Common Addictions
Common perceptions about drug and substance abuse are that drug abuse primarily affects adolescents and younger adults. However, drug abuse among older adults is a major undiscovered problem in the US as it is one of the fastest growing health problems in the US, especially among above 65-year-old adults. Research by SAMHSA posits that alcohol and drug abuse affects approximately 17% of older adults in the US. Moreover, these prevalent health problems are anticipated to grow in the near future from 13% in 1990 to approximately 21 % in 2030. Drug abuse among older adults is caused by distinct factors but is mostly related to deteriorating health conditions, reduced income, and loss of significant other. Other reasons relate to late-onset for drug abuse; thus, these individuals pursue the thrill present among adolescents and younger adults. SAMHSA (2019) states that approximately 1 million older adults aged 65 years and above live with substance abuse disorders. Some of the common addictions among older adults include alcohol, opioids, marijuana, nicotine, and prescription drugs (NIDA, 2020). According to Kuerbis et al. (2014), as drug abuse problems among older adults increase, alcohol-related addictions are more prevalent among older adults, posing greater health risks for the affected population.
Drug and substance abuse among older adults shows a tremendously increasing trend in the US. Notably, these increasing trends are related to a transitioning period for the baby boom generation comprising 30% US population. These increasing trends are anticipated to increase over time since the baby boom generation was born at a time when there were major changes in the attitudes towards drug and alcohol abuse (Kuerbis et al., 2014). Drug abuse among older adults exists as a problem because drug abuse has adverse effects on older adults compared to adolescents and younger adults. Alcohol, as one of the majorly abused drugs, has a unique physical influence on older adults compared to young groups (Degenhardt et al., 2010). Advancement in age results in reduced metabolic process, decreased lean body mass, and total body water leading to increased blood-brain barrier permeability and neuronal receptor sensitivity to alcohol. These major changes in the body result in higher impairment levels rendering older adults more vulnerable to higher effects such as functional impairment. Ideally, biological changes in the body result in distinct body responses to benzodiazepines and opiate medications (Kuerbis et al., 2014). As such, older adults using benzodiazepines tend to get more sedated by the medication compared to younger ones. These effects increase as one abuses more drugs such as alcohol and marijuana.
Addiction Treatment Perspective
Addiction among older adults is a hidden problem in the US, usually characterized by under identification, underdiagnosis, and undertreatment by healthcare professionals. Notably, drug abuse stands out as a hidden problem because symptoms of drug abuse among older adults can easily be misidentified and related to geriatric conditions such as dementia and depression. Fatigue and reduced cognitive capabilities among older adults are common symptoms among older adult victims but can also be related to dementia and other geriatric complications. For such reasons, many family members and healthcare professionals may adopt the wrong perspectives about drug addiction. Such perspectives tend to leverage older adult addiction to age and experience, which in most cases relate to the unwillingness to change older people’s habits, cultural perceptions about correcting older people and giving the older generation a chance to live to the fullest while they can. This perspective is wrong because, subject to drug addiction, victims’ frail body health deteriorates tremendously, which can cause more pain or shorten their life drastically.
Based on the severity of the addiction, interventions are useful tools for treating drug addiction among older adults. According to Moore et al. (2011), effective brief interventions take place in primary health care setups and focus mostly on alcohol and prescribed medication abuse. These brief interventions render education on the drug abused and inform the victims of the myriad harmful effects it can cause. Ideally, incentives to motivate the victims to change their habits are done while more intensive approaches are used on severe drug users. Kuerbis & Sacco (2013) posits that victim abuse habits can be compared to their peers, which is then integrated with counseling forming a normative feedback approach that, in the long run, has proved effective among older adults compared to young-age victims. Motivational Interviewing (MI) and Motivational Enhancement Therapy (MET) aspects are used in brief interventions to foster victim-centered and non-judgmental techniques to tackle drug abuse discussions while promoting positive changes in the habits of the victims. MET and MI approaches reduce drug abuse contradictions by allowing victims to synthesize the merits and demerits of avoiding drugs and using the drugs. Outcomes related to this approach include the need to change to foster independence, improve cognitive abilities and optimize health status and outcomes of current treatments.
Reflection
I focused on drug addiction because it is a major health problem in the US that can be caused by polypharmacy. According to Masnoon et al. (2017), multimorbidity and polypharmacy (use of multiple prescribed medications) are common among older people. Therefore, my interest in understanding drug abuse contexts among older adults would not be robustly discussed in this paper. Notably, underpinning the cause and dynamics of drug abuse among older adults is crucial in informing various stakeholders on suitable ways to eliminate the hidden healthcare problem, which can include adopting more effective ways to treat multiple chronic health conditions using fewer medications, thus reducing polypharmacy which can sometimes result in drug abuse.
References
Masnoon, N., Shakib, S., Kalisch-Ellett, L., & Caughey, G. E. (2017). What is polypharmacy? A systematic review of definitions. BMC Geriatrics, 17(1). https://doi.org/10.1186/s12877-017-0621-2
SAMHSA. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed tables. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. . SAMHSA.gov. Retrieved July 24, 2022, from https://www.samhsa.gov/data/
Kuerbis, A., Sacco, P., Blazer, D. G., & Moore, A. A. (2014). Substance Abuse Among Older Adults. Clin Geriatr Med, 30(3), 629–54. https://doi.org/https://doi.org/10.1016%2Fj.cger.2014.04.008
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Moore, A. A., Blow, F. C., Hoffing, M., Welgreen, S., Davis, J. W., Lin, J. C., Ramirez, K. D., Liao, D. H., Tang, L., Gould, R., Gill, M., Chen, O., & Barry, K. L. (2011). Primary care-based intervention to reduce at-risk drinking in older adults: A randomized controlled trial. Addiction, 106(1), 111–120. https://doi.org/10.1111/j.1360-0443.2010.03229.x
Kuerbis, A., & Sacco, P. (2013). A review of existing treatments for substance abuse among the elderly and recommendations for future directions. Substance Abuse: Research and Treatment, 7. https://doi.org/10.4137/sart.s7865
NIDA. (2020, July 9). Substance use in older adults drugfacts. National Institutes of Health. Retrieved July 24, 2022, from https://nida.nih.gov/publications/drugfacts/substance-use-in-older-adults-drugfacts#ref
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