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Drug and alcohol abuse among older Americans: What you should know

Q. I recently read that death from drug overdose in our country is staggering. I know this is a problem for our younger generation. I am curious is it equally a problem for older people? M.L.

The straight answer is a resounding yes. Data from the Health and Human Services Department indicate that in 2020, more than 800,000 older adults suffered from drug addiction and 2.7 million suffered from alcohol addiction. Deaths among older adults from these addictions are increasing.

Here are a few statistics related to deaths. From 2019 to 2020, deaths from fentanyl and other synthetic opioids increased by 53 percent among older adults, according to the National Center for Health statistics. In that same period deaths from alcohol abuse increased more than 18 percent. That means more than 5,000 older adults died of drug overdoses and more than 11,600 succumbed to alcohol. Some of the deaths are accidents; others are suicides.

Two drugs predominantly are related to these deaths. The first is fentanyl, an opioid 50 to 100 times stronger than morphine. Users have taken it not only for pain relief but also for an intense and short-term high, a temporary feeling of euphoria and relaxation. Reactions may include slow breathing and feelings of confusion, drowsiness, nausea, vomiting and more. This drug is legally used to treat severe pain during or after surgery or pain from a serious injury or cancer. It also is used when other painkillers stop working.

Older adults are particularly vulnerable. Compared to younger individuals, they are more likely to experience chronic pain and limited or painful mobility related to age-related changes. As a result, opioids are prescribed at a higher rate compared to younger folks. Additionally, older adults are more susceptible to these drugs because of their decreased ability to metabolize drugs or alcohol as well as an increase of brain sensitivity to them. Opioids are useful for short-term pain management and can cause many problems when used long-term.

Now let’s talk about alcohol, the most abused drug among older people. Among those age 65 and older, about 65 percent report high-risk drinking behavior defined as exceeding daily guidelines which is two drinks a day for men and one drink or less a day for women. More than one out of ten older adults report binge drinking which is five or more drinks at the same occasion for men; four for women. Furthermore, in 2020, research reported by the National Institute on Drug Abuse indicates alcohol consumption was greater for those aged 50 and older compared to younger age groups.

Age is a risk factor. With age, the body has a lower tolerance for alcohol that increases its effects more quickly, placing older adults at a higher risk for falls, car crashes and other injuries that result from drinking.

Life events and circumstances often are contributors to substance abuse in later life. These often are referred to as trigger events that can create significant emotional distress. Here are a few of those trigger events with some possible circumstances as identified by The Addiction Center.

  • Retirement

  • Death of a family member, spouse, pet, or close friend

  • Loss of income or financial strain

  • Loss of purpose

  • Relocation or placement in a nursing home

  • Trouble sleeping

  • Family conflict

  • Mental or physical health decline

Healthcare providers often overlook indicators of substance abuse among older individuals. That might be because of hurried appointments, lack of knowledge or symptoms that mimic medical or behavioral disorders that also are symptoms of substance abuse such as depression or dementia.

The good news is that help is available. The Substance Abuse Mental Health Services Administration (SAMHSA) forwards callers to resources in your geographic area. Call 1-800-662-4357. For a direct helpline for adults, call 1-833-605-1410.

Thank you M.L. for your important question. We all need to be aware of signs of addiction and be prepared to compassionately help. Stay well, and know kindness is everything.

Helen Dennis is a nationally recognized leader on issues of aging and the new retirement with academic, corporate and nonprofit experience. Contact Helen with your questions and comments at Visit Helen at and follow her on


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