Hidden in Plain Sight: The Silent Epidemic of Substance Abuse in Older Adults with Dr. John Dyben - Episode 130
The latest episode of the Caregiver Relief Podcast, featuring host Diane Carbo, RN, and guest Dr. John Dyben, Chief of Research and Innovation for Hanley Foundation, delves into a critical and often overlooked issue: substance abuse in older adults. This "silent epidemic" has devastating consequences for seniors, families, and caregivers.
Dr. Dyben, with his extensive background in addiction counseling and a focus on substance abuse in older adults, shares his expertise and calls attention to why this problem is so frequently missed and what can be done to help.
🗝️ Key Takeaways from the Conversation
- The Silent Epidemic: Millions of older adults meet the criteria for a substance use disorder, yet the issue is often hidden in plain sight.
- Why it's Missed: Seniors may not have jobs or travel, so the visible signs of addiction (like DUIs or missed work) are absent, leading to a cultural belief that the problem doesn't exist.
- Discount People: There's a myth that life engagement becomes less important or valuable as we age, contributing to the problem being ignored.
- Most Common Substances:
- Alcohol: It is absolutely the most common drug causing a substance use disorder in older adulthood.
- Physiological Changes: As people age (especially after 40), the body's ability to metabolize alcohol changes (due to a decrease in total body water), causing the same amount of alcohol to raise blood alcohol levels faster and keep them raised for longer.
- Cannabis: It is the second most common substance causing issues, though far behind alcohol.
- Prescription Drug Abuse:
- Problematic Drugs: Opioids and benzodiazepines (like Xanax) have very high addiction potential and are often combined with alcohol, which has a synergistic, skyrocketing effect on addiction.
- Misconceptions: It was once a common belief that if addiction didn't develop by age 40, it never would, but this is untrue—a person can cross over into addiction at any age.
- Grief and Anxiety: Medications like benzodiazepines can act as "emotional anesthesia" and only push a pause button on the grief process, hindering successful coping.
- Challenges in Diagnosis:
- Practitioners often look for causes associated with aging, not substance use, because symptoms of addiction (falls, memory problems) can mimic common age-related issues.
- Older adults are more likely to have at least two other chronic medical conditions, which practitioners triage, often missing the underlying substance issue.
- Caregivers' Role and Risk:
- The chronic stress of caregiving is immense, with 63% of family caregivers becoming seriously ill or dying before the person they are caring for.
- Caregivers may turn to alcohol or drugs to cope, which is a dangerous and unhealthy way to deal with distress.
- Effective Treatment Approaches:
- Peer Groups: Patients in older adult-specific programs have significantly better outcomes when they are in a peer group of other older adults.
- Holistic Care: Treatment must be interdisciplinary, addressing medical needs with geriatric-competent professionals, as well as psychological and social needs.
- Significance and Spirituality: The second half of life involves a movement from success to significance, and addressing issues of personal spirituality (which is the number one predictor of higher quality of life in older adulthood) is critical for healing.
📞 Seeking Help and Finding Hope
Dr. Dyben encourages anyone concerned about a loved one's substance use to seek professional help. It is a healthcare issue that should not be handled alone.
- Look for medical and clinical professionals who have specialized training and credentials in addiction (e.g., American Board of Addiction Medicine).
- Hanley Foundation: Visit hanley center.org or hanley foundation.org for more information and to find help in your area.
- Help for Children: Hanley Foundation, in partnership with the National Association of Children Impacted by Addiction, offers a free three-day program for children ages 7-12 impacted by addiction.
The greatest hope for addressing this epidemic lies in increasing awareness, training, and encouraging people—both professionals and those with personal experience—to tell their stories.
💖 A Message to Caregivers
Diane Carbo reminds all listeners: "You are the most important part of the caregiving equation. Without you, it all falls apart. So please learn to be gentle with yourself. Practice self-care every day because you are worth it."
Would you like me to find the links for the Hanley Foundation's resources or information on geriatric addiction specialists?
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Diane Carbo
Diane Carbo
Diane Carbo
