There are only three known addiction programs specifically for seniors in the United States, said John Dyben, director of older adult treatment at the Hanley Center at Origins. And this is a huge problem.
Dyben, who works at one of the three treatment centers, delivered his presentation on older adults on Tuesday at the National Conference on Addiction Disorders (NCAD) in St. Louis.
"Substance use and alcohol addiction is not just something that happens in older adults," Dyben warned. "It's common and it's at epidemic levels."
Studies have shown that older adults (in this presentation, those aged 65 to 79) are using drugs and alcohol and it's exacerbating their existing medical problems. But doctors aren't addressing the drug use, and it's not being addressed in mental health or medical communities, Dyben said.
"When addiction is recognized, and we refer them to a program, we're finding that the treatment needs of older adults are uniquely different from younger adults," Dyben said.
Senior drug of choice seems to be alcohol, Dyben said. More than 2.5 million older adults would qualify as having an alcohol use disorder, and that number is expected to double by 2020.
"The problem is so significant, the American Geriatric Association recommends scanning annually for alcohol use disorder in people over 65," Dyben said. "This is a big deal."
Prescription drug abuse is almost at the same level as alcohol use in seniors, and it's because access to these drugs is very easy, Dyben said.
"If I went into the doctor with back pain and asked for Xanax and oxycontin, the doctor would surely deny me," Dyben, who is middle-aged, said. "But if my grandma went in with the same complaint, she'd walk out with drugs."
When it comes to illicit drugs, seniors prefer marijuana. In a study from 2010, 4.8 million older adults admitted to intentionally using an illicit drug, Dyben said.
"The mentality tends to be 'Hey, they're old, let them have their booze or drugs,'" Dyben said. "People laugh it off, but these drugs are stealing their quality of life."
When designing a treatment program for seniors, here are some things to consider.
- Tailor your programs to address the issues of aging
- Include friends, family and other support. The more peer support, the more likely they are to open up
- Host respectful, non-confrontational programs. Seniors respond better to actual therapy, Dyben said
- Include medical staff. More than likely, you'll be working with seniors who have two or more chronic illnesses
- Host physical exercise classes that even those with an impairment can attend. "A study found that a practiced physical activity that required the mastery of a new skill (yoga, stretches) daily is as protective against depression as selective serotonin reuptake inhibitors (SSRIs), especially in seniors 65 and older," Dyben said.
- Consider cultural differences. Those born between 1908 and 1929 (Greatest Generation) experienced different life events than those born between 1946 and 1964 (Baby Boomers). The Greatest Generation tend to experience shame around alcoholism and drugs, and they tend to trust institutional authority more. Baby boomers feared and distrusted authority, and were never really told that drugs were bad, Dyben said.