Based on the 2010 census there were almost 309 million people in the United States (U.S. Bureau of the Census, 2011). People over the age of 65 made up 13% of the total population with just over 40 million people. Between 2000 and 2010 the population grew at a faster rate in the older population then the younger population. I feel the population of people older than 65 is important to focus on for this assignment because this population will continue to grow every year. In this assignment I am going to talk about the population of people over the age of 65 in the United States, then discuss the known patterns of substance abuse in this population. I will also talk about the treatment needs for people over the age of 65 affected by substance abuse.
While the primary focus of this report is about the population older than 65 it is important to note the age group percentages in the U.S. People under the age of 18 make up 24% of the total population with 74 million people. The 18-44 age groups make up 36% of the total population with just fewer than 113 million people. People aged 44-64 totals 26% of the population with 81 million. The rest of the population is the group of people 65 and older who total 40 million people and make up the remaining 13%. Understanding the population percentage in the U.S. is important, because by 2030 the percentage of people over the age of 65 will account for 21% of the total population (US Bureau of the Census, 1996). This percentage of the population is steadily increasing because of the “baby boom.” The baby boom was the dramatic increase in births from 1946-1964 following World War II. This generation is the largest generation in U.S. history (Britannica, 2014). What this information tells us is that as the population of older adult’s increases the number of potential abusers in this population will also increase.
The 13% of the population aged 65 and older account for over one third of the total outpatient spending on prescription medications in the United States. Older patients are more likely to be prescribed long-term and multiple prescriptions. 90 percent of people 65 and older take at least one prescription medication. A third has five or more prescriptions (NCHS, 2010). More than 50 percent of this population uses five or more medications including over the counter medications, vitamins, and herbal supplements. While a shocking 20% use 10 or more. Since many older patients usually have some sort of cognitive decline this can lead to improper use of medication. Those on fixed incomes may abuse another person’s remaining medication to save money.
With the high rates of comorbid (one or more) illnesses in the 65 plus population, age related changes in metabolism and the possibility of adverse drug interactions make any of these practices more dangerous than in the younger populations. Combining alcohol with prescription drugs and OTC’s and an individual is looking at serious health problems.
Substance abuse in the elderly is one of the fastest growing health problems and it is a silent epidemic. I feel this population is under estimated, under identified, and over all under treated. I will now discuss the treatment needs of the 65+ population. First off health care providers have a tendency to overlook substance abuse and misuse among its older patients and often misattribute the problem to other physical or mental disorders. Physiologically adults over 65 are more likely to be affected by one chronic illness; this makes them more vulnerable to the negative effects of prescription drugs and alcohol. There are 3 age related changes that significantly affect the way an older adult responds to drugs and alcohol. There include decreases in body water. They have an increased sensitivity and decreased tolerance, and a decrease in metabolism in the GI tract. As the lean body mass decreases total body water also decreases, and fat increases. So for a dose of alcohol the concentration of alcohol in the blood system is greater in an older person than in a younger person. What used to cause little effect now can cause intoxication. This results in an increased sensitivity and decreased tolerance to alcohol as people age (Rosin and Glatt, 1971).
In the US it’s estimated that 2.5 million older adults have problems related to alcohol. 38.2% report having a drink in the last 30 days, 7.6% report binge drinking, and 1.6% reported heavy drinking (Schonfeld and Dupree). According to the National Institute on Alcohol Abuse and Addiction (NIAAA) heavy alcohol use in elders is more than 2 drinks a day for males and more than 1 drink a day for females.
Some of the risk factors for elderly adults include: a prior history of alcohol abuse, family history of alcoholism, medical problems, and loss of a spouse, recent retirement, and social isolation. Late onset abuse affects around 30% of elderly addicts and it is usually attributed to a major life stressor after the age of 50.
Among other challenges older adults face when it comes to treatment needs are transportation needs. Often the older adults are home bound and have a small support system. The people they are around have a lack of expertise in the field. They have gaps in services and inadequate financing.
Treatment is highly recommended but often overlooked when it comes to the elderly population. One of the most important factors I found when it came to age and need specific treatment options for elderly adults was to employ staff experienced in working with elders. Another is to find a treatment program for the individual that is age-specific and offers group treatment that is highly supportive and non-confrontational. It is important to find a treatment facility that attends to negative emotions such as depression, loneliness, and overcoming losses. One must also look for a treatment center that works at slower pace and has a broad holistic approach recognizing age-specific psychological, social and heal aspect.

Works Cited

Day, J. C. (1996). Population Projections of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050. Retrieved from http://www.census.gov
Meyer, L. M. (2011, May). U.S. Department of Commerce Economics and statistics Administration. (L. M. Meyer, Editor) Retrieved July 5, 2015, from http://www.census.gov
Quiping Gu, M. (2010, September). Prescription Drug Use Continues to Increase. Retrieved July 10, 2015, from Centers for Disease Control and Prevention: http://www.cdc.gov
Rosin, A. J. (Msrch 1971). Alcohol Excess in the Elderly. Quarterly Journal of Studies on Alcohol, 53-59.
Schofeld, L., and Dupree, L.W. (1991). Antecedents of Drinking for Elderly Alcohol Abusers. Journal of Sudies on Alcohol, 587-592.
The Editors of the Encylopedia Britannica. (2014). Baby Boom Population Trend.