Substance Abuse Among the Elderly: Prevention and Treatment

This essay provides insight into substance abuse among the elderly and recommends ways to prevent it. It discusses the factors that lead to substance abuse, its harmful effects on the elderly, and the need for treatment. The essay also highlights the concept of successful aging and its importance in human development.

Running head: Social Work
Social Work
Name of the Student
Name of the University
Author Note

1SOCIAL WORK
INTRODUCTION:
The global populace is on the rise and according to the Canadian Institute for Health
Information, in Canada the number of older adults increased from 2.7 million in 1986 to 4.8
million in 2010 (Azulai, 2014) . By the year 2036, it is expected that approximately 25% of the
population of Canada will be sixty-five years of age and older (Azulai, 2014). Studies reveal that
elderly people use substances that are both prescribed and non-prescribed and that which is both
legal and illegal. Elderly people most frequently consume alcohol, nicotine and cannabis.
Although the prevalence of substance use is lower among elderly people than other age groups,
they are at an increased risk of failing health due to the use of non-prescription substance abuse.
This essay aims at providing an insight to the use of substance abuse among the elderly and
recommends ways by which one can prevent substance abuse among older adults.
DISCUSSION:
A sense of financial security and social security, stability in life, physical wellness and
health, preserving social contacts, engaging with activities that stimulate the mind and the body
and having a sense of purpose in life all aid in successful ageing in individuals. Absence of these
factors leads to substance abuse. The plethora of factors due to which elderly people resort to
substance abuse include social isolation that results in depression, sudden changes in lifestyle,
for example retirement and a decline in physical health.
Retirement often leads to substance abuse as retirement leads to reduction of work,
lessening of social contacts and an increase of time meant for leisure (Azulai, 2014). Among
some elderly people, these changes can bring about depression and reduce a sense of well-being,

2SOCIAL WORK
especially when retirement is perceived to have happened too early. Individuals, who have a
limited social circle, can resort to substance abuse post-retirement.
Physical health among elderly people might also lead to substance abuse. Poor
medical conditions and having chronic physical illnesses increases the risk of using non-medical
use of prescription drugs. Illnesses like chronic pain, anxiety and insomnia increases the
potential to abuse prescription drugs especially drugs like benzodiazepines, skeletal muscle
relaxants and opiate analgesics (Azulai, 2014).
Social Isolation is another factor for substance abuse. Loneliness leads to alcohol
abuse. Living alone at home contributes to the use of non-prescription drugs among elderly
people. Marital status also plays a factor in increases substance abuse with those being widowed
more likely to consume alcohol, nicotine and cannabis (Boudini, 2013).
Studies reveal that the effects of smoking tobacco are more severe in elderly people.
Older Canadians were also likelier to be more dependent on nicotine as compared to younger
Canadians (Boudini, 2013). Binge drinking is another problem among older Canadians as are
prescription drugs such as pain relievers and sedatives. These findings are integral to
understanding the effects of alcohol on the aging brain and the consequences of substance abuse
among the elderly people.
Drug abuse leads to a plethora of negative consequences on the human body of an
elderly person. As individuals grow older, cognitive functions like vocabulary and verbal skills
remain stable. However, substance abuse of drugs like ketamine, tends to impair language and
lead to a disordered thought process (Mapoma, 2014). Memory is another cognitive function that
declines with age. Excessive consumption of alcohol has a detrimental effect on the working

3SOCIAL WORK
memory of an elderly person. Drugs like cocaine and ecstasy tend to impair declarative memory
of an elderly person by its tendency to interfere with the ability to recall and store memories. A
plethora of drugs like cannabis, opioids, cocaine also have a detrimental effect on executive
functions like planning, reasoning, shifting tasks, impulse control, abstract thinking and problem
solving on older adults (Mapoma, 2014). Substance use in older adults also affects the grey
matter in the brain. For instance, cannabis use is associated with a reduction in bilateral
orbitofrontal cortex while use of cocaine leads to a decrease in grey matter. Aging also causes
changes in white matter integrity and studies revealed that alcohol, heroin and cannabis cause
disruption in white matter integrity in elderly people (Boudini, 2013). Use of cannabis regularly,
also leads to memory loss in elderly people. Thus, problematic use of drugs places an additional
stress on the already frail and vulnerable system of the elderly and reduces the ability of the body
to deal with the consequences of aging (Mapoma, 2014). This additional stress and reduced
ability of the body is exacerbated by substance abuse. Harmful effects of drug abuse on the
elderly include death, hospitalization, accidents, falls, changes in the nervous system, respiratory
system, gastrointestinal system especially the liver and renal system making elderly people more
physiologically vulnerable to the detrimental effects of substance abuse. Drug abuse also leads to
a higher mortality hazard ratio. It is highest in people who use opiates, followed by people who
take sedatives, cocaine and cannabis (Boudini, 2013).
Aging makes the human brain more vulnerable to the harmful effects of drugs. Substance
use among the elderly people puts an additional stress on the vulnerable body systems of older
adults and reduces the ability of the individual to deal with the aging process. Unfortunately,
addressing the problem of substance abuse in older adults is laced with difficulties. More often
than not, doctors dismiss the symptoms of substance abuse as the symptoms of growing age. In

4SOCIAL WORK
addition, the social isolation experienced by the elderly people leads to fewer opportunities for
monitoring by family and friends (Ranzijn, 2010). As the social networks of the elderly people
continue to grow smaller, most elderly people are hesitant to talk about the issue of substance
abuse with their family and friends because they do not want to start a conflict with the few
relationships they have left.
Elderly people can live healthy and long lives during recovery. Families, healthcare
providers and caregivers can prevent substance use among older adults by incorporating
successful ageing strategies. Efforts should be made to reduce physical and mental illness,
increase social development and enhance psychological well-being of a person. An increase in
the levels of social support and engaging in self-efficacy might lead to positive psychological
traits in an individual thereby curbing the desire to resort to substance abuse. Caregivers can
preserve substance abuse by increasing social engagement and by promoting a healthy lifestyle
ensuring that the elderly individual resorts to walking or moderate exercise and engage in various
activities that lead to cognition such as board games and crossword puzzles (Ranzijn, 2010).
Healthcare providers while talking to an elderly person should enquire beyond his
physical health since psychological factors also play an important part in contributing to
substance abuse. One should carry out screening process taking into account the concerns of
elderly people regarding stigma. Screening should be carried out during routine health checks
and hospitalizations, when mental or physical problems arise, or if an elderly person is suffering
from immense mental stress. A comprehensive analysis of elderly people should be carried out
taking into account a medical history pertaining to substance abuse and the use of medication,
psychiatric illnesses and comorbid medical illnesses, family and social history, cognitive
screening and functional assessment. There is an immediate need for training of caregivers,

5SOCIAL WORK
students and healthcare professionals on the detection, prevention and care of elderly people
suffering from disorders of substance use. For elderly people treatment can be both non-
pharmacological and pharmacological in nature and may involve short-term treatment,
detoxification and maintenance treatment. Physicians play an important role in increasing the
awareness of an elderly person regarding the relationship between substance abuse and
deteriorating health. A plethora of patient-oriented approaches and techniques can be used in
clinical practice in order to identify, refer and also treat substance use in older adults (Ranzijn,
2010).
A lack of understanding that addiction is a chronic disease and not a choice contributes to
the shame and stigma that prevents elderly people from asking for treatment. Elderly people,
owing to their frail health are at a greater risk to the harmful effects of alcohol and medications.
The increased vulnerability of elderly people puts them at a greater risk for drug addictions,
injury, sleeping disorders, cognitive decline, liver disease, memory problems, cardiovascular
diseases and issues pertaining to mental health. Many elderly people develop a prescriptive
medication misuse due to depression, pain, insomnia and anxiety (Nuta, 2011). Treatment for
nicotine dependence includes nicotine replacement therapy combined with behavioral
counseling. Other treatments include varenicline and bupropion which alleviates cravings of
nicotine and have proven to be effective (Mendes, 2013).
Cannabis use disorder can be treated with motivational therapy, contingency management
and cognitive behavioral therapy. Oral THC reduces the withdrawal symptoms of cannabis
disorder.

6SOCIAL WORK
In the case of an overdose of benzodiazepine in elderly adults, flurnazenil can be
administered in low doses. A medically supervised withdrawal schedule along with
psychotherapy is also helpful and an awareness and education about benzodiazepine use is
imperative to treat the initial symptoms of benzodiazepine dependence (Nuta, 2011).
The main goal of addiction treatment is to motivate and educate individuals to participate
in their recovery. Elderly people do best in programs that entail age appropriate care. Programs
for the elderly people should be accessible and open to the family and friends of the elderly
person. They should not be too strict but at the same time, they should possess a structure. In
general, elderly people prefer approaches in treatment that is structured but flexible programs,
treatment that is gender-specific, a focus on developing self-esteem, written materials that are
easy to read, caregivers and staff who specializes in elderly care, availability of a sliding scale,
counseling or individualized attention. Treatment that entails the optional involvement of family
and friends, accommodation for elderly people who have physical disabilities, treatment that is
group based, transportation, peer support, food, shelter and clothing, counselors who practice
self-care and genuinely cares for patients and counselors who focus on coping skills among other
things help elderly people to combat drug abuse (Mendes, 2013).
With aging comes real and inevitable change. All the above-mentioned issues affect the
quality of life, levels of satisfaction, wellbeing and positive health outcomes in the cases of the
aging people. Human Development in the cases of aging care heavily depends on the individual
ability to approach change and embrace in a positive and productive manner. This also includes
the support from having a mental advantage and knowing how to keep on a positive thinking
over the negatives by challenging circumstance. This improves likelihood for the positive
changes as well as healing in life. The healthcare demand of the ageing population is higher in

7SOCIAL WORK
the developed nations ass there are various aspects of neglecting the aging problems and not
supporting the older people psychologically to cope up with their physical problems. A large
number of elderly people with schizophrenia, depression, anxiety, bipolar disorder use
prescription drugs for purposes that are non-medical in nature. Health problems amongst the
elderly people such as cardiovascular diseases might be aggravated by substance abuse (Mendes,
2013). These are the reasons why the inpatient treatment is needed for older adults who are
victims of substance abuse.
Substance abuse disorders that occur with mental illness and physical illness may be
related to insomnia and chronic pain, which results in substance abuse. Substance abuse also
leads to bipolar disorders, depression and anxiety disorders in elderly people (Mendes, 2013).
These can be overcome through successful aging. The concept of successful aging is closely
linked with the human development in sociology. Successful aging fulfills all the demands of the
older people in the society which are shared by the governmental support through different types
of policies as well as the other non-governmental associations. This relates to the psychological
belief of the aging persons when they feel themselves better in health than their same aged peers.
Human development in the successful aging is an emphasizing factor to eliminate the physical
and cognitive disabilities. This involves three components which include freedom from disability
and disease originated from the old age, higher physical and cognitive functioning and
productive and social engagement.
Development in the late adulthood depends upon two main theories. These include
disengagement theory and activity theory. The first one states that the older people with the
ageing of the people, withdraw from the society. This is due to the fact that the responsibilities
and roles become quite difficult to play. This process opens up opportunities for the younger

8SOCIAL WORK
generations who fill up the vacated positions. However, this particular process enhances the
health care demand or menta support for the elderly people retired from their social and
economic responsibilities. Another theory of successful aging is activity theory (Boudini, 2013).
This contends that actions are essential for maintaining a high quality of life. In this respect, the
people need to be active in any time irrespective of their age. According to this theory, the
elderly people need to adjust better with the aging processes in every respect like social, mental
and physical. Therefore, for human development in the old age need to involve both intrinsic
genetic factors as well as extrinsic external factors. The factors such as effective diet, personal
habits, exercises and psychological aspects in the aging care which develop the lives of the
people of late adulthood. Thus, the aging people needs to be productive, becoming mentally fit
and able to lead a meaningful life.
CONCLUSION:
Older adults comprise the fastest growing sub group of the population of Canada: by
2036, approximately one quarter of Canadians will be above sixty-five years of age. Although
substance abuse is less prevalent among elderly people than younger adults, the detrimental and
harmful effects of substance abuse is more problematic and pronounced in older adults than in
younger adults when it occurs. Aging is associated with a plethora of physiological and
anatomical changes, which in turn makes an elderly person more vulnerable to substance abuse.
In particular, ageing is associated with a decline in homeostatic reserves, that is, the capacity of
the body to bounce back and is unable to deal with the harmful effects of substance abuse on the
brain, kidneys and the liver. There is an immense need to spread awareness among healthcare
providers and caregivers and families of older adults on the subject of substance abuse in elderly

9SOCIAL WORK
people. Families of the elderly people along with caregivers, healthcare providers and the general
populace should be educated about the issue of substance abuse prevalent among the elderly
section of society. Healthcare professions need more training and education to effectively detect,
prevent, assess as well as treat substance abuse in older adults. Services that are age- specific for
the treatment of substance abuse need to be made easily accessible to elderly people and their
families. One should spread awareness about the prevalence of substance disorder among older
adults and develop standardized screening tools. Programs that are age-specific and have proven
to be effective in treating substance abuse among the elderly population should be made
accessible and widely available. Together, one can prevent substance abuse among the elderly
people and help them if they are diagnosed with it.
REFERENCES:

10SOCIAL WORK
Azulai, A. (2014). Ageism and future cohorts of elderly: Implications for social work. Journal of
Social Work Values and Ethics, 11(2), 1-12.
Boudiny, K. (2013). ‘Active ageing’: from empty rhetoric to effective policy tool. Ageing &
Society, 33(6), 1077-1098.
Boudiny, K., & Mortelmans, D. (2011). A critical perspective: Towards a broader understanding
of'active ageing'. E-journal of applied psychology, 7(1), 8-14.
Boulton-Lewis, G. M., & Buys, L. (2015). Learning choices, older Australians and active ageing.
Educational Gerontology, 41(11), 757-766.
Foster, L., & Walker, A. (2013). Gender and active ageing in Europe. European Journal of
Ageing, 10(1), 3-10.
Jones, M., & Allen, C. (2013). Successful interventions to encourage active ageing. Nursing &
Residential Care, 15(7), 498-500.
Mapoma, C. C. (2014). Determinants of active ageing in Zambia. African Population Studies,
28(3), 1286-1296.
Mendes, F. R. (2013). Active ageing: A right or a duty?. Health Sociology Review, 22(2), 174-
185.
Nuta, A. C. (2011). Active Ageing: An Analysis. Acta Universitatis Danubius. Œconomica, 7(5).
Pavlova, M. K., & Silbereisen, R. K. (2016). Perceived Expectations for Active Aging, Formal
Productive Roles, and Psychological Adjustment Among the Young-Old. Research on
aging, 38(1), 26-50.
Ranzijn, R. (2010). Active ageing—Another way to oppress marginalized and disadvantaged
elders? Aboriginal elders as a case study. Journal of Health Psychology, 15(5), 716-723.

11SOCIAL WORK
World Health Organization. (2002). Active ageing: A policy framework (No.
WHO/NMH/NPH/02.8). Geneva: World Health Organization.