Substance Use in Older Adults

profile of a elder man

When you think of substance use and substance use disorders (SUD), you might immediately think of young to middle-aged men, the homeless population, partying college students, “wine moms” or people working in high-stress jobs. The group that probably does not immediately come to mind is older adults. Drug use does tend to decline with age. However, according to data reported in 2018, almost one million adults age 65 and older were living with a SUD. Drug use among people 50 and older was projected to increase 2.2% to 3.1% between 2001 and 2020.  Since older adults face increased health risks from SUDs, seeking treatment and getting help is imperative to improving health and maintaining an optimal quality of life.

What Substances Are Most Commonly Misused by Older Adults?

While prescription and illicit drug use rates have increased, alcohol remains the most commonly used substance among older adults. The National Institute for Alcohol Abuse and Alcoholism (NIAAA) and The American Geriatric Society recommend that older adults drink no more than seven standard drinks per week. However, prevalence rates for at-risk drinking are estimated at 16% for men and 10.9% for women. Binge drinking is an issue among older adults as well. Data from the 2005-2006 National Survey on Drug Use and Health indicated that 19.6% of older men and 6.3% of older women binge drink.

Fifty-four percent of adults aged 50 and up use marijuana, making it the most frequently used illicit substance by older adults.  Although many state laws have changed recently, marijuana is still considered an illicit substance because it is still illegal under federal laws.

Older adults frequently use opioid pain relievers. Between 4% to 9% of adults age 65 or older use prescription opioid medications for pain relief. Misuse of prescription medications can lead to heroin use due to its lower price or when doctors will no longer prescribe it. During those same years, the proportion of older adults using heroin more than doubled.

Substance Use Is Devastating to the Health of Older Adults

As people reach older age, physical and lifestyle changes occur that can make substance use especially dangerous at this life stage. Certain medical conditions are more common among older people, and substance use can exacerbate conditions such as:

  • Hypertension
  • Congestive heart failure
  • Liver problems
  • Mood disorders
  • Memory problems

As a result of various medical conditions, older adults often take more prescription and over-the-counter (OTC) medications than younger people. Unfortunately, these medications can have harmful interactions with substances such as alcohol and illicit drugs. In addition, even misused prescription medications can interact with other prescription medications in extremely harmful ways. A few of the dangers of substance use in older adults are:

  • Misuse of prescription medications plays an indirect role in 14% of hip fractures in people 60 and older.
  • Increased risk of respiratory issues in older adults who smoke marijuana.
  • Using one or multiple substances with a depressant effect can increase the risk of falls, confusion, bradycardia, respiratory depression, coma, death.
  • Alcohol and OTC medications containing acetaminophen can put enormous stress on the liver leading to liver damage due to age-related liver changes.
  • Stimulant use in older people with hypertension can lead to dangerously high blood pressure and even stroke.
  • Stimulant use can lead to severe damage to the heart. Use can even lead to myocardial infarction.

What Are Some Reasons Older Adults Use Substances?

SUDs are complex, and people, including older adults, use substances for many different reasons. Some of the reasons older adults may use substances are:

  • Misuse of opioid pain medications due to physical pain.
  • Aging Baby Boomers grew up in a time when illicit drugs were readily available and use held a dark allure.
  • Turning to substances to cope with the grief over the loss of family members, spouses, and close friends.
  • Using substances to manage increased anxiety related to health concerns, job security, savings, and retirement.

Older Adults and SUD Treatment

Treatment is available for older adults, but they do face some unique challenges when seeking  SUD treatment:

  • A basic lack of attention to SUD in older adults.
  • Providers confusing signs of a SUD with other medical issues or age-related changes.
  • Disapproval of the older adult’s children.
  • The older adult’s shame and guilt are associated with substance use disorders.
  • Negative and false assumptions such as SUDs cannot be successfully treated in older adults, and it is not worth treating SUDs in older adults.

Although older adults have been successfully treated with various treatment methods, there is still much to learn about what treatment models work best for older adults. Research does show that this population has more success with longer treatment episodes. It is important to remember that once older adults enter treatment, they can respond well to care and reap abundant mental and physical health benefits.

Untreated substance use disorders can lead to increased health risks and dramatically decrease older adults’ quality of life. It can be challenging for anyone, including older adults, to seek treatment and get help. Casa Palmera is here to help and support you. We offer multiple levels of care to adults up to age 70, and we also treat co-occurring substance use and psychiatric disorders.  While at Casa Palmera, you will be treated with empathy and compassion as our experienced, highly trained staff help you begin your recovery journey. We go deeper than just trying to treat symptoms. We will work with you to develop an individualized treatment plan that incorporates the latest evidence-based treatments and eastern intuitive modalities to meet your unique needs and address the complex factors that lead to substance use. Call Casa Palmera today at (855) 508-0473 to discover how we can help you begin your recovery process. 


This blog is for informational purposes only and should not be a substitute for medical advice. We understand that everyone’s situation is unique, and this content is to provide an overall understanding of substance use disorders. These disorders are very complex, and this post does not take into account the unique circumstances for every individual. For specific questions about your health needs or that of a loved one, seek the help of a healthcare professional.