Senior Citizen’s Guide to Withdrawal and Detox

Seniors and Substances

Baby boomers are retiring. One of the largest and most prosperous generations have been approaching or entering retirement age, and the number of seniors (50+) with substance use disorder (SUD) is expected to reach 5.7 million in 2020. Alcohol, opioid drugs (painkillers), and benzodiazepines are the most commonly used drugs, all of which can present serious difficulties during withdrawal if not managed by medical professionals.

Senior Citizens are likely to face a number of difficulties when dealing with substance use disorder. Declining health, retirement, and increased isolation can converge, creating an environment in which addiction and mental illness can thrive. Additionally, there is a tendency in western medicine to overprescribe medications for senior citizens which also contributes to addiction and substance abuse in this age demographic.

By The Numbers - Addiction for Senior Citizens

To see exactly how prevalent drug and alcohol use is in the elderly population, let’s take a look at some statistics:

• In 2011, there on average 189 emergency department visits PER DAY related to prescription medication abuse by senior citizens (including benzodiazepines, antidepressants, and painkillers)
• Binge drinking is more prevalent in older adults.
• Illicit drug use is rising steadily among adults aged 65 and over, doubling between 2002 and 2012 (on average from 1.9%-3.4% to 3.6%-7.2%).
• There is strong evidence linking alcohol use disorder and death by suicide among the elderly.
• It’s estimated that up to 19% of older Americans misuse alcohol and prescription drugs.
• As many as 89% of adults 65 and older have at least one prescribed medication.
• 9.6% of adults 60 and older were prescribed opioid drugs between 2013-2016.

Common Signs of Drug Withdrawal for Senior Citizens

It may not always be easy to tell when someone is experiencing withdrawal from drugs. It’s not uncommon for people who are suffering from substance use disorder to hide their addiction and the symptoms of their withdrawal. Signs of abuse or drug withdrawal for senior citizens could include:

• “Lost” Medication or Signs of Prescription Mismanagement: It can be common for seniors to misuse their medications. This may not always be intentional, but if someone claims they have lost their medication, can’t find certain medications, ran out of medication, or claims they were shorted medication these could be a sign of prescription mismanagement. For example, someone who is abusing painkillers may claim they lost their medications in an attempt to secure more than they were prescribed. Desperate or unreasonable attempts, such as doctor shopping, to get more medications could be signs of both drug abuse or withdrawal.
• Confusion or a Detachment from Reality: A senior citizen suffering from withdrawal, especially in withdrawal from alcohol and benzos. Withdrawal can result in hallucinations (visual, auditory, and tactile), confusion, and abnormal body sensations are all signs of withdrawal and could indicate the need for medical intervention.
• Abnormal or Prolonged Illness: Withdrawal from alcohol and drugs – especially opiates – can produce flu-like symptoms. If someone has been sick for a long period of time, or if they get sick at fairly regular intervals that could be a sign of withdrawal or an indication that they have a substance use disorder.
• Missing Social Engagements or Distant Behavior: People in withdrawal may choose to isolate to hide their symptoms. If someone you know is missing social events or is self-isolating this could be a sign of drug abuse and/or withdrawal. Not answering calls, missing family functions, and reclusive behavior changes could be a sign of withdrawal.
• Changes in Mental Health: Among the many symptoms of withdrawal, mental symptoms are very common across all drug types and ages. These symptoms may be present before withdrawal, or they may present themselves as symptoms of withdrawal. These signs of withdrawal could be:
  • Depression
  • Anxiety
  • Mood Swings
  • Irritability

Physical Symptoms of Withdrawal

In terms of physical withdrawal symptoms, the type of drug and the extent of the abuse will play a major role in the severity of withdrawal. To some extent, withdrawal symptoms are unavoidable, but they can be managed with support. Medical intervention can mitigate symptoms, and careful observation can help ensure safety in the detoxification process.

Despite the dangers, withdrawal can be treated. When the detox process is overseen by medical professionals the chances of safe detox and lasting recovery dramatically improve. The most commonly used drugs for senior citizens and their withdrawal symptoms are listed here:

• Opiate Painkillers: Older adults are increasingly abusing opioid painkillers such as hydrocodone, oxycodone, and Dilaudid (hydromorphone). Many older adults are prescribed these medications to treat pain, but they are highly addictive, especially in older individuals with a slowed metabolism, and can be misused, leading to severe withdrawal symptoms. Withdrawal from opiates is typically very uncomfortable, and it can be dangerous and deadly in some cases. Extreme sensitivity to pain, joint/muscle pain, flu-like symptoms, and headaches are common. The most dangerous symptoms are increased blood pressure, vomiting, and diarrhea (risk of dehydration). Seniors are especially at risk. Depending on the severity of the addiction, there are FDA-approved drugs that can be used to treat opiate withdrawal.
• Alcohol: Alcohol withdrawal can be deadly! It is always recommended to seek professional care when detoxing from alcohol. Besides profuse sweating, nausea, and insomnia, alcohol withdrawal can lead to seizures and delirium tremens – both of which can be deadly if untreated. There are FDA-approved medications for treating alcohol withdrawal, and alcohol detox can be done safely with the help of medical professionals.
• Benzodiazepines and Other Sedatives: Withdrawal from these drugs can be deadly. Benzodiazepines (benzos) are frequently prescribed to older adults for anxiety and sleep disorders. Older people can quickly become addicted to and physically dependent on benzos. As we age, we tend to have less lean muscle, a slower metabolism, and more body fat. This affects older people who use benzos both because of their fat-solubility and slowed metabolism. This can make detox especially troublesome. These withdrawal syndromes affect the body much like alcohol will, although in a less severe manner, and many side effects are similar. Headache, insomnia, nausea, shaking, loss of appetite are all common during benzo withdrawal. The most dangerous symptoms would be increased blood pressure and seizures.

What To Look For In Senior Citizen Detox Centers

Selecting the right detox center is a critical phase in recovery from drug and alcohol addiction. Detox centers should have the medical staff to properly oversee the detoxification process, which could take up to a week or longer depending on the person. Detox centers will also have psychiatric staff who will monitor and address the mental symptoms of withdrawal. Outside of these critical elements, there are specific things to look for in a senior citizen detox center:

• Acute Inpatient / Intensive Medical Care: If there are underlying medical conditions, or if overall health is of concern, look for facilities that offer intensive medical care. These facilities may be affiliated with, or even located in, hospitals. It’s impossible to predict how the body will respond to withdrawal, intensive care could be a life-saving option.
• Aftercare and Long-Term Planning: Detoxification is the first step to recovery, but it can’t address the long-term needs of someone in addiction. Facilities that offer strong aftercare programs and long-term planning can help by assessing the needs of the patient and aligning them with available resources to help ensure recovery continues, long after the drugs have left the system.
• Family Programs: Facilities that cater to seniors may offer family programs. Family programs would offer therapy and education for caregivers and family members. This will help during the uncertain times in early recovery, and continue to pay dividends as relationships are repaired and healing continues into long-term recovery.
• Pain Management: It’s estimated that up to 50% of senior citizens are prescribed medications for pain. Managing pain in a recovery setting will require specialized medical care and attention. It is possible to manage chronic pain during recovery while maintaining sobriety.
• Group Therapy and Community Healing: Loneliness is increasingly being recognized as having a significant impact on health and wellbeing, and our oldest citizens are substantially at risk. Programs that offer group therapy and community healing can help combat loneliness, which can not only improve the odds of recovery but help support overall health and longevity.

Types of Drug Detox Centers for Senior Citizens

The range and type of service offered will vary from facility to facility. There are 3 basic types of medical detox centers:

Inpatient Detox: Inpatient facilities are “live-in” facilities that will offer 24/7 medical care and observation, as well as psychiatric support and therapy. These detox facilities will offer programs to treat the entire person, all in a residential-style environment. Stays at inpatient facilities will typically last 7-14 days.

Outpatient Detox: Outpatient detox facilities will offer the same high level of care but in an outpatient environment. These facilities are ideal for seniors who have a strong network outside of treatment but still require medical and psychiatric care.

Rapid Detox: Rapid detox is a new detox method that’s effectiveness is still up for debate. There are some unique risks that accompany this type of detox since anesthesia is often required, so it may not be suitable for senior citizens.

Additional Resources for Seniors

You are not alone! There are many resources dedicated to senior citizens available. Just a few of these include:

• AARP is a non-profit group dedicated to improving the lives of adults over 50. AARP offers resources on aging, wellness, healthcare, housing, retirement, and more.
• Giving back and serving the community can help in recovery from addiction. Senior Corps is a group dedicated to serving our country and her communities.
• Stay informed on the science and health-related aspects of aging. The National Institute on Aging has a wealth of information on health and wellness for older adults.
• Stay social! Web platforms like Meet Up! make it easy to connect with people who share similar interests. Find seniors who share in your passions, from gardening, fitness, travel, and more. Pursue your passion for recovery!