If you or someone you know is in crisis right now: call or text 988 (Suicide & Crisis Lifeline). For a possible overdose or any medical emergency, call 911. For help finding treatment, the SAMHSA National Helpline is free and open 24/7 at 1-800-662-4357.
The short answer
Alcohol and prescription drug problems are common and often missed in people over 60, because symptoms can look like aging and many older adults take multiple medications. Treatment works for older adults and should be tailored to age-related changes. Talk to a doctor, and never stop alcohol, sedatives or opioid pain medicines suddenly on your own.
Why older adults are at higher risk
- The body changes. With age, the body processes alcohol and medicines more slowly, so the same amount has a stronger effect.
- Many medications. Mixing alcohol with prescriptions can be dangerous.
- Sedatives and pain medicines. Benzodiazepines, sleep medicines and opioids raise the risk of falls, confusion and overdose.
- Life changes. Retirement, loss of a spouse, loneliness, chronic pain and health problems can lead to increased drinking or medication use.
- Hidden problems. Falls, memory problems, mood changes and poor sleep can be blamed on aging, and substance use may go unnoticed.
Signs to watch for
- New or worsening confusion, memory problems or mood changes
- Falls, bruises or accidents
- Poor sleep, changes in appetite or weight
- Hiding or hoarding alcohol or pills
- Running out of medications early, or visiting several doctors
- Withdrawing from friends and activities
- Neglecting hygiene or home
- Drinking at times or in amounts that worry family or doctors
These can also have other causes, so a medical evaluation matters.
Alcohol after 60
Because of the body’s changes, older adults are advised to drink less than younger adults, and some conditions and medications make any alcohol unsafe. Ask your doctor what is safe for you. If you drink heavily, do not stop suddenly without medical advice, because withdrawal can be dangerous. (See [Can You Detox at Home? Dangers of Alcohol and Benzodiazepine Withdrawal] and [Alcohol Use Disorder Treatment Options: From Detox to Medication].)
Prescription drug problems
Common medicines of concern include:
- Benzodiazepines for anxiety and sleep. Guidelines advise caution about using them in older adults and recommend supervised tapering when they are being stopped. (See [Benzodiazepine Dependence: Why Tapering Should Be Medically Supervised].)
- Opioid pain medicines. Long-term use raises risks. A doctor can review options for pain and treatment if there is dependence or addiction. (See [Opioid Addiction Treatment: Buprenorphine, Methadone and Naltrexone Compared].)
- Sleep medicines and some muscle relaxants.
Never stop these suddenly. Ask your doctor or pharmacist for a full medication review.
Treatment that works for older adults
- Medical evaluation of overall health, medications, memory and mood
- Age-appropriate care, often at a gentler pace, with attention to hearing, vision, mobility and other needs
- Medication for alcohol or opioid use disorders, adjusted for age and other conditions. (See [Medication-Assisted Treatment (MAT): How It Works and Who It’s For].)
- Therapy, including approaches that address grief, loneliness and loss. (See [Evidence-Based Therapies in Addiction Treatment: CBT, DBT and Contingency Management].)
- Treatment for depression, anxiety and chronic pain. (See [Dual Diagnosis Treatment: When Addiction and Mental Health Overlap].)
- Groups with peers around the same age, when available
- Involvement of family or caregivers
Look for programs experienced with older adults, and ask whether staff are trained in geriatric care. (See [Inpatient vs Outpatient Rehab: Which Level of Care Is Right for You?].)
Paying for treatment
Medicare covers many substance use services. (See [Does Medicare Cover Rehab? Parts A, B and D Explained].) Medicaid and other programs can help too. (See [Does Medicaid Cover Addiction Treatment? How It Works by State] and [Free and Low-Cost Rehab Options Without Insurance].)
Where to find help
- Your primary care doctor, who can screen and refer you
- SAMHSA helpline (1-800-662-4357) and FindTreatment.gov. (See [How to Use FindTreatment.gov and the SAMHSA National Helpline].)
- The Eldercare Locator (1-800-677-1116) or your local Area Agency on Aging, for local services
- Medicare and State Health Insurance Assistance Programs, for coverage questions
Safety at home
- Use a pill organizer and keep a current medication list.
- Do not mix alcohol with medicines unless your doctor says it is safe.
- Dispose of unused medicines safely.
- Keep naloxone at home if you use opioid pain medicines. (See [How to Get Naloxone (Narcan): Where to Find It Free and When to Use It].)
If you are a family member
Approach with care and respect, focus on health and safety and offer to go with them to the doctor. Avoid assuming that confusion is just aging. (See [How to Talk to a Loved One About Addiction Without Pushing Them Away].)
Frequently asked questions
Can older adults get addicted to prescription drugs?
Yes. Dependence and addiction can affect people of any age, and older adults are especially sensitive to sedatives and opioid pain medicines.
How do I know if my parent has a drinking problem?
Look for changes in memory, mood, balance and routines, and talk to their doctor.
Is treatment different for seniors?
Often yes, with more attention to health, medications and pace.
Does Medicare cover rehab?
Yes, in most levels of care, with deductibles and coinsurance.
Should my parent stop their sleeping pills suddenly?
No. Stopping suddenly can be dangerous. Ask the doctor for a supervised plan.
Sources
- SAMHSA. Substance Abuse Among Older Adults (TIP 26). samhsa.gov
- National Institute on Alcohol Abuse and Alcoholism. Older Adults and Alcohol. niaaa.nih.gov
- National Institute on Aging. Alcohol Use in Older People. nia.nih.gov
This article is for general information only and is not medical advice. Talk to a qualified health professional before changing any medication or how you drink.