When the idea of your “Golden Years” — retirement with a life full of fun, spent volunteering, and enjoying the fruits of your labor — meets with reality — chronic illness and pain, loneliness, and decreased income — the shine can quickly diminish.

Increasingly, seniors are turning to a readily available, easy-to-find “solution” in their medicine cabinet.

Study after study tells the story of the nation’s aging population and its struggles with addiction. A 2018 Johns Hopkins University School of Medicine paper chronicled a steady rise in older adults seeking treatment between 2004 and 2013. Those numbers exploded in the next three years, jumping more than 50% between 2013 and 2015. And Medicare data suggests that, since 2013, the estimated rate of opioid use disorder in older adults — the result of chronic use — has increased by more than 300% overall in the U.S.

The last set of data available from the National Institute on Drug Abuse says that in 2018, nearly 1 million people over the age of 65 lived with a substance abuse disorder. In the dozen years between 2000 and 2012, the number of older adults admitted to treatment facilities has doubled. And this was all before COVID-19 and the struggles the pandemic brought.

That’s because the triggers have always been there, addiction and recovery counselors say.

“As counselors, we look at something called ‘social determinants of health’: Fifty percent of a person’s health is the healthcare they receive. The other 50% is all the other things happening in their lives,” says Angela Morton, the director at Recovery Is NWPA, a consortium of agencies in Erie, Crawford, Clarion and Venango counties that provides support and resources to families impacted by substance abuse. It's a rural corner of Pennsylvania served by a handful of electric cooperatives. 

“It’s a much different picture in someone who’s 70 and widowed and living alone,” Morton adds. “They are alone and very isolated, maybe depressed … even possibly having thoughts of suicide. If you don’t have some kind of sense of purpose or a sense of belonging in the world, you can fall risk to the isolation that can lead to misusing medications, prescriptions, illicit drugs or alcohol just to self-medicate.”

And many seniors have the drugs on hand — prescribed for chronic pain or an illness they’ve been battling. 

Easing the pain

Dr. Jill Miller, who is certified in addiction medicine, sees patients at the Meadville Medical Center’s family practice office as well as at the Saegertown Recovery Clinic, both located in territory covered by Northwestern Rural Electric Cooperative (REC).

“It’s easy for a patient to use more than prescribed when they’re in pain, especially if they can’t remember whether or not they took the medication,” she says of her patients, who then can slip to the next level. “As access to opioids diminishes, more and more older adults switch to illicit pain-control drugs, such as heroin and fentanyl. 
“We also have had older patients come in using fentanyl/opioids from the streets after their children encouraged them to try it for pain.”

And in a cruel irony, the very symptoms they are trying to self-medicate can be aggravated by drug use, creating a spiral that’s hard to break. Older adults metabolize drugs and alcohol in different ways, and that can add to the issues they are already trying to deal with.

“Often, coordination and judgment are impaired,” Miller says. “We see many of our older patients presenting after multiple falls. Frequently, they are covered in bruises, have fractured ribs, concussions and open wounds. Many times, they don’t even remember where they fell or how they injured themselves.”

Treatment for older adults, at least when it comes to medicine, can also differ. Buprenorphine, methadone and naltrexone are routinely prescribed to treat addiction, chosen based on the patient’s age and their health. When working with older patients, Miller says, physicians will often prescribe medication that leaves the system quicker to reduce the risk of overdose and impairment.

As always, knowing when you need help is the first step in getting it. Angela Morton of Recovery Is NWPA says if your relationships, finances, work or social activities are being impacted, it’s time to look for help. Caregivers should also be looking for these signs.

Older adults struggling with drug — and more commonly, alcohol — misuse are a “quiet population,” says Christy Steidle, a prevention specialist at Mainstream Counseling in Huntingdon, a region served by Valley REC.

“The abuse that we see with things like opioids or other medications in the older population tends to be accidental,” she says. “People forget that they took their medication, and so then they’re taking another dose.”

So even just having the drugs in the house can be a danger. Morton says medication management in the home is critical: Take the medication as prescribed by your doctor, don’t share medications or take something prescribed to someone else and, if you don’t finish a prescription, dispose of it properly.
 

Greg Henry of Hustontown, a director for Huntingdon-based Valley Rural Electric Cooperative, agrees. A longtime “regular” bicycle rider, he says the e-bike has unlocked new worlds.

“It’s more of a mountain bike; you can take it into the woods,” says Henry of his heavy-duty, fat-tired machine that gets him to his fall archery hunting spots. “And I can see them helping people who’ve had surgeries. They want to start exercising and [with the e-bike] they’re still moving their legs, but don’t really have to exert themselves.”

Finding the help you need

Each county in Pennsylvania has a Single County Authority, a local clearinghouse for drug and alcohol help and information. Visit the Department of Drug and Alcohol Program's website, ddap.pa.gov, and look for “County Drug and Alcohol Offices” under the “Get Help Now” tab. In addition to information on where to find help, many county offices can provide an at-home opioid drug disposal kit as well as naloxone (commonly known as Narcan), a medicine that rapidly reverses an opioid overdose.

For Morton, facing the crisis head-on starts with eliminating the stigma surrounding drug use and misuse.

“It might be an embarrassing thing for a 70-year-old; the stigma might even be bigger [in this age group]. If we’re afraid to talk about it, it’s hard to get help,” she says. “We need to shift our language, treatment and understanding of substance use to include compassion, so that anybody who does need help is able to come forward.”