Dr. Diana Rangaves, PharmD

Elder Wellness and Addiction: Treating Substance Use in Older Adults

Why Elder Addiction in Older Adults Gets Missed

Changing Life Stage, Changing Risks

By the time one reaches 60 or 70, their elder addiction health picture may include chronic illnesses, multiple medications, and changes in social connections. These changes create new vulnerabilities to substance use. Loneliness or bereavement can drive an individual to use alcohol or drugs. Even modest substance use may trigger major problems due to decreased metabolism and reduced organ function.

Blaming Problems on Aging

Many healthcare providers—and older adults themselves—assume that memory lapses, fatigue, falls, or mood changes are “just aging.” But these may reflect substance misuse. When symptoms are mistaken for dementia, depression, or other age-related issues, substance use stays hidden. It matters because older adults often respond well to treatment if they get it—but too many don’t.

Medication Interactions and Polypharmacy

If you’re older, you are likely taking a number of medications: pain relievers, sleeping pills, blood pressure pills. These raise the risk of hazardous interactions with alcohol or other substances. Most providers focus on each prescription individually, not the total risk from combining them, or how aging changes drug metabolism.

Treatment Tailored for Older Adults

The Need to Personalize Care

What is effective for someone younger is not necessarily effective for a person in their 60s, 70s, or beyond. Older adults are underrepresented in treatment settings; however, those who attend tend to show very strong outcomes. You deserve treatment that sees you, not just your age.

Integrating Physical Health and Addiction Care

Your treatment plan needs to consider the following:

  • Current medications and potential interactions

  • Increased risk for side effects

  • Conditions such as heart disease or arthritis which may influence the treatment options

  • Physical or sensory limitations that make travel or participation harder

Addressing Isolation, Loneliness, and Social Change

Retirement, loss of a spouse, reduced social networks, and declining mobility all mean your world is narrowing. They also put you at increased risk for substance use. Substance problems often start in later years as opposed to continuing from earlier years. Treatment needs to take into account social support—peer groups, transportation, and age-appropriate settings.

Using Age-Appropriate Treatment Methods

Practical strategies include:

  • Regular screening in primary care

  • Simple assessments that reflect age-specific signs

  • Outpatient or home-based options

  • Family involvement at your request

  • Goal flexibility: some may prefer reduced use over full abstinence

  • Coordination with mental health care

  • Full reviews of medicines to avoid harmful combinations

You may want to join group therapy that is about issues such as aging, loss, and isolation, in addition to elder addiction topics.

Your Action Steps If You or Someone Older Is Struggling

Recognizing Elder Addiction Signs

Watch for these warning signs:

  • Increased use of alcohol or drugs since retirement or death of a loved one

  • Mixing alcohol with prescriptions

  • Falls, confusion, or mood changes without a known reason

  • Substances to cope with loneliness

  • Hiding use or feeling ashamed

Getting Help

You do not have to go through this alone. Support is available:

When choosing a program, ask:

  • Do they treat older adults differently?

  • Are the staff trained in geriatric care?

  • Is the facility accessible?

  • Will they work with your existing doctors?

  • Do they consider your social and emotional needs?

Supporting Wellness Beyond the Clinic

To support your recovery:

  • Stay active to enhance your mood and reduce cravings.

  • Reconnect with others—join a local group or club.

  • Have your medications reviewed yearly.

  • Stay on a routine.

  • Seek support groups for older adults.

  • Be honest with your provider about your use of alcohol or drugs.

Why This Matters for You

If you’re older and using alcohol or drugs heavily, you’re not alone. You’re part of a growing group that often gets overlooked. Treatment works when it fits your age, health, and lifestyle. You deserve care that meets you where you are in life and helps you move forward.

If you see the signs of substance use in yourself or someone you care about, take action now. Recovery is possible—and worth it.