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Substance Use Disorders in Older Adults

Table of Contents


People who have substance use disorder keep using alcohol or other substances even though it causes harm to themselves or others. Many people think that substance use disorder happens only to teens and younger adults. But people of all ages can have this disorder, including older adults.

Older adults may use illegal drugs, misuse prescription or over-the-counter medicines, drink too much alcohol, or mix alcohol and medicines. Doing any of these can cause serious health problems and problems with money and the law. It also can harm relationships with family and friends.

Substance use disorder in older adults may be overlooked, because:


Alcohol use disorder can be dangerous for older adults. They:1

In older adults, alcohol can trigger some health problems or make them worse. These health problems include high blood pressure, ulcers, liver disease, anxiety, sleep problems, and depression.1

Misuse of medicine

Older adults often have to take many medicines. This can easily lead to misuse of medicines. You misuse medicine when:

Warning signs of substance use disorder

Below are some warning signs that an older adult may have substance use disorder. Signs can include changes in behavior as well as changes in mental abilities.

Drinking, misusing medicines, or using illegal drugs often starts after a big change in a person's life. Retiring, the death of a spouse or good friend, leaving your home, or being diagnosed with a disease can trigger substance use. If a life-changing event happens to a loved one, watch for signs of substance use disorder.

If you notice any of these signs in someone you care about, talk to the person's doctor. Tell the doctor about the person's substance use, including misuse of prescription and over-the-counter medicines. Tell the doctor about any substance use in the person's past.

These signs may not mean that a person has substance use disorder. Many of the signs listed here also can be signs of health problems many older adults have. Changes in behavior also could be signs of stress.

Changes in behavior

Signs that older adults may have substance use disorder include:

Changes in mental abilities

Other signs that older adults may have substance use disorder include:


Treatment for substance use disorder in older adults is the same as for younger people. Detoxification, medicine, counseling, therapy, and substance use education all may be used.

If prescription medicine misuse is the problem, sometimes it can help to talk to a doctor, friend, or family member. Treatment may include learning more about your medicines and organizing how you take them. You may be able to work with your doctor to cut back on how many medicines you take or make it easier to take them.

Your success in treatment is strongly linked to admitting that you have a substance use disorder and to your desire to stop using substances.



  1. Department of Health and Human Services (2008). Substance abuse among older adults. Treatment Improvement Protocol (TIP), Series 26 (DHHS Publication No. SMA 08-3918). Available online:

Credits for Substance Use Disorders in Older Adults

Current as of: November 8, 2021

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
Martin J. Gabica MD - Family Medicine
Kathleen Romito MD - Family Medicine
Peter Monti PhD - Alcohol and Addiction
Christine R. Maldonado PhD - Behavioral Health

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