Senior Drug Rehab: Substance Abuse Among the Elderly

Understanding Senior Addiction

Geriatric substance abuse is often missed by healthcare providers and even family members.

Symptoms of substance abuse in older adults are similar to the symptoms seen in other illnesses common to this population, including diabetes, heart disease, depression, and dementia. Grief, which has a higher prevalence among older people, also creates symptoms that can mimic substance abuse.

Substances Commonly Abused by Seniors

The drug most often abused by senior citizens, for which treatment is sought, is alcohol.

Heroin, an illicit opioid, is also often abused by seniors, who use it to replace their more expensive prescription opioid medications. Cannabis (marijuana) use among seniors has risen significantly since the pandemic.

12% of people ages 50-80 who responded to a study conducted by the University of Michigan Department of Psychiatry said that they had used a THC-containing substance within the past year. 4% of respondents said they consumed THC multiple times a week.

Deaths due to drug abuse among seniors have also increased. According to the Centers for Disease Control (CDC), in 2020 alcohol use was an underlying cause of death for an increasing number of seniors. The number of alcohol-related deaths that year rose 18% from the previous year.

How Addiction Affects Seniors Differently than Younger Substance Users

The National Institutes of Health National Institute on Drug Abuse (NIDA) 2020 Substance Abuse in Older Adults Fact Sheet describes how substance abuse can lead to physical and mental health problems in older adults.

According to the Fact Sheet report, older people’s brains are more sensitive to drugs because their bodies metabolize the substances more slowly. This results in more of the drug remaining in the body longer, and therefore causing greater adverse consequences.4

Older drug users can experience negative health consequences, such as heart or breathing problems, that are more common with opioid use, as well as confusion, drug interaction problems, and falls.

Alcohol can cause stomach bleeding, high blood pressure, potential liver damage, and mood disorders–anxiety and depression. It can also impair judgment and affect coordination and reaction time, leading to falls or accidents.

Challenges for Seniors that Contribute to Drug Abuse

Life Challenges: Older adults may take substances to cope with big life changes such as retirement, grief and loss, declining health, or a change in living situation.

Memory Challenges: Seniors are more likely to forget to take their prescription pain medications, and then use alcohol or other drugs to get pain relief.

Challenges Related to Prescription Drugs: Seniors may opt for alcohol, marijuana, or other substances to relieve pain if prescription drugs cause side effects or are too expensive.

Warning Signs of Senior Addiction

Signs of possible substance abuse to be aware of in an elderly family member include:

• Insomnia
• Injuries
• Mood swings (anxiety, depression)
• Change in hygiene or eating habits
• Secrecy about medication regime

Signs of possible withdrawal from substance use in an elderly family member include:

• Mild to moderate tremors
• Mood swings
• Irritability

Senior-Specific Drug Rehab Considerations

Seniors have special needs and concerns that should be addressed when considering a drug rehab treatment program. Medication management for the individual’s general health issues as well as for detox or addiction treatment needs must be included in the goals.

The overall mental health needs, nutritional needs, and socialization needs of the senior person must be managed as well.

Family involvement and coordination is important for getting the senior into rehab, helping them adhere to their treatment plan, and helping them remain abstinent in aftercare.

Benefits of Drug Rehab for Seniors

Physical and Mental Health Benefits

A thorough health and mental health assessment can identify and address both known and unrecognized physical and mental health needs in seniors.

Risk Reduction

While in a drug treatment program, the senior will be monitored, and overdose risks can be identified and addressed. Education about medication and substance use interactions, the importance of following proper medication regimes can also be addressed.

Socialization

While in a rehab program, seniors have easy and consistent contact with peers and can restore their social interactions.

Improved Quality of Life

When seniors address their drug abuse issues, they will improve both physically and mentally, and will and gain greater independence. With the support of rehab staff and their family members, they can find better ways to cope with physical pain, illness, grief, depression, or anxiety.

Drug Rehab Options for Seniors

 The types of drug rehab programs for seniors include detoxification and withdrawal management, inpatient treatment, and outpatient treatment.

Detoxification and Withdrawal Management

Detox for seniors starts with an evaluation, with the assessment including evaluation of their alcohol or drug use, plus all medications they take, and any age-related social concerns. After assessment, a detoxification process, possibly using medication-assisted treatment (MAT), can be initiated.

The choice of medications is made by clinical staff who take into consideration the senior’s other medicine use. Close monitoring during the detox process is especially important for seniors.

Inpatient vs Outpatient Treatment

 For seniors, who require careful monitoring, inpatient treatment for detox may be appropriate. Outpatient programs vary in length of treatment and scheduling. Full day treatment, half-day treatment, and individually scheduled counseling sessions are all options, that are chosen according to the severity and need of the senior client.

Also considered are special age-related factors, such as the stamina of the elder client, their socialization capacity, and any mobility concerns. Continuation of inpatient treatment may be chosen over outpatient treatment for seniors who would have difficulty traveling back and forth to attend outpatient treatment.

Therapies that Address Senior Drug Rehab Needs

Family Therapy

Family therapy is more important in senior drug rehab than in rehab for younger individuals.

Family members are often involved in assisting the elderly client with their daily living needs, such as scheduling and providing transportation to appointments, monitoring their medications, and handling other needs.

So, family members must be included in the discussions about the senior’s responsibilities and time commitments to their rehab program, as well as the family dynamics involved in their relationships, and how these may affect the senior’s drug use.

Family members also provide the major source of support for aftercare, and they should be well-versed on the client’s goals, progress, and any “homework” or skills practice that the senior is prescribed by staff.

Group Therapy

Group therapy is important for seniors in rehab, especially if they are in a group of peers. It allows them to learn from others who are experiencing situations similar to theirs, create new social bonds and friendships, and feel less isolated.

Individual Therapy

Sometimes a senior, like people of all ages who are attending rehab, have issues to discuss that they want to keep private, even from family.

Shame associated with drug use, feelings of embarrassment for being a “burden” to family, and other personal concerns are often better able to be discussed in one-on-one sessions between a senior and their therapist. Individual sessions often take place once or twice a month, or on an as-needed basis.

Counseling Approaches

The most common type of therapy used for people of all ages is cognitive behavioral therapy (CBT).

Cognitive behavioral therapy is a form of “talk” therapy, where the client and therapist discuss problems that need to be addressed, and how the client’s thoughts and feelings create beliefs and expectations about the problems that may be irrational or unworkable.

Then they look at the problem from a different perspective and explore how the client can rethink their issue and come up with a better way of assessing and approaching it.

Support groups are also an important part of alcohol and drug rehab, for any age client. Sometimes peer support group meetings, such as Alcoholics Anonymous or Narcotics Anonymous are incorporated into the programming of a rehab program. Other times, they are recommended as part of aftercare.

Case Management

Drug rehab programs often include case management services, where program participants are offered help with finding and setting up linkages with additional community services they may need, such as meal delivery programs.

Financial Considerations for Senior Drug Rehab

For seniors, paying for drug rehab may be even more of a concern due to their limited income. But there are options:

Medicare and Medicare Advantage Health Plans

Medicare and Medicare Advantage plans covers mental health and substance abuse care for seniors who have a medical diagnosis of a substance use disorder (SUD). The coverage includes both inpatient and outpatient programs and detox treatment.

Medications used during treatment, such as methadone for detox, psychotherapy, and patient addiction and relapse prevention education are covered therapies.

For seniors not diagnosed with SUD, but who need early intervention, Medicare covers screening assessments, brief intervention counseling, and referrals for additional treatment.

Other Financial Assistance

For uninsured or underinsured seniors, financial aid is available to help with drug rehab. State funded drug rehab programs offer free or low-cost drug rehab. You can find a listing of state drug rehab agencies here.

If you are a military veteran, the VA offers substance abuse programs in many VA locations. Go here to find a directory listing of VA substance abuse programs.

Many drug rehabs have their own internal financial assistance programs. Check with the facility you are considering and ask about the possibility of financial assistance.

Finding the Right Rehab Program

For seniors, finding a drug rehab program that addresses their special age-related needs is important.

Some factors to consider are: 

• Location — The program should be within easy driving distance. 
• Cost — If insurance is not an option, check out the financial assistance options listed in the segment above.
• Treatment approach  — Whether traditional or alternative/holistic, the senior should be comfortable with the approach.
• Specialization in senior care — Look for a rehab that offers senior-oriented programs.
• Accreditation and qualified staff — Look for rehabs that have accreditation by a reputable agency, such as JACO– the Joint Commission on Accreditation of Healthcare Organizations, or CARF–Commission on Accreditation of Healthcare Organizations.

For an opioid treatment center, look for a SAMHSA certified opioid program.

Resources for Finding Senior Rehab Programs

You can call today to learn more about mental health and substance abuse disorder treatment options.

For local treatment center information, you can access our directory and search for your state and city and filter by “senior rehab”. Get the help you need, today!