Addressing Substance Use Disorders Among the Elderly: An Overlooked Struggle for The family

Introduction: Illuminating a Hidden Crisis  
The opioid crisis hasn't spared any demographic, yet the impact on certain populations, particularly older adults, like our parents, hasn't been sufficiently highlighted. Roughly a million elderly Americans are grappling with substance use problems, yet they are less prone to seek help, despite having equal chances of benefiting from treatment as any other age group. This article delves into the nature, risk factors, and accessibility barriers related to addiction among older Americans.

Substance Use Among Elderly Individuals: Revealing the Truth
Problematic substance use in the elderly is a multifaceted issue. Research indicates that two-thirds of older adults battling substance use disorders have a consistent condition, while the rest develop substance use problems later in life. The probability of substance use development in this demographic is heightened by factors such as loneliness, social isolation, bereavement, chronic pain or illness, mental health disorders, and shifts in their work or living conditions. These elements increase their vulnerability, with substance use often being a coping mechanism for dealing with diverse losses. We get to ask, why the pain, not only why the addiction.

Addressing Stigma and Age Discrimination
Opioid and alcohol use disorders are amongst the most stigmatized health conditions globally, as highlighted by the World Health Organization. Age discrimination compounds this stigma, fueling misconceptions about the incapacity of older individuals to modify their behaviors. Nevertheless, empirical evidence contradicts this perception, demonstrating that elderly patients can achieve similar recovery rates from substance use disorders when given suitable treatment. Recognizing the potential for change in older adults and its beneficial effects on their life quality and health is crucial.

Screening: A Neglected Essential
Substance use screenings in the elderly are often overlooked, leading to under-treatment. Despite recommendations for regular screenings throughout life, healthcare professionals often fail to perform substance use screenings in elderly patients. Additionally, the use of age-appropriate screening tools that can detect co-existing conditions is insufficient. Due to the overlap of substance use disorder symptoms with those of age-related ailments, it's challenging to identify substance use disorders in older individuals, potentially leading to inaccurate diagnosis and delayed treatment.

Access to Services: Overcoming Obstacles
Older adults face numerous hurdles in accessing substance use treatment. The scarcity of specialized geriatric addiction treatment programs limits available options. Barriers such as negative attitudes from providers and caregivers, lack of awareness about diagnosis and treatment, denial of the problem, transportation and financial difficulties further obstruct older adults' access to treatment. Given that many elderly Americans rely on Medicaid and Medicare, the availability of treatment options within their insurance network that accept public coverage is vital. Increasing affordable, local treatment options can improve accessibility and affordability. We get to do better by our elders.

Treatment: Catering to Specific Needs
Elderly individuals are less likely to receive accurate diagnosis for substance use disorders. It's vital to distinguish between substance use symptoms and typical aging symptoms to ensure suitable treatment and referrals. Large discrepancies exist in treatment methods, particularly with the underuse and lack of research on medication-assisted treatment (MAT) in this demographic. Substance use treatment for older adults should consider the intersection of addiction, mental, emotional and physical health. Customized approaches that consider age-specific physical health issues, cognitive decline, and emotional challenges faced by this population are necessary. Adopting age-sensitive treatment methods and taking into account potential medication interactions is crucial for effective treatment.

Conclusion: Forging the Way Forward
The population of older adults with substance use disorders requires targeted attention and improved prevention and treatment strategies. Recognizing the unique needs of this demographic and breaking down barriers to treatment are vital. Through enhancing understanding, increasing screenings, widening access to services, and tailoring treatment methods, we can ensure older Americans get the support and care they need. Together, we can build the path towards progress.

​References:

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6. World Health Organization. (2019). Substance abuse. https://www.who.int/health-topics/substance-abuse

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