Guide to addiction treatment for older adults
Addiction for older adults is often overlooked. It’s an important issue, though, especially as drink and drugs generally have more pronounced effects in older age. Sadly, these effects can also be more easily missed.
The Office for National Statistics (ONS) has reported the UK has an aging population with more than 11.8 million people aged over 65.(1) The ONS also predicted that the aging population is set to increase over the next twenty-five years. With this in mind, addiction, causes, and treatment for older people is more important than ever before.
Early or late-onset addiction for older adults?
It’s useful to consider when an addiction began for a person. This might influence the approach to treatment.
There are those with early-onset addiction. These are people who lived the first generation of free love and exploration. The baby boomer generation are those born between 1946-1964. Socially, when this generation hit their teens, they were listening to rock stars like Santana, Janice Joplin, Jimi Hendrix, then came the generation of 1970s disco. It was the post-world war II period where people wanted to have fun and explore.
Part of this exploration included drug-taking. Cannabis, mushrooms, and acid were popular. Drug use, including heroin, started to increase in the 1960s.(2) By the 1980s, heroin and crack cocaine were so widely used that this time period is now referred to as being heroin and crack epidemics.
On the other hand, there are people with late-onset addiction. This means the addiction has started in later life. One study reported that people with late-onset alcohol problems are more likely to complete treatment than those with early-onset drinking problems.(3)
One of the most important aspects of treatment, however, is accessing it.
It was once estimated that by 2020, “4.4 million older adults [would] require substance abuse treatment compared to 1.7 million in 2000/01.”(4) Being that we’re past 2020, treatment options for older people have never been so relevant.
How is addiction different for older adults?
For those who have been addicted to a substance for many years, there’s more likelihood that long-term repercussions have taken hold. This has the knock-on effect of potentially causing great damage to a person’s mental and physical health. The causes for starting to drink and use drugs early in life can be quite different from people who have late-onset addiction.
People are often prescribed psychoactive medications for anxiety and depression. These mental health issues are common in older people with addictions. The link between mental health problems and addiction is well-reported. In terms of addiction treatment for older adults, mental health support has to be a top priority when options are weighed up.
Along with mental health, social and personal aspects of a person’s life have to be considered. The entire picture of a person’s life can help to decipher the factors that have contributed to an addiction beginning.
Causes of addiction in older people
When addiction begins later in life, it can be due to lifestyle changes. As a person ages, life alters. The emotions around losing a spouse, for example, can drive a person to drink or use drugs. This might occur unwittingly. For instance, if a person is prescribed pain medication for a physical ailment then they might accidentally become addicted to it, especially if taken with alcohol at the same time.
Causes of addiction in older people can include the following:
- Losing independence
- Close people, a spouse or friends, dying
- Family and/or children moving away
- Health problems
- Retirement and losing a “sense of purpose”
- Increased isolation
- Financial issues. This can cause people to drink or use drugs again
- Prescriptions for pain, injuries and ailments that might end up becoming abused
A comorbid condition is when two conditions are present at the same time. In the case of addiction, mental health problems are usually highly present. The two are intertwined and cause and affect each other.
A person might use drink or drugs to ease symptoms of depression, anxiety, or bipolar. This is known as self-medication. Alternatively, drinking and doing drugs can affect hormones and chemical balances in the brain and body. This can thereafter cause mood disturbances linked to mental health problems.
Substances can create dependencies. A dependency is when a substance is needed in order for a person to function “normally”. When this occurs, it’s incredibly important that people receive a medically supervised detox as withdrawal can be dangerous.
Addiction and the older person
When addiction has existed for many years. There’s an increased age-related decline (people age quicker). This is related to such things as the stress hormone (cortisol) being more present in people who have abused alcohol for years.
Also, when older people drink, they’re unable to process alcohol and drugs as quickly. This is due to the metabolism and circulation slowing down. It results in older people becoming less tolerant of drink and drugs.
There’s also the increased likelihood of interactions with prescribed medications because the older a person gets, the more likely they are to need medications. When being prescribed medications, alcohol and other drugs should be discussed with the doctor.
With older age comes more risks of accidents and injuries due to falling over. Coupled with the effects of drugs and alcohol, these chances are even higher.
Finally, as mentioned earlier, the emotional aspect of lifestyle changes in older life might also make a person use or drink more.
Why addiction in older adults is often missed
There are many reasons addiction often goes unnoticed in older people. They can include the following:
- Ageism. People in the older person’s life, including professionals, might assume that a person of a certain age won’t experience an addiction.
- Isolation. The less a person sees family and professionals, the less chance that addiction will be discussed or spotted.
- Older people might feel that as they’ve had alcohol or drugs all their lives, they shouldn’t have to cut them out.
It’s a sensitive topic. For those who care for an older person who appears to have an addiction, it should be treated with an open mind, compassion, and with the goal of maintaining the person’s dignity.
How aging can look similar to symptoms of addiction
Another reason that addiction in older age might get missed is that on the surface, the symptoms of both aging and addiction look similar. Here are some examples:
- Mood Swings
- Memory loss
- Inability to focus as usual
- New or increased pain
- Falling over
- Harder to get hold of or keep in contact with
- Poor self-care or self-neglect
If it becomes clear that someone you care for has a drink or drug problem, there are ways you can approach this…
What to do if you suspect an older person has an addiction
It might feel very worrying if you’ve noticed symptoms of addiction in an older person who you care about. When a person is older, it can also be difficult to bring the topic up, especially if they’re older than you.
Older people might find it harder to access treatment for the following reasons:
- Feelings of embarrassment due to the stigma often attached to addiction.
- Denial that there is a problem.
What is the goal of an intervention?
The goal of an intervention should be to enable the person to see and reflect upon their use of a substance. It should highlight any concerns as well as what the next steps should be in terms of support.
An intervention is best handled by a close family member and a doctor or trained professional that the person has a good relationship. It’s best that there are only one or two people present when raising the topic. This provides more privacy and dignity for the person at the centre.
Treatments for older people
In the UK, there are options to treat addictions for people who come from all walks of life. In the first instance, it’s advisable to contact the person’s local GP or our team of advisors for guidance on your local services.
What treatments are available?
There are various types of treatment available for older adults with addictions. The two main options are inpatient and outpatient.
Inpatient treatment usually means a residential stay in a rehab clinic, or it could mean a stay in a hospital depending on the circumstances and what support is required. There are rehab clinics all over the UK. Some people might want to stay close to home, whereas others might want to go elsewhere (for example, closer to a particular family member).
A rehab stay will include a medical detox for those who are physically dependent on a substance. It’s essential that this is overseen by trained doctors and clinical nurses. These members of staff are on hand 24/7 at rehab. This also includes highly experienced therapists and drug and alcohol workers who will make the programme as comfortable as possible. Both one-to-one and group support sessions are facilitated to provide psychological treatments.
A residential stay at a private rehab clinic can last anywhere between 7-28 days. This really depends on the individual’s needs and what’s most suitable. A stay at rehab is a good option for people with severe addictions.
Aftercare programmes are provided at the end of a stay at rehab. This is to outline the most efficient action plan for the future to support a person towards a life of sobriety. It also provides strategies around relapse prevention.
Outpatient treatment involves accessing services either at a rehab centre or within local community services. Trained, experienced alcohol and drug workers are hand to support those who access one-to-ones and group sessions when they’re timetabled in. This can be very effective for those who have a mild to moderate addictions.
Psychological Treatments in Rehab Programmes
After any necessary detox has taken place (to rid the body of substances), treatment moves towards the psychological and emotional. The types of treatments offered in rehabilitation programmes are as follows:
- Cognitive Behavioural Therapy: this provides strategies that enable a person to become aware of and become better able to control their thoughts. This has the knock-on effect of influencing behaviours and habits.
- Motivational Interviewing: to equip a person to gain autonomy of their hopes and goals. It works to build a person’s confidence, especially around creating change.
- Dialectical Behavioural Therapy: this is really effective for people who have deep emotional issues and want to regain control.
- Holistic therapies: music and art groups are a safe, relaxed space to communicate feelings in an alternative, non-verbal way.
Peer Support Groups in Rehabilitation Programmes
Peer support groups where 12 Step principles are followed are often included in rehab programmes. This provides support from others in the same situation. Both Alcoholics Anonymous and Narcotics Anonymous groups are available.
In these groups, people are encouraged to be honest with themselves and others, admit that they have an addiction, and to draw strength from a higher power. Mentoring is a key part of the guidelines governing 12 Step Work.
How can you access treatments?
To get more information and access rehabilitation services, all you or a loved one needs to do is contact your local GP, or one of our friendly and highly experienced members of staff. You’ll then be guided through your options.
Unfortunately for older adults, addiction is often missed completely or misdiagnosed. This can be dangerous as symptoms can be more pronounced in people as they get older and the body becomes less able to process and tolerate substances.
It’s essential that if you’re concerned about an older person having an addiction, you take a tactful approach to intervention with a trained and trusted professional that is known to the person.
There are treatment options throughout the UK for older people wanting support in this area. All you need to do is call your GP, or contact one of our team today to find out more.