Substance Abuse including alcohol and drugs (particularly prescription medications) is the hidden and secret malady among elders. The following two sections will include brief descriptions about alcohol and then drug abuse. 

        Alcohol Abuse

        What You Should Know:

        Alcohol abuse by elders is often kept a secret or ignored.

        • Determining how many elderly people abuse alcohol has been a challenge.
        • Identifying which individual elder is abusing alcohol continues to be very difficult.
        • Among elders blood alcohol levels remain raised longer (than for others).
        • Elders have an increased sensitivity to and a decrease in tolerance to alcohol.
        • Elders who drink the same amount of alcohol as younger individuals will maintain a higher concentration of alcohol in their blood system.

        Behaviors and Symptoms to Look For:

        • Drinking is used to calm and relax nerves.
        • Drinking increases after a loss or more stress.
        • Drinking is used to reduce loneliness.
        • Drinking reduces feelings of hunger and meals are skipped.
        • Drinking is used to reduce shakiness and tremors.
        • Drinking makes it difficult to recall recent events.
        • Drinking reduces thinking about problems.

        For More Information About Alcoholism and Elders Click Here

        Some resources:

        Drug Abuse

        Among elders, this is often prescription medications.

        • Medications may interact adversely with alcohol.
        • Elders take more prescription medications than any other age group.
        • Some elders take many prescription medications every day.
        • Many prescriptions for elders include psychoactive medications.

        Some resources:

        • Elders may use psychoactive medications for longer periods than do people who are younger.
        • Physiological changes in aging, increased health problems and other social and familial changes often lead to increased prescription drug use.
        • Elders can unintentionally become dependent on psychoactive medications.
        Symptoms and Behaviors to Look for:
        • Non-compliance with prescription medications.
        • Is more than one health care provider prescribing medications?
        • Is more than one pharmacy used?
        • Are directions for all medications followed?
        • Worries about having enough pills.
        • Changes in sleep patterns.
        • Complains about a doctor's refusal to write prescriptions for particular drugs.
        • Activities revolve around pill schedule.
        • Continues to use and to require refills after the condition should have improved.

        Treatment/Intervention Choices for Substance Abuse May Include:

        Brief/Immediate Treatment or Interventions:
        • Affirm ability to adapt healthy behavior.
        • Provide education resources. (Some resources:
        • Assessment.
        • Goal setting.
        • Direct Feedback.
        • Behavioral Modification.


        This may be necessary at times to withdraw from alcohol or drugs in a hospital setting in order to: 1. Increase safety; 2. Remove access to alcohol or drugs.

        This may be useful when:

        • Presence of suicidal ideation or attempts.
        • Lack of social supports.
        • Presence of other major medical and/or psychiatric problems.
        • Involvement in other addictions.
        Long Term Approaches for Elders:

        Should Involve:
        • Age specific group treatment.
        • Focus on depression and loneliness.
        • Build/re-build social network.
        • Staff comfortable with elders.
        • Links with the spectrum of elder care services.
        • Flexible approaches.
        • Age specific settings.
        And May Include:
        • Groups.
        • Cognitive approaches.
        • Behavioral approaches.
        • Family involvement.
        • Case management.


            When people age and also take different kinds of medications their bodies may respond differently than when they were younger. Some medications will not mix well with other medications - including over the counter and harbal remedies.Many will not mix well with alcohol. Some may take too many or too few medications or forget to take them.

            Look For The Following As Signs Of A Problem:


          • Memory trouble after taking medication or having a drink
          • Loss of coordination
          • Changes in sleep habits.
          • Feeling unsure.
          • Unexplained chronic pain.
          • Changes in eating habits.
          • Wanting to say alone much of the time.
          • Failing to bath and to keep clean
          • Having trouble finishing sentences.
          • Having trouble with concentration.
          • Lack of interest in usual activities.
          • Frequently wanting to stay at home and alone.

              You Can Do The Following:

              Talk to someone or refer to someone you trust

            • Doctor or other health care professional
            • Staff member at a senior center or other program in which you are involved.
            • Family member or friend.

                If you speak with someone have appropriate information


              • Make a list of medications
              • Ask questions(always leave an office knowing what instructions mean, knowing you have sufficient information, understanding what was said)
              • Inform the doctor or pharmacist about diagnoses, conditions, changes.
              • Try to obtain written advice and information.
              • Provide observations about any behaviors which are new or changed.