Baby boomers appear to be carrying their substance abuse habits with them as they age, according to a behavioral health expert at the University of Pennsylvania’s Perelman School of Medicine. David W. Oslin, MD, says binge drinking and prescription drug use are particular concerns in this population.
The implications are important for the substance abuse field, since there are 50 million people over age 65 in the United States, and people over 70 are the fastest growing group in the nation, he says. Despite the relatively common occurrence of substance use issues in baby boomers, health care providers often overlook them, Dr. Oslin observes. He adds that doctors and other health care professionals should routinely screen for and consider substance use when caring for older adults.
The 2012 National Survey on Drug Use and Health found the rate of binge drinking among people ages 65 and older was 8.2 percent, and the rate of heavy drinking was 2 percent. Among adults ages 50 to 64, the rate of current illicit drug use has increased during the past decade, the survey found.
The survey authors estimate the number of adults age 50 and older who will need alcohol or drug treatment will increase from 2.8 million in 2002-2006, to 5.7 million by 2020. Currently, 4 million older adults need substance use treatment, including 0.4 million needing treatment for illicit drugs, 3.2 million needing treatment for alcohol, and 0.4 million needing treatment for both.
The rate of illicit drug use among baby boomers has been higher than those of older generations, Dr. Oslin noted at the recent California Society of Addiction Medicine meeting. Baby boomers, particularly those born after 1950, had much higher rates of illicit drug use as teenagers and young adults than people born in earlier years.
According to the survey, in 2012, only 19.3 percent of persons aged 65 or older had ever used illicit drugs in their lifetime, while the lifetime rates of use were 47.6 percent for those aged 60 to 64 and were above 50 percent for those ages 20 to 59. The survey found marijuana and prescription psychotherapeutic drugs used nonmedically were the most commonly used illicit drugs among adults ages 50 or older in the past year.
Dr. Oslin says older adults have increased sensitivity to alcohol and over-the-counter and prescription medications, compared with younger adults. They also take more medications, and these drugs can interact with alcohol.
“It’s quite common for older adults to drink and to suffer from depression at the same time,” he says. “Many of them are on antidepressants, but that won’t help them stop drinking. They need an abstinence-oriented approach to get better.”
He is especially concerned about the increased use of benzodiazepines and opioids among the aging population. He co-authored a study that found despite continuing concerns about benzodiazepines in older adults, they continue to be commonly prescribed in this age group.
Older adults often are successfully treated for substance use disorders, particularly if the treatment is geared toward their age group, according to Dr. Oslin. “Many older adults don’t want to go to group therapy with younger adults, but they will go to individualized therapy or to groups with peers,” he says.
In a study he conducted, Dr. Oslin found treatment for alcohol dependence with the drug naltrexone and therapy sessions was effective for older adults, who were less likely to relapse than younger adults.
While baby boomers with substance use disorders have some considerations that are specific to their age group, Dr. Oslin says he has found many strategies that work apply to all age groups. Addiction treatment is not one size fits all, he says. “There are many options—use them. Compliance with treatment is important. While abstinence is often the goal, it is not the only goal. And getting the right treatment from the beginning may not be as important as changing the treatment when it isn’t working.”
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