Substance Abuse in the Older Population

Karen Kent

Substance abuse is one of the hidden problems in the older population. As we age, our bodies become more vulnerable to the effects of alcohol and other drugs. The most common substance abused in the over-60 population, after nicotine, is alcohol.  It is primarily used in the privacy of the home rather than in public bars and taverns, so friends and family may be unaware it is occurring. 

Substance abuse counselor Connie Wurm meets with a client at Evergreen Healthcare’s Behavioral Health Department

The second most common substance misused is prescription medications.  Usually, the person is not taking the drugs as prescribed, or is taking them in combination with alcohol, which increases the risk of injury and illness. According to the U.S. Department of Health and Human Services, as many as 17% of older adults are affected by substance abuse and it is identified as one of the fastest growing health problems in our country.  Older adults may medicate themselves with alcohol for depression, anxiety, or chronic pain without their physician being aware of it. Research shows that older adults who “self-medicate” with alcohol or prescription drugs are more likely to characterize themselves as lonely and having little life satisfaction.

The good news is that research studies clarify that older alcoholics are significantly more likely to complete treatment than younger patients. In one longitudinal study, there were improvements in general health with older adults who completed treatment and maintained sobriety over six months. Abstinence is not the only measure of success. At Evergreen Healthcare’s Substance Abuse Services for older adults, success includes not only a decrease in the use of the substance and in depressive symptoms but also an increase in socialization, medical care, use of community resources, exercise, and better nutrition.

Connie Wurm is the substance abuse counselor at Evergreen Healthcare’s Behavioral Health Department.  Because of a grant from Aging and Disability Services, she is able to provide up to five free sessions anywhere in King County. Currently, there is a long waiting list for these outreach services. Starting January 1, 2008, the program will expand because of a contract awarded by King County Department of Community and Human Services.

Connie evaluated Ms. C., a woman in her eighties living with a roommate.  Ms. C. had a mental health disorder which she was self-medicating through the use of alcohol.  Most of her friends in the building drank with her. Because of the alcohol misuse, Ms. C. exhibited poor insight and judgment by allowing a drug addict to be her roommate. She was also falling more often and smoking a pack of cigarettes each day. Ms. C did not want to have inpatient or outpatient substance abuse treatment, but she was willing to work with Connie to make changes in her lifestyle. She agreed to gradually decrease her drinking, which meant she had to tell her friends she could no longer drink with them. She reported the roommate’s stealing and the police removed her roommate from the premise. The plan was for her to fill excess time by increasing community involvement and time with sober friends and family. Connie offered support and motivational counseling each step of the way. Ms. C. decreased her smoking to only three cigarettes a day, gradually stopped drinking alcohol completely, and has now been sober one year.

If you or someone you know is the caregiver of an older adult substance abuser, you may qualify for our caregiver counseling program that is also free. These services are offered throughout King County and we can meet with you at your home or in the community at a neutral location. To make a referral to Substance Abuse Counseling and Referral or Caregiver Counseling, please call (206) 923-6300 and ask for Intake.

Karen Kent is the Clinical Supervisor of the Geriatric Regional Assessment Team