Older Women and Drug Addiction

How do you picture a drug abuser or addict? Young, disheveled, gaunt, male? While this picture does represent a large proportion of drug abusers, could it be you or a loved one or friend? Unfortunately, the rate of drug abuse by mature men and women has increased alarmingly over the last 15 to 20 years. Let’s explore this trend and what it may mean for you as a mature woman.

How common is substance abuse/addiction in “mature” or “older” people?

There is no single age that is defined as “mature” or “older,” but studies have utilized lower limits of 50, 55, 60, or 65 years of age. Studies show that the incidence of substance abuse has significantly increased over the last ten to twenty years, with some evidence that substance abuse/addiction has doubled or tripled during this time period among this age group. Fortunately, mature adults account only for 3 to 7 percent of people seeking addiction treatment. So compared to younger age groups, we mature folks are definitely less likely to become addicted. That’s a good start!

Are women more or less likely to become addicted than men?

It’s generally thought that women have lower addiction rates than men, although specifics in the mature age group are unclear. However, women tend to become addicted more quickly and at smaller doses of substances abused.

What drugs are we most likely to abuse?

The most commonly abused substance for all abusers is, not surprisingly, alcohol. However, as of 2012, cocaine/crack, marijuana/hash, heroin, nonprescription methadone, and other opioids all occurred more frequently within the older age group as compared to 2000 data, with opioid use increasing by over 200 percent. Over 70 percent of mature women in addiction treatment were being treated only for alcohol abuse as of the year 2000. That percentage dropped to around 55 percent in 2012. Taken together, this means that more mature women are seeking treatment for abuse of substances other than alcohol and may be more likely to abuse multiple addictive substances. This may mean that mature women will become more severely affected by their addiction over time. Increases in prescribed drug misuse, measures to address the current opioid death epidemic, and changes in the legal status of marijuana will probably change data over the next five to ten years.

A quick note about alcohol

The combination of alcohol with any other substances (including illicit drugs, prescription drugs, over the counter medications and vitamins or supplements) ups the ante on dangerous effects in all age groups. Combinations of alcohol with opiates, sedatives, and antidepressants are common. All of these combinations can cause decreased consciousness and slow, ineffective breathing, which is the most common acute cause of death due to addiction.

Do women differ from men when it comes to substance addiction?

Yes, although individuals can vary and it’s unclear how a woman’s age might change the effects. Some of these differences are good for women, some may be a disadvantage, and other differences are just that—differences. It’s thought that metabolism and hormones account for at least some of them. Here’s a list of some of those differences.

The good news for women when it comes to SUDs:

Women have lower rates of substance abuse and addiction in general.
Women are more likely to seek drug abuse treatment than men and often seek it earlier.
Women are less likely to binge drink than men.

The bad news for women when it comes to SUDs:

Women progress more quickly from beginning drug use to becoming substance-dependent.
Cravings and withdrawal symptoms tend to be much worse than for men.
Women are more likely to suffer depression, anxiety, PTSD, and eating disorders alongside substance use disorders (known as co-occurring disorders).

What are some of the effects of increasing age on addiction?

The vulnerabilities to and effects of substance abuse in mature adults mostly relate to normal physiologic changes of aging and the effects of chronic medical problems and medications used to treat them. Here are some of most concerning effects of addiction later in life:

Harmful drug interactions between prescribed medications and other substances of abuse are more common and may be fatal.
Age-related decreases of kidney, liver, heart, and brain function can cause drugs of abuse to be more toxic or to have an exaggerated effect.
Tolerance for alcohol and other substances decreases. Not taking this into account after a period of abstinence may essentially result in an overdose. You just can’t drink or take drugs like you used to!
The ability to compensate for adverse effects of substance use or acute disease decreases.
Symptoms of drug use often mimic those of other medical problems. Without information about a patient’s drug misuse, the physician doesn’t have all the important data to form a diagnosis and treatment plan. Because of these issues, good coordination of a patient’s care is difficult. It’s a complex dance that is sometimes not done well even without the contributions of substance abuse.
The body may already be affected permanently by long-term substance abuse in younger years, giving you an automatic disadvantage. These effects vary with the abused substance and duration and severity of the addiction. Mature people who have never been addicted before or have only been addicted for a short period of time tend to do much better.

How is substance addiction treated?

Treatment of substance abuse disorders needs to be a team effort, incorporating physicians, mental health workers, substance abuse therapists, social workers, routine medical care providers, and an engaged and committed patient. The treatment plan needs to be comprehensive but flexible and should include long-term follow-up and support. In most cases, the needs of women and men vary by the individual rather than by gender.

Outpatient treatment is generally effective for low complexity patients (those with only one substance abused, no major medical problems, no history of previous addictions, and short-term history of abuse). This applies to most mature adult addiction patients.

Inpatient treatment is most effective for more complex patients, including those with more complicated substance abuse patterns, multiple medical problems, severe addictions, longer history of substance abuse, separate mental health disorders, or who require more complex management of withdrawal symptoms. This allows for closer monitoring, observation for and treatment of withdrawal symptoms, initiation of multiple types of therapy if needed, and more control over stress triggers.

Other features of addiction treatment may include:

Treatment of withdrawal symptoms, including medications for nausea and anxiety and drugs such as buprenorphine or methadone for opioid withdrawal symptoms and long-term maintenance of abstinence. This is commonly known as medication assisted treatment.
Cognitive behavioral therapy (CBT) focuses on examining and changing unrealistic thoughts caused by abused substances and behaviors that result from abnormal thoughts (such as the resumption of substance abuse). It provides the patient with new, better, socially acceptable life skills. It prepares the patient over three to six months for more intensive psychiatric treatment.
Individual, group and family counseling
Access to 12-step and other support groups
Social services
Long-term follow-up and support

Are women more likely to stop and sustain addiction behaviors?

Yes, although most closely studied in the context of opioid addiction treatments, women do tend to be more likely than men to achieve and sustain abstinence from addictive substances following treatment. Older addiction treatment patients are also more successful.

So yes, substance addiction is increasing among mature folks. Both age and gender influence the effects of substance abuse, with women possibly suffering fewer and less severe consequences and achieving better treatment outcomes. Substance abuse in mature age groups needs to be a future priority for much more study. It may also be a more significant part of your life and the lives of those around you than you think.

How do you picture a drug addict now?