Although nearly two in ten American adults age 60 and over misuse alcohol or prescription drugs, many are never diagnosed or receive treatment. There are a number of reasons seniors are less likely to be identified as having a substance use disorder. Healthcare providers may lack expertise in this area and avoid asking about alcohol and drug use, the individual may deny or minimize use, and the family may also be unaware of what is happening. Older adults who are no longer in the workforce, are socially isolated, and drive less (or not at all), can more easily conceal an addiction.

Even when a problem is identified, getting the right help may be challenging. Barriers for older adults with a substance use disorder may include lack of transportation, financial and insurance constraints, lack of mobility or cognitive impairments, and a lack of suitable treatment programs. Social stigma related to addiction is also a stumbling block for many people, who consider alcohol or drug dependence to be a character flaw or a moral failing, rather than a treatable medical condition.

Some of the warning signs of alcohol or prescription drug abuse include:

  • Cravings and loss of control
  • Blackouts
  • Withdrawal symptoms when the effects of the substance wear off
  • Bloodshot or glassy eyes
  • Trouble with balance and coordination
  • Rambling or repetitive statements
  • Mood swings; agitation, anxiety, and depression
  • Disorientation
  • Visits to multiple doctors to obtain multiple prescriptions
  • Unexplained bruises; falls, accidents, and injuries


Older adults are more likely to abuse alcohol and prescription drugs as opposed to illegal street drugs such as heroin and cocaine. However, the health problems associated with heavy drinking or prescription drug misuse can be severe in older adults and include liver diseases, cancer, pancreatitis, heart problems, malnutrition, and stroke.

The good news is, recovery from a substance use disorder is possible for people of all ages. The first step is recognizing and acknowledging there is a problem.