Deaths From Substance Abuse Rose Sharply Among Older Americans in 2020

Deaths from substance abuse, particularly alcohol and opioids, rose sharply among older Americans in 2020, the first year of the coronavirus pandemic, as lockdowns disrupted routines and isolation and fear spread, they reported Wednesday. federal health investigators.

Deaths from alcohol and opioids were still far less common among older people than among middle-aged and younger people, and the rates had been rising in all groups for years. But the steep uptick, another data point in the long list of pandemic miseries, surprised government researchers.

Opioid deaths rose among Americans 65 and older by 53 percent in 2020 from the previous year, the National Center for Health Statistics found. Alcohol-related deaths, which had already been increasing for a decade in this age group, increased by 18 percent.

“The rate of deaths from alcohol in older people is much lower than that of younger adults, but the change caught our attention,” said Ellen Kramarow, a health statistician with the center and lead author of the report, which analyzed the death certificate data.

Synthetic opioid overdose deaths account for less than 1 percent of deaths in people older than 65, noted Dr. Kramarow. “But the shape of the curve caught our attention,” he said.

Physiological changes that occur with aging leave older adults more vulnerable to the harmful effects of alcohol and drugs, as metabolism and excretion of substances slow, increasing the risk of toxicity. Smaller amounts have larger effects, researchers have found.

Alcohol and opioids can interact poorly with the prescription medications that many older adults take for common conditions like high blood pressure, diabetes, and mood disorders. Misuse can lead to falls and injuries, exacerbate underlying medical conditions, and worsen cognitive decline.

Substance abuse by older adults is often overlooked by healthcare providers who rarely refer these patients for treatment. Many facilities that offer rehabilitation services tailor their programs to younger populations. Older patients have different needs and may feel uncomfortable being treated with people who are the same age as their children or grandchildren.

Many baby boomers have struggled with addiction since they were young adults. Some got off the bandwagon after retirement or during the pandemic, when they suddenly had more free time and little structure and lost access to treatment due to lockdowns and fear of infection.

The death rates indicate a widespread problem with substance abuse among the elderly. Although alcohol and drug use typically decline with age, nearly a million adults age 65 and older have a substance use disorder, according to government data. About 3 percent use marijuana and one in 10 drink excessively, defined as five or more drinks on a single occasion for men and four or more for women.

“This is a hidden population that is often ignored,” said Dr. Frederic Blow, a professor of psychiatry and director of the Center on Addiction at the University of Michigan.

Dr. Blow said that comparatively few older Americans enter treatment. Families and spouses are embarrassed, and health care providers tend to be less aggressive in referring older patients to rehab, he added.

“Younger people are going to get care because their family gives them an ultimatum or their employer has identified the problem, while the main way older people get treatment is through the criminal justice system,” often after a drunk driving arrest, he said. .

Lochiel P., a 72-year-old man from Albany, New York, who asked that his last name not be used, began drinking when he was 18 (then the legal age) and began smoking marijuana and taking psychedelics in the college.

He had been in and out of treatment his entire life. But he had been sober for eight years when the withdrawal from him triggered a relapse.

“I never smoked marijuana before going to work or during the work day, only when I was going home,” he said. But after he retired, he said: “I smoked pot all day and drank a pint of vodka every day, starting with a half pint at noon and a second at night.”

He was miserable and his wife was about to leave him, he said, when he was finally ordered to receive treatment after he was pulled over for drink-driving.

He has now been sober for four years and has become a fellow recovery advocate at Senior Hope, an outpatient clinic in Albany serving people 50 and older who are struggling with substance abuse.

The program is the only one of its kind in New York that offers non-intensive treatment outside of a hospital to people in that age group, according to Nicole S. MacFarland, executive director of Senior Hope.

Treatment groups are smaller, which is preferred by older patients, and facilitators make sure to speak loudly and slowly to accommodate those with hearing and cognitive impairments, he said.

The new federal data offers granular information about who is most at risk. Men are more likely to suffer alcohol-induced deaths: in 2020, the rates for men ages 65 to 74 were more than three times higher than those for women of the same age.

According to the new report, alcohol-related death rates for men 75 and older were four times higher than for women of a similar age.

Native Americans and Alaska Natives 65 and older experienced the largest increase in age-adjusted alcohol-induced death rates in 2020, with the rate increasing nearly 50 percent since 2019. The number more than doubled than the rate among older Hispanic Americans.

White Americans had the next highest death rate, with the lowest numbers for black Americans and the lowest for older Asian Americans. In total, 11,616 Americans age 65 and older died from alcohol-induced causes in 2020.

Some 5,000 older adults died from drug overdoses. But that number represents a tripling of the drug death rate in the last two decades, with faster increases among men in recent years.

Drug overdose death rates for men age 65 and older are higher among black men, compared to men of other racial and ethnic backgrounds. Among women, overdose death rates are highest for black women ages 65 to 74, while white women have the highest death rates among women age 75 and older.

Aging baby boomers—the Woodstock generation—were more exposed to alcohol and drugs than earlier generations, who viewed the use of such substances as a moral weakness and were far less familiar with marijuana, Dr. Blow said.

The attrition of social media and lockdowns during the early part of the pandemic exacerbated substance abuse, as did access to cannabis and alcohol increase: You could order drinks or cannabis over the phone and have it delivered to your home, said the Dr Blow.

“When you add that to the feelings of loneliness and isolation, of feeling at the end of the world in a way, it became a push for people to start consuming more than they ever had in the past,” he said.