Older Adults and Addiction: Why Now?

Four major factors contribute to the large number of older adults now having problems with alcohol and other drugs: the sheer number of retirees, generational influence, pain management, and conditioning. Let’s look at each of these more closely.

In 2011, the first of the 76 million baby boomers turned sixty-five. In what’s been dubbed the “silver tsunami,” every day for the next twenty years, eight thousand to ten thousand boomers in the United States will reach age sixty-five, and many will retire—with time on their hands.

Second, about 50 percent of those who make up the boomer generation grew up experimenting with illegal drugs, even if only briefly. When careers and raising a family took precedence, most of this generation gave up their attachment to mood-altering substances. But in retirement, or as empty nesters, a growing number of boomers are reverting to using drugs as a means of dealing with the stressors that can accompany aging—including boredom, health issues, and financial worries, as well as loss of a spouse, loss of identity, and, in some cases, loss of a certain degree of freedom.

Add to this the fact that, in the late 1990s, the medical community felt that patients suffering with chronic pain were being undertreated. A recent study had concluded that most people who took opioids (think OxyContin) for pain did not get addicted. So doctors were now required to monitor pain as a fifth vital sign (in addition to temperature, heartbeat, breathing rate, and blood pressure). The result was an alarming increase in the number of prescriptions written for opioid painkillers. Since then, prescription-painkiller use has experienced a dramatic rise in the United States. Worldwide, Americans take the lead, consuming about 80 percent of all prescription painkillers. Painkillers such as OxyContin and Vicodin fall into a highly addictive class of drugs called opioids, which also includes heroin. Since 2002, use of prescription painkillers has doubled. The result: From 1998 to 2008 the number of people being treated for opioid abuse increased 400 percent.

Lastly, older adults grew up with the pharmaceutical industry—witnessing the introduction of everything from blood pressure medication to the pill. The option not to suffer and to live a longer, healthier life sold itself. So, most older adults have been conditioned to turn to drugs for relief, whether taking a couple of ibuprofen to soothe an inflamed joint or an opioid painkiller for major back pain. In 2014, Americans filled over 4 billion prescriptions at retail pharmacies alone; and adults over sixty-five fill more than twice as many prescriptions as those younger than sixty-five. This is for a nation of 290 million people.

Pharmaceuticals reduce suffering for millions of people every day. The problem starts when the drugs stop helping and start hurting instead. In some cases, the drug combination (whether mood-altering or not) is the problem. In these situations, addiction is not the issue—toxic drug combinations, some of which produce dementia-like symptoms, are the problem. But when people cross the line from normal use to misuse and then dependence, addiction starts running the show. And when addiction takes over, the negative consequences start piling up and affecting anyone and everyone who has a relationship with the older adult.