Helping older adults with substance abuse problems

Learn to recognize the signs and help older adults get the help they need to recover their health and quality of life.

If an older adult were ill or needed help, most people would reach out and help in whatever ways they could. But, if the illness were signs of alcoholism or drug abuse, it’s often really hard for most people to know what to do or say. Often, it’s difficult to tell if what we see are symptoms of substance abuse. In older adults, these signs can seem to mimic other conditions, such as diabetes, dementia or depression.

Is it substance abuse? According to Hazelden, a prominent addiction recovery center, there are two types of alcoholism in older adults. Two-thirds of older adult alcoholics are early-onset – those who have been heavy drinkers most of their adult lives. The other one-third are those who began to drink excess amounts in their older years, often in response to a difficult life situation or transition.

Doctors routinely prescribe tranquilizers for older adults. More tranquilizers are prescribed annually than for all other medications, over 16.9 million prescriptions each year – with the exception of heart medicine.

Some of the challenges that come with prescription drug use by older adults include:

  • Older people often take higher doses than prescribed because they forgot that they already took a pill or because “if one is good, two are better.”
  • It is not unusual for older persons to take their prescription drugs to a friend or spouse — even when the prescription is old, if the drug fits a self-diagnosed ailment.
  • An older person may also become dependent on alcohol or drugs after a major operation or a lengthy hospital stay. This dependency can be life threatening, yet is treatable.

What are possible signs of abuse? Hazelden has identified several warning signs:

  • Drinks in spite of warning labels while on prescription drugs.
  • Always has bottles of tranquilizers on hand and takes them at the slightest sign of disturbance.
  • Is often intoxicated or slightly tipsy, and sometimes has slurred speech.
  • Disposes of large volumes of empty beer and liquor bottles and seems secretive about it.
  • Often has the smell of liquor on his/her breath or mouthwash to disguise it.
  • Is neglecting personal appearance and gaining or losing weight.
  • Complains of constant sleeplessness, loss of appetite or chronic health complaints that seem to have no physical cause.
  • Has unexplained burns or bruises and tries to hide them.
  • Seems more depressed or hostile than usual.
  • Can’t handle routine chores and paperwork without making mistakes.
  • Has irrational and undefined fears, delusions or seems under unusual stress.
  • Seems to be losing his or her memory.

How can we begin to help our loved ones get help for substance abuse problems? Before talking to your older loved one or friend, talk to a professional trained in addiction and older adults. Prepare by gathering information:

  • A list of prescribed and over-the-counter drugs the person is taking.
  • A list of doctors the person is seeing. They may have a general practitioner and a specialist.
  • A brief life history including religious and cultural background and important life events.
  • An idea of the person’s present ability to live alone and take care of themself.
  • How drinking or the misuse of medicines is affecting their health, family and social life, etc.
  • A list of family members and friends who are concerned and would be willing to help, if necessary.

Together, you and the professional should be able to make an informal assessment as to what type of help the older person needs and how to approach the topic with them. You may decide, for example, that it would be better for your friend’s physician to bring up the problem, since many older people trust their doctors. Or perhaps you can ask another close person, such as a minister or an old acquaintance of your friend to sit down for a personal talk. Find out more at about how you can help your friend or loved one get help for substance abuse.

If the person is ready to make a change, the first thing to do is listen and be supportive. You may want to urge your friend to see a physician to get a professional assessment of the problem. Depending on the severity, the older person may need hospital care to treat the physical symptoms of alcohol and drug reactions. Many older persons can benefit from inpatient treatment for alcoholism or drug dependency, if their health insurance or other resources will cover the costs.

Alcoholics Anonymous (A.A.) can be a good alternative, along with individual counseling from an addiction professional that is trained to work with older adults. Founded in 1935, A.A. has helped millions of people achieve sobriety. When you talk to an A.A. volunteer, ask for a meeting where an older person could be comfortable. See for more helpful information for friends and families of older adults dealing with substance abuse.

Fortunately, today it is more accepted to seek help for alcohol and drug abuse problems. There are excellent resources in many communities to help loved ones and friends address the issue. Michigan State University Extension staff works with the Geriatric Education Center of Michigan at Michigan State University to bring the latest health information about older adults to health care providers throughout the state. See for more information.

For more about older adults and substance abuse read Substance abuse in older adults: Underdiagnosed and undertreated.

Michigan State University Michigan State University Close Menu button Menu and Search button Open Close