07/12/2023    Robert G. Smith DPM. MSc, RPh

Substance Abuse Is Climbing Among Seniors

I read with great interest: “Substance Abuse Is
Climbing Among Seniors” written by Paula Span of
the New York Times on July 9, 2023 and reported by
national news outlets the morning of July 10, 2023.
Data is presented from experts in the fields of
gerontology, sociology, psychology, and addiction
medicine.

A number of salient points are offered by this
narrative that include: ‘Despite alcohol playing a
major role in elderly substance use disorder most
substance use disorders among older people involve
prescribed medications, not illegal drugs, 8.6
percent of substance use disorders involved
opioids, mostly prescription pain relievers; 4.3
percent involved marijuana; and 2 percent involved
non-opioid prescription drugs, including
tranquilizers and anti-anxiety medications, and
fatal overdoses have also soared among seniors.
From 2002 to 2021, the rate of overdose deaths
quadrupled to 12 from 3 per 100,000.”

Further, this narrative offers that although most
seniors with substance use problems don’t die from
overdoses, the health consequences can be severe to
include injuries from falls and accidents,
accelerated cognitive decline, cancers, heart and
liver disease and kidney failure.

Moreover, the elderly face more barriers than
younger people when attempting to seek treatment.
Higher rates of stigma concerns, things like
worrying about what their neighbors would think.
More logistical barriers present such as finding
transportation, not knowing where to go for help
and being unable to afford care. Because the
realism that it may be harder for older adults to
try to navigate the substance use disorder
treatment system, I believe podiatric physicians
may be in the unique position to be instrumental in
screening our elderly patient population for
substance use disorder as we dovetail screening
tools for fall risk, injury prevention, medication
reconciliation tools and validated substance use
disorder screening tools.

Screening and Assessment Tools Chart | National
Institute on Drug Abuse (NIDA) (nih.gov) may be a
helpful site for the podiatric physicians to access
validated substance use disorder screening tools.

Robert G. Smith DPM. MSc, RPh, Ormond Beach, FL

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