Adults 65 and older aren’t exempt from struggling with substance misuse. About 2% of adults aged 65 or older have a substance use disorder (SUD), and some older adults may use substances to cope with changes in their lives (e.g., retirement, grief and loss, or declining health). Identifying a substance use issue in a senior can be more complicated than identifying one in a teenager or younger adult.

Here are the four most common types of substance misuse issues in the elderly, how to identify them, and how to provide help.

Opioids and pain management medications

Opioid use and misuse are rising among the senior population. Adults aged 65 and older may have persistent pain connected to other health conditions, such as cancer or heart disease. According to the National Institute on Drug Abuse (NIDA), about 4-9% of those aged 65 and older use prescription opioid medications for pain. Unfortunately, this population has increasingly needed help for opioid use disorder, with heroin use doubling in this age group to save on costs. 

This increased dependence makes seniors more vulnerable to the harmful effects of opioids and pain medications. Paying attention to signs of drug misuse is critical in addressing the issue head-on and suggesting treatment. A few signs to look for are irritability, sadness, depression, unexplained bruises, changes in eating and sleeping habits, isolation, and memory problems. 

Contacting a treatment center specializing in addiction in older adults is necessary for recovery. Case management services can also help as the aging population typically lacks physical support from loved ones who may not live near them.


Alcohol is the most commonly used substance by older adults, according to the NIDA. High-risk drinking for older adults involves surpassing seven drinks in one week.

How an individual copes with stress, including avoidance, may contribute to developing a drinking problem later in life. Social factors and alcohol consumption history may also play a part in a senior’s relationship with alcohol. 

If you believe your loved one is struggling with alcohol, communicate your concerns directly with them or their physician. It is more challenging to diagnose SUD in older adults because the physical aspects of alcoholism may show up as other diseases such as stroke, high blood pressure, and liver issues. Typically, increased consumption means a higher tolerance, but older adults experience a reduced tolerance which can lead to cognitive decline. A physician may recommend an alcohol/drug treatment program for a senior struggling with alcohol misuse.


Nicotine is an addictive component in tobacco and another common addiction in seniors. Studies have revealed long-term smokers make up 14% of those physiologically dependent on nicotine. According to the NIDA, older adults who smoke have a greater probability of frailty.

It’s difficult to stop a nicotine addiction, and sometimes smokers make a few attempts to quit before complete abstinence. Working with a counselor, taking medications, and following through with a treatment plan can help seniors quit for good.

Other prescription medicines

The older population receives prescription medication more than any other age group, and this can lead to misuse and abuse. A study from the NIDA found adults aged 57 to 85 commonly mixed prescription and non-prescription drugs and dietary supplements — and many have adverse effects. 

Like pain medication misuse, prescription drug abuse is possible if your loved one is more isolated. Several factors lead to drug dependence, such as losing a loved one, family conflict, trouble sleeping, financial strain, or mental/physical health decline. Risk factors include a history of SUD or a mental health disorder and medical exposure to prescription medicines with a history of misuse. 

The American Society of Addiction Medicine suggests several effective treatment methods, such as cognitive behavioral therapy, group therapy, individual counseling, and family therapy.

The best treatment method for SUD depends on many factors, including the individual and their addiction. For information, referrals, and additional resources turn to Wellspring Center For Prevention offices at 732-254-3344.

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