Rx Summit Spotlight: SUD Prevention Among Over-50 Population Requires Special Considerations

While many of the nation’s substance misuse prevention efforts are designed to cover the entire lifespan, an aging population demands a sharper focus on the over-50 population.

During the upcoming Rx Drug Abuse & Heroin Summit, to be held virtually April 14-16, Elisha Figueroa, LMSW, CPS, and Angie Jones, MSSW, of JBS International will discuss ways that prevention professionals can proactively address this emerging issue.

Ahead of their session at the Rx Summit, they spoke with Addiction Professional about why substance use disorders among the over-50 population don’t receive the same level of attention as SUD among younger populations, unique contributing factors to SUD among older adults, and considerations for practitioners who work with older populations to keep in mind.

Editor’s note: This interview has been edited for length and clarity.

Do you feel that substance use disorders among the over-50 population are being overlooked in comparison to how substance use disorders among younger populations are being addressed, and if so why?

Figueroa: In prevention especially, we have historically overlooked the older adult population. Many of our efforts and strategies have been focused on youth and their parents, and that’s a great population to focus on. But what we know from some of the emerging data is that some of the older adult population also is beginning to use at a higher rate and that there are prevention efforts we can put into place to address that.

Jones: Part of the issue with older adults is that there are complicating factors. When they are using, there’s a lot that goes along with that. They have to think about the medications they’re taking. It’s not as easy as it being just that they’re using. There are complicating factors.

What are some of the unique factors contributing to the rise of substance use disorders among older adults vs. other age groups?

Jones: One thing to think about is that the older adult population is growing. There are more older adults now than ever before. In 2018, 16% of the U.S. population was 65 or older. By 2060, it’s projected to be 23.5% of the population. They’re a growing population group. Baby boomers are aging.

Figueroa: I would add that in particular for this age group, they have stressful life events and transitions that other age groups might not have. For instance, if you think about an older adult, they often are at the end of their career, retiring or adjusting to retirement, which is a huge life change. We also know that many move out of their family homes and downsize into smaller homes, or maybe even move into a different neighborhood or town, which changes their support system. Their children have grown up and moved away, if they have children. Their health is declining. They’re experiencing the death of friends, family members or maybe even their spouse. All of those are huge life transitions that are occurring during this period of time that will contribute significantly to substance use.

Can you share a couple examples of special considerations for practitioners to keep in mind when working with older adults?

Jones: One consideration is the context of the whole person. There are these life events and transitions, so being cognizant of them is one thing. Another big thing is that their body chemistry is changing. What used to be an acceptable amount of a substance like alcohol, your body can’t break it down like it used to when it’s 65 or older. There are different drinking guidelines for you when you’re older. It’s important for older adults to understand and that practitioners train them and help them understand that their tolerance is less than it used to be. That’s one thing, and then how it interacts with medications and things like that.

Figueroa: For prevention practitioners, something to be aware of is the partnerships you’ll develop to be able to implement strategies to help this population can be different from traditional partnerships. We often partner with schools and youth-serving organizations like the Boys & Girls Clubs. When we’re talking about this population, we’re going to expand into non-traditional partnership—maybe with the area’s agencies on aging and with geriatric education centers and senior service centers that we might not have already developed partnerships with.