It’s probably true that when most of us think about people addicted to drugs, the pictures that pop up are of younger or middle-aged persons, not seniors. Indeed, most people and service agencies focus on addiction as experienced by the younger generations. Often, older addicts are neglected or even ignored. Yet, according to a recent study at the Gerontological Society of America, there was a 78% increase in the number of emergency health visits among older adults who abused prescription or illicit drugs between 2006 and 2012. Abuse of opioids accounted for around 11% of this figure. The study was carried out among over 71,000 seniors, with more than 50% aged 65 to 74 years. According to researchers, almost half of the emergency room visits came from people 75 years and above.

Older adults are at increased risk of becoming opioid addicts because opioids are often described for various health problems associated with chronic pain, problems that increase with age. Some severe conditions require regular doses of narcotic painkillers which under unmanaged situations can lead to an addiction problem. As with younger people, it’s easy for seniors to find doctors who can prescribe all the opioids they want. Common opioids prescribed to seniors include OxyContin and fentanyl.

An elderly person who is addicted to analgesics may become very anxious and depressed. In extreme situations, they appear confused or disorientated and can harm themselves. Taking more than the recommended dose of prescribed medications, or combining them with alcohol or other drugs, can lead to disastrous results. Most drugs numb the effects of alcohol, increasing tolerance levels and chances of alcohol poisoning, which is fatal. In other cases,  as with the younger generation, drug overdose is a serious risk.

Recognizing addiction among the elderly

Seniors do not fit the profile of the typical drug abuser so most of the time, physicians and family members miss the relevant signs.

If your older relative or friend starts using medication for non-intended purposes or starts taking prescribed narcotics, you may wish to check in on or monitor their usage.

Obvious signs of prescription addiction:

  • Increased dosage

How much are they using? If they suddenly increased dosage from one or two a day to four or six, there’s something wrong. Always ask or look at the label prescription to make sure they are adhering to instructions. This can give you a clue about their user habits.

  • Changes in behaviours

Is there a swift change in their behaviour? Perhaps from cheerful to withdrawn and antisocial behaviour? Are they aggressive, depressed, secretive or nervous?

  • Inventing excuses to take medication

Sometimes people who abuse prescriptions make up excuses to justify using them at odd hours. For example, they might claim that they forgot. Or in order to double the dosage, they might complain of twice the pain discomfort. Although they might be genuine, if the excuses continue a lot then consider it a red flag. Also, double dosage for double pain is not a medical recommendation so be aware of that in particular.

  • Show remorse or concern about taking their medication

A drug abuser is often anxious when it comes to their medication time. They can exhibit anxiousness and look too concerned or remorseful after taking their drugs. When you notice this, it might be grounds for further investigation.

  • Secret stashes or “pocket supplies”

Be watchful to ensure the older person isn’t storing away medications for ‘later use’. Having a pocket supply can only indicate they are using it in an un-prescribed dosage. This could be a red flag too.

  • Do they have a history of drug abuse?

While this should not be used as a reason to identify someone as having a problem, it helps to know that a vulnerability exists so the elderly patient may receive more focused care.

  • Do they change doctors or drugs regularly?

Frequent change of physicians could indicate the older person is not adhering to doctor’s prescription. This happens when a doctor refuses to give them what they want, so they move on to a new unsuspecting doctor.

  • Receive same prescription from multiple physicians or pharmacists

The older person may have two or more doctors to provide them with twice the dosage of a specific painkiller. This is dangerous and could lead to addiction. Make sure you are aware of every doctor they meet up with.

  • Do they hide or sneak their drugs?

If you observe the older person hiding or taking their drugs secretly, there might be a problem.

Effects of drug abuse on the elderly

The health situation of a typical elderly person is already fragile, and an addiction will pose more complications for them. For example, withdrawal symptoms may be too unbearable to control. The cold turkey detox method is out of the question because patients must be in good physical conditions first.

Clinical research is beginning to expose the consequences of un-prescribed drug use and dependence in the aging population. The effects worsen with age, examples include medical comorbidity, cognitive impairment and weakness.

Typical medical consequences include a failed immune system, liver damage, cardiovascular failure, gastro intestinal complications and endocrinological failure.

Early onset and late onset abusers

Substance abuse among the elderly can be categorized as early-onset or late-onset abusers. In early onset abusers, the drug abuse develops before they are 65 years old. In these patients, the incidence of psychiatric and physical issues is usually higher than in the late-onset patients.

In the late-onset drug abusers, the behaviours are often associated with a stressful life occurrence like loss of money, death of a spouse, poor living situations, retirement or social neglect. Late-onset abusers generally exhibit less physical and mental health issues than early-onset abusers.


In elderly patients, opioid abuse problems are often misdiagnosed, mainly because of the multiple possibilities applicable to the aged population. One is also forced to confront their own biases and beliefs. Another challenge is the denial of drug abuse by the elderly patient, which can affect accuracy of diagnosis and make treatment difficult.

A comprehensive evaluation needs to be carried out to identify and treat the opioid addiction in the elderly patient.

What to do when you suspect an older person may be addicted to opioids

Confronting an older relative or friend about a possible opioid addiction (or type) may be daunting, but it is something that must be done, especially when you have verified some of the signs listed previously.

If they admit they can no longer control their opioid intake, they can begin to navigate their way towards treatment and recovery. Everyone, regardless of age, deserves the right to live free from addiction and prepare themselves for a better lifestyle.

To get the most out of treatment, consider the type of facility that will be most suitable for their situation. It is better to consult a physician who specializes in opioid abuse. There are modern facilities specifically designed to treat drug addictions. Make sure they are accredited too.

Professional help

The recovery process will often include in-depth psychological testing because they may have co-morbid problems and cognitive issues including depression, or other mental illnesses. If the doctor confirms an opioid addiction, the next step is to begin a medicated detox.

Treatment will often include monitored medication because the withdrawal symptoms from opiods may be too severe among the elderly. It will help ease the pain and make withdrawal more bearable. During that time, they will be introduced to a support group for moral support in their recovery. The best way to ensure healing and success is to for you to provide support, but not enable them. Remember, like younger people with addiction issues, older persons will also benefit from supported recovery and go on to lead healthier, happier lives.

This Guest Blog Post was written by James Cummings from Addiction Helper. Addiction Helper has been operating a free 24/7 helpline service in the United Kingdom offering addiction treatment advice since 2009. Addiction Helper has nearly 4,000 pages of informative content to help enquirers, families and people in need of help for addiction issues.

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