Today, addictions treatment providers are working with more older Americans than ever before in history.
In part, this is simply a reflection of demographics. The population as a whole is aging, with a large cohort of Baby Boomers benefiting from advanced healthcare, better nutrition, greater wealth, and other factors that see them living longer than their parents.
According to the Census Bureau, in the ten-year period leading up 2020, the segment of the U.S. population over the age of 65 grew by 40%, putting another 56 million Americans into the ranks of senior citizenship.
In some ways, the reality of aging adds to the factors that push the risks of addiction higher among this population. With more frequent contacts in a healthcare system that increasingly writes prescriptions for treatment, they are also in a position where they may be more likely to encounter notoriously addictive prescription opioids in the course of treatment.
In fact, according to a review of the literature, substance use disorder among older individuals is one of the fastest growing healthcare issues in the country.
Addiction counselors are finding that traditional training isn’t keeping up with the challenges they face in treating this population, but new continuing education and college courses are helping bridge the gaps.
Uncovering an Underserved Population Struggling with Addiction
A quick glance at the home page of the National Center for Drug Abuse Statistics tells you exactly what you need to know about the emphasis in tracking and treating drug use in America today: youth has its own category, but there isn’t a corresponding one for older adults.
You have to get more than halfway down the page before you hit the bad news:
- The drug-related death rate for users over 50 is increasing by 3 percent per year
- Three-quarters of those deaths are caused by opioids… while teen opioid use has actually been in decline recently
Seniors face significant risks from other drugs, too. Studies have shown that:
- Chronic cannabis use in older adults creates a higher risk of falls and elevated risk of developing major depressive disorders
- Older adults are more susceptible to cardiovascular events provoked by cocaine or other amphetamines
- Benzodiazepines, such as valium, have been associated with higher rates of cognitive decline in older adults
Seniors are also more likely to be on other prescribed medications which may have interactions with alcohol, which can further complicate treatment options. Finally, they are at high risk of inadvertent overdose and other unexpected interactions between prescribed medications.
Why Aren’t More Resources Available for Seniors Facing Addiction Issues?
You might think all these risks would call more attention to senior substance abuse issues. But there are reasons that addiction in kids and younger adults receives more attention and gets more resources than the same issue in older adults.
First, there’s a very real, even biologically engrained, human tendency to protect and guide children through their vulnerable years toward a stable adulthood.
Next, from the standpoint of public perception, there are few things more heartbreaking than a parent losing a child. It’s easy to understand how tragic cases of youth overdose result in a focus of resources and publicity to prevent these kinds of losses.
It’s also the case that older adults have often learned a measure of stoicism and self-suppression over the years when dealing with highly personal problems like addiction. They are less likely to have individuals in their social networks who might notice such issues and less likely to seek help.
It turns out the Silent Generation isn’t just staying quiet about their personal accomplishments; they don’t have much to say about the personal challenges they face, either.
The symptoms of substance use disorder (SUD) can also be easily mistaken for other chronic health conditions common in this population. They can also be confused with natural changes in behavior or cognitive capacity that come with aging.
Finally, there’s a misplaced sense that older individuals experiencing addiction must be incorrigible and untreatable. People believe that they have had their chance and made their choices and must deal with the consequences personally.
For all these reasons, substance abuse issues in older adults often go untreated.
Getting Older Adults To Acknowledge Issues Is Almost as Hard as Getting Them To Accept Assistance
Of course, it’s these last few reasons that are often the most intractable. Yet they are also the easiest to prove wrong.
It’s never too late to beat a substance abuse problem, and lives are important at all ages. More importantly, quality of life remains one of the major factors in aging gracefully and successfully. While challenges of disease, finance, and social isolation are tough to overcome, overcoming addiction is a relatively straightforward way to make big gains in quality of life.
Addiction counselors can have their work cut out for them when it comes to reaching older clients.
A bridge of years exists between many counselors and their older clients, one that represents vastly different cultural attitudes. This shows up most clearly in the reality that alcohol is the most heavily abused substance used by seniors… who, in many cases, have engrained perspectives from their formative years that don’t count substantial drinking as quite the same problem it is seen as today.
Counselors have to re-tool their persuasive methods to account for these vast gaps in assumptions.
How Counselors Are Figuring Out How To Treat Substance Use Disorders Among Older Adults
It’s also true that there is relatively little research on the most effective techniques for treating older adults. In fact, not a lot is known about the impacts of drugs and alcohol on aging brains.
Alcohol is by far the most commonly used substance reported among older adults. A 2019 National Survey on Drug Use and Health reported more than 10 percent of over 65s engaged in binge alcohol use in the prior month. And unfortunately, they are also more susceptible to the impacts of that drug for both physiological and psychological reasons.
While the bias that society has against treating older adults experiencing addiction can be overcome, there’s another unexpected bias that many therapists working with this population have to get past: the tendency of older adults to discount the advice and expertise of younger therapists.
Decades of lived experience don’t automatically grant an advanced understanding of addiction science or effective treatments.
But, as any qualified peer support counselor can attest to, there is a reality that comes in coping with addiction that no school can quite replicate. Having adapted over years to their current state, some seniors can be perfectly happy in what a counselor recognizes as a completely dysfunctional situation.
Older adults also face transportation and mobility issues in getting to treatments and a tattered social network that leaves them with fewer friends and family to rely on for assistance. They are in fewer situations where they may be screened for substance use disorders and find fewer treatment options when they are diagnosed.
Building on a Core of Addiction Counseling Education Improves Your Capacity To Help Seniors in Need
Addiction counselors beginning their educational journey toward certification and licensure can focus on particular courses to help prepare for this surge in demand for treating older adults with substance abuse issues.
While few, if any, degrees are offering coursework that specifically addresses work with this population, there are many common core and elective classes that can give you the grounding you need.
In particular, master’s in addiction counseling degrees will come with advanced coursework in psychopharmacology that can help you sort out various interactions between drugs that seniors may be taking. They also usually go in-depth on the psychopathology of co-existing disorders, which are common in older patients.
Undergraduate degrees in addiction counseling have even more opportunities to help you specialize in working with an older population. That’s because the extra time and credits that are involved in earning a four-year bachelor’s degree gives you a lot of elective options. Even better, many of those electives can be drawn from programs and departments from across the university.
This means you’re free to dip into classes in social work or counseling that may shed more light on elder care issues. You may even find courses in healthcare for geriatric patients that may be useful.
Most Dedicated Training for Substance Abuse in Older Adults Is Available Only After Graduation
For the most part, however, counselors interested in upping their game for treating older adults with substance abuse issues will find their best educational bets through continuing education options.
Because the subject has been largely overlooked in mainstream addiction counseling, it doesn’t get a lot of attention in time-tested and established degree programs covering substance use disorders. In fact, since it’s not in any of the required materials for education needed for licensure or certification, it definitely takes a back seat.
But specialists in the field have an easier time putting together and offering continuing education courses that focus in on seniors.
Where To Find Continuing Education in Geriatric Addiction Counseling
You can find plenty of these options through popular CE sources like NAADAC, the Association for Addiction Professionals. NAADAC actually offers a dedicated certificate in treating older adults, the end product of a six-part specialty online training series called Thriving in Later Life: Treating Older Adults in Recovery. It’s available free to NAADAC members and covers everything from the science of aging to grief and bereavement in the older adult community.
There are also CE classes that are conducted by universities even if they aren’t available in addiction counseling degree programs directly. The Boston University School of Social Work, for examples, has an online class in Substance Use Among Older Adults that offers 4 CE hours and gives a broad overview of challenges and solutions dealing with this population.
You may also find resources that aren’t specific to substance abuse but still useful in connecting and treating this population. The Elder Education Institute is a CEU-granting organization with experts in geriatric mental health treatment who can help you hone your skills in connecting with and treating older adults.
The issues of older adults and addiction isn’t going away, and counselors who choose to take on this challenge will find themselves more and more in demand. Prepping now with the skills needed to offer effective treatment is the responsible and proactive way to serve your community and help seniors find a healthier and happier path through their golden years.