SAN ANTONIO – As Americans are living longer and longer, substance abuse disorder is becoming more prevalent in older adults.
One in 11 adults over the age of 60 has a substance abuse disorder, according to 2022 data from the American Psychological Association.
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Neuropsychiatrist Thomas Weiss has been practicing medicine for over 35 years, but has focused on serving older adults after his father, mother, and sister died from Alzheimer’s dementia.
“It’s an unseen epidemic,” Weiss said. “There’s a high percentage of folks that are over 65 that are using more and more drugs and substances.”
Alcohol, marijuana, opioids and prescription medications are major contributors to overdoses in older adults and substance disorders, according to the National Institute of Drug Abuse.
The disorder ranges from mild to severe, and can look different depending on the individual. Substance abuse disorder is diagnosed and treated by a medical professional.
Dr. Weiss says depression and co-morbid health conditions can lead to more excessive drug use and drinking.
“We’re alone. Maybe our children live in another state, and they maybe call us once a month if we’re lucky,” Weiss said.
“[Older people] often have chronic pain. There’s some immense challenges there,” Weiss said. “The great news is we have medicines for that. The bad news is those are medicines that can be easily abused.”
Research shows older adults face biopsychosocial changes that alter the body’s ability to process drugs and alcohol, and that it’s easier to misuse substances compared to younger adults.
That misuse can affect nearly every aspect of life - from social relationships to poor mental and physical health, leading to falls, illness, or death.
Weiss said that because substance abuse is a complicated issue, it is not always identified at a primary care visit.
“Only 18% of those over 65 hospitalized for substance abuse are referred by physicians,” Dr. Weiss said. “The rest are brought in by a family member or law enforcement.”
John De La Garza, a mobile integrated health officer with the San Antonio Fire Department, screens 911 calls daily, looking for opioid overdose cases in order to provide support and services to reduce the chance of people ending up in an emergency room.
Garza has seen memory issues come into play when responding to opioid overdoses in older adults.
“[People] tend to forget when they’re supposed to be taking medication,” Garza said, “which might mean you take an extra dose of medication.”
Garza says he understands older adults may have feelings of shame and guilt preventing them from recieveing treatment.
“Here with the San Antonio Fire Department. We understand that [drug use] could be a disorder, and it’s a serious one,” Garza said. “It’s important that if they’re receptive, they get services with us and with the community.”
Doctors of Osteopathic Medicine list increased falling, frequently changing physicians, filling prescriptions at multiple pharmacies, and new onset irritability or confusion as major warning signs if you suspect you or your family member has substance abuse issues.
Weiss said the first step to change is awareness and honesty.
“It’s easy to turn a blind eye,” Weiss said. “The first thing I say is thank you for noticing the issue. I think there’s a ton of hope.”
Research by the Substance Abuse and Mental Health Services Administration (SAMHSA) shows that older adults have been treated well by modern substance abuse programs, medications, and cognitive behavioral therapy.
Weiss hosts presentations to educate families and medical practitioners to better educate the public on substance abuse in an older population.
“If we could get the word out that the shame doesn’t have to happen, we can prevent a lot of health issues,” said Helen Flores, client development specialist with one of the event’s sponsors, Hallmark Homecare.
Weiss will hold presentations at 1 and 6 p.m. Tuesday at Woodland Church. Medical professionals who attend can receive continuing education credit. You can register to attend the talk here.
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