Tips for Talking to Older Adults About Substance Abuse

We usually associate growing old(er) with unwavering dignity. "I have it all figured out" kind of attitude. And it's only sensible to assume that life has taught us valuable lessons and given us healthy mechanisms to cope with whatever is left to come (as we've already seen and experienced plenty; not to be read in an ominous tone). 

By default, we associate substance abuse with younger people. It's a reflex. Youth comes with an innate urge of a sort; we want to see the world, feel it, touch it, smell it, and experience life to the fullest. Get reckless. – And learn how to regret things we've done. "Never again, lesson learned." And it's onward from there. On to the next one, the next endeavor, the next chapter.

However, to everyone's surprise, substance abuse and addiction are more than common among older adults (with adolescents being at a higher risk of addiction). The unimaginable has become our reality. 

Talking to older adults about substance abuse can be quite an uncomfortable experience – for all parties included. Read on for tips on how to make the taboo a little less daunting. According to ANR Clinic, an accredited opioid treatment, older people are one of the most common populations that have fallen victim to substance abuse. This is because it makes prescription pain medication readily available to them. However, opioid use in senior citizens is riskier because they may be taking several medications for the treatment of various health problems, increasing the risk of side effects and negative interactions.

Epidemic, the Unexpected

Prescription drugs, alcohol, and cannabis; older people seem to enjoy it, too. And a bit too much. Substance misuse in older adults has somewhat become a potentially life-threatening habit, an epidemic of global proportions. Yet, we don't talk about it enough. Why? Simply because it is unorthodox. – from our perspective, at least. 

Just think about the era many Boomers grew up in. Many hit records from the 60s and 70s dealt with drug or alcohol use. These songs reflect the cultural zeitgeist of the time when drug use was widespread and often glamorized. While some of these songs may be seen as cautionary tales, others celebrate the hedonistic lifestyle of the era.

Here are some hit records from the 60s and 70s about drug or alcohol use:

• Lucy in the Sky with Diamonds by The Beatles (1967)
• White Rabbit by Jefferson Airplane* (1967)
• Brown Sugar by The Rolling Stones (1969)
• Helter Skelter by The Beatles (1968)
• Light My Fire by The Doors (1967)
• Purple Haze by Jimi Hendrix (1967)
• Born to be Wild by Steppenwolf (1968)
• Knockin' on Heaven's Door by Bob Dylan (1973)
• Hotel California by The Eagles (1976)
• Free Bird by Lynyrd Skynyrd (1973)

*group denies the song is about drug abuse despite much of the public believing it is.

Hippie Generation Now Older

Not everyone who grew up during this time were "hippies," yet the music and lifestyle of that era were common. People who grew up in that era are now in their 60s, 70s, and 80s. Those who partook in that lifestyle might be likelier to do so much later in life. 

One study, published in the journal Addiction in 2016, found that people who used drugs and alcohol in their 20s and 30s were more likely to have an alcohol use disorder by the time they were in their 60s and 70s. 

The study also found that people who used drugs and alcohol in their 20s and 30s were more likely to have health problems, such as liver disease and heart disease, by the time they were in their 60s and 70s.

Another study, published in the journal Alcoholism: Clinical and Experimental Research in 2017, found that people who used drugs and alcohol in their 20s and 30s were more likely to have cognitive problems, such as memory loss and difficulty concentrating, by the time they were in their 60s and 70s.

These studies suggest that people who use drugs and alcohol during their younger years are at an increased risk of developing an alcohol use disorder, health problems, and cognitive problems later in life.

The problem is that friends and family often fail to engage in a productive dialogue, leaving immediate action indefinitely pending. When our parents, relatives, or older neighbors show definite signs of addiction, be it alcohol or prescription drugs, uttering a meaningful narrative can prove to be more than elusive. How do you approach the subject without them immediately backing away and shutting down (and off)? How do you ask questions without being offensive? Oppressive? Overwhelming? – It's possible.

The Statistics

Interestingly, the number of studies looking into addiction and substance abuse among older adults is quite limited at this time. However, we do have other available information that confirms the premise. As we grow older, our need for pain relief will likely increase. Hence, opioid addiction. Highly addictive, notorious opioids are known as the "feel-good providers," as our neurotransmitters release endorphins when ingesting the substance. In turn, endorphins are superior at muffling our pain receptors, giving the individual an invigorating sense of well-being. Albeit temporary. Getting "hooked" is a no-brainer, especially if the person is experiencing chronic pain.

Additionally, around 70% of hospitalized older individuals (affecting up to 50% of those in nursing homes) have what we call – a drinking problem. Mixing prescription drugs with alcohol is pretty common among the elderly. Needless to say, the combination can be deadly.

Keeping Quiet is Not an Option

Talking to older adults about substance abuse can be a bit tricky, as the symptoms often correlate and mimic signs of aging. Tremors (shaking hands) and cognitive decline (forgetfulness) is widespread in older individuals; all the same, it can also be a clear sign of substance abuse. Better safe than sorry, though. Older adults are subjected to natural, physiological changes that make them more susceptible and sensitive to substance intake. 

As the body ages, we experience more side effects, drastically increasing the chances of experiencing negative consequences. Substance abuse experts from Archstone Behavioral Health share: "Consequences can include anything from accelerated cognitive decline and additional health problem onset to worsening of one's current health condition." Turning a blind eye is not an option.

Talking to Older Adults About Substance Abuse: Icebreaker

Accusing them will get us nowhere. Why? Because the chances are they're probably unaware of their substance abuse problem. They just don't see it that way. The very lack of necessary knowledge and information creates room for excessive indulging, as there is no potential consequence cognition. 

Given that they're most likely in denial (or utterly unaware) of their ongoing condition, the easiest way to open dialogue would have to be the good, old open-ended questions. Open-ended questions provide the desired two-way street narrative without the imminent feeling of imposition. We don't want them cornered but at ease and with their tongue untied. Shoot the breeze. Nonchalant conversation. No biggie.

No to Judgment

Come from a place of concern, not judgment. Don't be afraid to ask: "So, what do you like about alcohol/cannabis/prescription drug use? What does it do exactly?" – Their answer alone will give us a pretty good idea about where the need for numbing stems from. Creating a collaborative discourse around the difficult topic is enough to get our foot in the door. – And that's all we need, really. Just a conversation starter. It all moves pretty quickly and organically from there. Again, refrain from expressing reflex judgment. – They know we care. They're the vulnerable ones right now; approach them with kindness.

Guidelines to Keep in Mind

• Approach the situation with gentleness and unconditional understanding. Be loving and supportive.
• Avoid speaking to them about the subject when they're under the influence. Having a sober conversation is paramount.
• Refrain from derogatives. "Addict" or "alcoholic" carries a certain weight. Putting a negative identity label can cause them to detach further and isolate (leading to new binge cycles)
• Lose the confrontational style, but be sure to display directness. They're not children. Treat them like an adult. Ultimately, it's how we show respect for the person.
• Be consistent. Be persistent. Additionally, keep in mind their age. They may not be able to fully grasp a too intricate and complex concept. Give it time. Don't push it. But don't give up, either. Slow but steady wins the race.
• Don't bring up the past. They feel guilty as it is. Focus on "right now."
• Be straightforward but choose your words carefully. Don't say: "You're a drunk." Use euphemisms along the lines of: "I couldn't help but notice five empty beer bottles resting peacefully at the bottom of your trash bin last night. And I haven't slept. Are you okay? What's happening? I'm worried. This isn't the first time."

Final Words

Talking to older adults about substance abuse is seldom easy, especially if the adult in question is our parent. If you are concerned about someone's substance abuse, encourage them to see a physician; and let them know you'll be there. Every step of the way. Finding the right rehab center is key to success. You can find one in your area, like the rehab center in Indianapolis, which will help you overcome addiction.