injuries.

Supporting Older Individuals Abusing Drugs

Supporting elderly individuals struggling with drug abuse requires a comprehensive and compassionate approach tailored to their unique needs. Recognizing signs of substance abuse in older adults, such as changes in behavior, isolation, or neglect of personal hygiene, is critical for early intervention.

Medical evaluation and health care are essential to determine the extent of the abuse and any underlying health issues. Treatment options include medically supervised detoxification, inpatient or outpatient rehabilitation, and therapy such as cognitive behavioral therapy (CBT).

Regular medical reviews, patient and caregiver education, and the use of support groups and community resources are also crucial to effectively support recovery and improve the quality of life for elderly individuals facing substance abuse issues.

Explore Options for Elderly Drug Abuse With Lumina Recovery

Addressing drug abuse among older adults demands a nuanced understanding of the unique challenges and risks they face. By fostering a compassionate and informed approach, we can significantly mitigate the impacts of drug abuse in older adults and promote healthier, safer aging for all.

Lumina Recovery’s specialized program for seniors and older adults provides optimal support for the older population dealing with an addiction to prescription drugs or alcohol.

Learn more about your options with specialized programs that effectively address prescription drug abuse in older adults. Ensure a healthier, safer aging process with informed, compassionate care.



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