American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

Substance Abuse in Senior Citizens - Recognizing the Signs

​​​Substance abuse isn’t just a problem for the young. Loneliness and mental health issues, coupled with pre-existing alcohol and drug habits have turned many older adults to controlled substances in their golden years. Here’s what you should know about recognizing substance abuse in your elders and where to turn for help.  

Substance abuse knows no boundary of age,” says Stephen Scheinthal, DO, an osteopathic geriatric psychiatrist from Stratford, New Jersey. “Whether you are 20 or 80 years old, you may see drinking or taking drugswhether legal or illegalas a way of coping with grief, anxiety, depression or pain.”   

Alcohol can have significant interactions with prescribed medications. Findings from the National Institute on Alcohol Abuse and Alcoholism show that 20-30% of people ages 75 to 85 have experienced drinking problems and, according to the Substance Abuse & Mental Health Services Administration, 3.6% of adults ages 60 to 64 report using an illicit drug.

“While the rate of seniors using illegal drugs, like marijuana, is low, older adults often take a higher number of medications to treat chronic illnesses,” says Dr. Scheinthal. “On average, seniors take four to nine pills per day between their prescription drugs and over-the-counter medications and abuse of these medications is not always easy to spot,” he adds.  

Health Consequences

According to Dr. Scheinthal, overuse of prescribed medications or the act of combining medications with alcohol or other controlled substances can lead to a number of serious consequences, such as:

  • balance issues

  • cognitive problems

  • delirium

  • depression

  • sleeping problems such as insomnia

  • increased odds of developing other medical disorders

  • adverse reactions that have the potential to be lethal 

“With so many potential complications, it is vitally important for older people to talk with their physicians about all medications they are taking, both prescribed and over-the-counter, and to be forthcoming about the amounts they are ingesting and their alcohol and drug intakes,” says Dr. Scheinthal.   

Dr. Scheinthal also points out that it’s important for senior citizens to disclose their alcohol, drug, and controlled substance intakes so that a physician will be aware of any withdrawal symptoms

“If a person becomes hospitalized and the attending physician does not know his patient has a drug habit, he might prescribe medication to treat the patient for being restless or jittery, without realizing the patient actually is going through withdrawal symptoms,” he says. 

Warning Signs

The following are warning signs caregivers can watch for to see if an older friend or family member might have a substance abuse problem:

  • Changes in sleep patterns and/or appetite that cannot be attributed to other reasons

  • Increased falling

  • Frequently changing physicians or “doctor shopping” to get multiple prescriptions

  • Filling prescriptions at multiple pharmacies

  • New onset irritability or agitation

  • Periods of confusion

  • Empty liquor bottles in the garbage or recycling bucket. 

Doctors of Osteopathic Medicine, or DOs, look beyond your symptoms to understand how lifestyle and environmental factors affect your wellbeing. They listen and partner with you to help you get healthy and stay well. They also encourage your body’s natural tendency toward self-healing.​


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