RESEARCH STARTER

Age and addiction

Age and addiction is a complex issue that affects individuals across the entire lifespan, from infants born addicted to substances through to older adults grappling with various forms of dependency. While many may associate addiction primarily with younger populations, increasing evidence highlights significant rates of substance abuse among older adults, particularly with alcohol and prescription medications. The rise in substance abuse treatment admissions among individuals over fifty-five, which surged from 3.4% to 12% in recent years, points to a growing recognition of this hidden problem.

Older adults often face unique challenges, such as loneliness, the loss of loved ones, and health issues, which can contribute to compulsive behaviors, including gambling. Symptoms of addiction in this age group may go unrecognized or be misattributed to other age-related health conditions, leading to underreporting and denial from both individuals and their families.

Furthermore, the physiological changes associated with aging can exacerbate the effects of substances, making even moderate use more dangerous. Strategies for addressing addiction in older adults may require specialized approaches, particularly when co-occurring mental health disorders, such as depression, are involved. Despite these difficulties, older adults tend to respond well to treatment when they seek help. Understanding the multifaceted nature of addiction across different age groups is crucial for effective prevention and intervention strategies.

Full Article

DEFINITION: There is no age limit for addictions. Babies are born addicted to the illicit drugs and prescription medicines that their mothers abused while pregnant, and addiction to a wide range of substances and behaviors is endemic among teenagers and young adults. Although not as widely recognized, older adults may also have substance use disorders (SUDs).

A Hidden Problem

In the early twenty-first century, the proportion of admissions to substance use treatment programs of people over fifty-five increased from 3.4 to 12 percent by the 2020s. While the majority of these admissions were for alcohol abuse, that proportion declined slightly, while the proportion of admissions for substances like cocaine, marijuana, heroin, and other opioids went up. Some medical professionals in the early 2000s predicted this increase. They asserted that the number of older Americans needing substance abuse treatment would increase as the baby boom generation aged and substance use patterns changed. However, the increase was only predicted to reach 4.4 million by 2020, which was far exceeded. Overall, around 16.4 percent of American adults over twenty-six had a substance use disorder in 2025.

The scope of the problem of addiction among older adults is not clear, largely because many cases go unreported. In addition, older adults and their families often deny the problem. For example, family members might excuse an older relative’s gambling addiction as a harmless hobby, or they might argue that heavy alcohol use is an entitlement for a relative after a long, hard life. Also, many older people rarely admit they have a problem. They rationalize that they are experienced, wise, and able to handle any situation. This way of rationalizing is especially true for people addicted to prescription medications. The symptoms of addiction are often less evident in older people than they are in younger people. For example, many older adults addicted to alcohol or drugs indulge at home, so they are less likely to drive a vehicle and to risk arrest while intoxicated. Also, many older persons live alone, making it difficult for others to notice problems with drinking or with drug abuse. Furthermore, many older persons are retired, so common determiners of a SUD, such as work absenteeism or poor job performance, are poor determiners of addiction.

Substance use disorders in older adults often go unrecognized, even by health professionals. Symptoms of addiction are mistaken for diseases common to old age, such as high blood pressure, dementia, stroke, Parkinson’s disease, and sleep disorders. Moreover, most of the medical and psychological screening tests for addiction are designed for younger adults, making the tests inadequate for older adults.

For young people, the American Academy of Pediatrics recommends the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model as part of routine pediatric primary care. Many experts emphasize that early exposure to drugs places children at significantly higher risk for later addiction, making prevention during childhood and adolescence far more effective than treatment after substance-use patterns emerge.

Data from the University of Michigan’s Monitoring the Future survey showed that adolescent substance use was notably higher in the mid-2010s, with 2015–2016 rates for illicit and cannabis use well above those seen later in the decade. Use then declined by 2020, followed by an unprecedented drop during the COVID-19 pandemic, and according to a 2023 National Institute on Drug Abuse (NIDA) report, these lower levels have largely persisted. However, fentanyl-contaminated counterfeit pills continue to drive elevated overdose deaths among teens despite lower overall drug use.

Despite declining rates, though, individuals ages eighteen to twenty-five continue to experience the highest rates of SUDs, according to the National Center for Drug Abuse Statistics. Some have struggled with substances since adolescence, while others begin using during this period due to life transitions such as moving away from home, starting college or work, managing finances, and adjusting to new responsibilities. For many, alcohol and drugs become a tempting escape from these pressures and are more likely to be misused in this age range.

Substances and Behaviors

Using a working definition of addiction as “a physiological or psychological dependence on a substance or behavior to the extent that its withdrawal causes extreme distress to the user,” addictions in older adults are the same as those in younger people. However, two substances, alcohol and prescription medications, and two behaviors, gambling and watching television, appear to be particularly troublesome for older adults.

Alcohol is the drug most often abused by older adults. A 2017 study published in JAMA Psychiatry found that 3.8 percent of Americans over sixty-five engaged in "high-risk drinking"—a 65-percent jump over the period of the study, which was from 2001 to 2013. In many cases, alcohol addiction leads to other problems. Older adults addicted to alcohol are three times more likely to already have or to develop another mental disorder. Furthermore, according to the National Survey on Drug Use and Health published in 2025, 2.9 million adults ages 65 and older met criteria for past-year alcohol use disorder, and Centers for Disease Control and Prevention (CDC) data showed that people 65 and older accounted for 40.9 percent of all alcohol-attributable deaths between 2022 and 2023.

Prescription medications rank as the second most commonly abused substance among older adults and include sedatives, antidepressants, sleeping pills, and pain relievers, especially the narcotic analgesics. The National Institute on Drug Abuse reported that people aged sixty-five years and older received over 30 percent of all medications prescribed by doctors in the United States, yet this group makes up less than 15 percent of the US population. According to NIDA, some 18 percent of adults aged sixty years and older abuse prescription drugs. Older adults take prescription medications three times more frequently than the general population and are more likely to disregard dosing directions, often choosing to self-medicate instead. To compound the problem, NIDA reported that, in general (for some drugs), older adults receive prescriptions with higher doses and with longer dosage times than younger adults receive.

Gambling is a common pastime among older adults, and participation has grown steadily as this age group has expanded throughout the 2010s and 2020s. Research across North America has consistently shown that a small but meaningful percentage of adults who gamble—particularly older adults—experience problem or pathological gambling behaviors. Because older adults now make up one of the fastest-growing segments of gamblers, the overall number of those addicted to gambling has also increased. Various community and clinical settings have reported that a notable minority of adults aged 55 and older show signs of at-risk or problem gambling, underscoring the need for screening and support within aging services and primary care.

Television watching, too, can become an addiction, according to many mental health professionals. Most older adults watch television regularly, more so than any other age group. For many older adults, especially those living alone or with limited mobility, television is a companion, and watching television is an activity that helps them cope with their problems. Watching television is considered an addiction when a viewer cannot stop watching at a chosen time, when they want to but cannot watch less, when they complain that watching replaces other activities and takes up too much time, and when they are uneasy and experience withdrawal symptoms when not watching for a time.

Some adults carry an addiction into their later years. Most baby boomers with an addiction to illicit drugs, for example, continue a pattern of abuse that began for them in the 1960s and 1970s. However, not many individuals with substance use disorder live to old age because of the devastating physical effects of lifelong addiction.

Other adults switch addictions when they get older. Studies of the chemistry of addiction are helping to explain why some people and not others become addicted. A seminal study prepared for the National Academy of Sciences in 1983 identified certain personality traits that can contribute to the onset of addiction. A person with an addictive personality, for example, might have been addicted to heroin when young but may have switched to prescription drugs later in life.

Other adults become addicted only in their later years. Many older persons turn to substances and behaviors that become addictions as a way to cope with growing older. The factors that contribute to addiction at any age are complex, but certain circumstances and elements are unique to older people.

In general, as people reach their sixties, they are more vulnerable to compulsive behaviors such as gambling. Older people experience many more types of loss than do younger people—loss of physical and mental capabilities; loss of older family members, of spouses, and of friends in the same age group; loss of earning power; and loss of status in society, especially following retirement and estrangement in a society that reveres youth. Older adults deal with more serious medical conditions, such as heart disease, Parkinson’s disease, hearing loss, and dementia. Following retirement, many people are unsure how to spend their time and are unaware of social opportunities and community resources. Boredom and loneliness plague many older people.

The consequences of addiction are, in many cases, more serious for older people than for younger people. The aging body processes substances differently from the young body. The level of alcohol or drug use, for example, considered light or moderate in the younger body, is often dangerous to the organs and systems of the older body. Recovery from substance abuse takes longer in the older body. Older people, on average, are more likely to be taking more medications than younger people and, thus, risk serious problems when combining medications with alcohol or illicit drugs. Finally, financial losses are more difficult to recoup for persons, such as older adults, who often live on fixed incomes.

Addiction affects a person’s self-esteem, coping skills, and relationships, which, when combined with the other losses common in later life, can lead to other serious mental illnesses. Clinical depression, although not specifically a disease of age, afflicts many older people. The link between clinical depression and addiction is well established.

Treatment for addictions in older people is similar to treatment for younger people, with the exception that most older individuals receive treatment for co-occurring disorders (two or more diseases present at the same time). On the positive side, health professionals report that once older adults enter treatment, they achieve greater success than any other age group.


Bibliography

“Alcohol and Older Adults Ages 65+.” National Institute on Alcohol Abuse and Alcoholism, 19 Aug. 2025, www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics-z/alcohol-facts-and-statistics/alcohol-and-older-adults-ages-65. Accessed 21 Nov. 2025.

Bamberger, Peter A., and Samuel B. Bacharach. Retirement and the Hidden Epidemic: The Complex Link between Aging, Work Disengagement, and Substance Misuse and What to Do about It. Oxford UP, 2014.

Chhatre, Sumedha, et al. "Trends in Substance Use Admissions among Older Adults." BMC Health Services Research, vol. 17, 2017, doi:10.1186/s12913-017-2538-z. Accessed 21 Nov. 2025.

Colleran, Carol, and Debra Jay. Aging and Addiction: Helping Older Adults Overcome Alcohol or Medication Dependence. Hazelden, 2002.

“Drug Abuse Statistics.” National Center for Drug Abuse Statistics, 2025, drugabusestatistics.org/. Accessed 21 Nov. 2025.

Elinson, Zusha. "Aging Baby Boomers Bring Drug Habits into Middle Age." Wall Street Journal, 16 Mar. 2015, www.wsj.com/articles/aging-baby-boomers-bring-drug-habits-into-middle-age-1426469057. Accessed 21 Nov. 2025.

Nakken, Craig. The Addictive Personality: Understanding the Addictive Process and Compulsive Behavior. Hazelden, 1996.

“Reported Drug Use Among Adolescents Continued to Hold Below Pre-Pandemic Levels in 2023.” National Institutes of Health, 13 Dec. 2023, www.nih.gov/news-events/news-releases/reported-drug-use-among-adolescents-continued-hold-below-pre-pandemic-levels-2023. Accessed 21 Nov. 2025.

Ruiz, Pedro, and Eric C. Strain. The Substance Abuse Handbook. 2nd ed., Wolters, 2014.

Span, Paula. "Alcohol Abuse Is Rising among Older Adults." The New York Times, 14 Sept. 2017, www.nytimes.com/2017/09/14/health/alcohol-abuse-elderly.html. Accessed 21 Nov. 2025.

Span, Paula. "Why Are Older Americans Drinking So Much?" The New York Times, 31 Mar. 2024, www.nytimes.com/2024/03/30/health/seniors-alcohol-consumption.html. Accessed 21 Nov. 2025.

“Substance Use Among Youth.” Centers for Disease Control and Prevention, 22 Nov. 2024, www.cdc.gov/youth-behavior/risk-behaviors/substance-use-among-youth.html. Accessed 21 Nov. 2025.

"Substance Use in Older Adults." National Institute on Drug Abuse, July 2020, nida.nih.gov/publications/drugfacts/substance-use-in-older-adults-drugfacts. Accessed 21 Nov. 2025.

Full Article

DEFINITION: There is no age limit for addictions. Babies are born addicted to the illicit drugs and prescription medicines that their mothers abused while pregnant, and addiction to a wide range of substances and behaviors is endemic among teenagers and young adults. Although not as widely recognized, older adults may also have substance use disorders (SUDs).

A Hidden Problem

In the early twenty-first century, the proportion of admissions to substance use treatment programs of people over fifty-five increased from 3.4 to 12 percent by the 2020s. While the majority of these admissions were for alcohol abuse, that proportion declined slightly, while the proportion of admissions for substances like cocaine, marijuana, heroin, and other opioids went up. Some medical professionals in the early 2000s predicted this increase. They asserted that the number of older Americans needing substance abuse treatment would increase as the baby boom generation aged and substance use patterns changed. However, the increase was only predicted to reach 4.4 million by 2020, which was far exceeded. Overall, around 16.4 percent of American adults over twenty-six had a substance use disorder in 2025.

The scope of the problem of addiction among older adults is not clear, largely because many cases go unreported. In addition, older adults and their families often deny the problem. For example, family members might excuse an older relative’s gambling addiction as a harmless hobby, or they might argue that heavy alcohol use is an entitlement for a relative after a long, hard life. Also, many older people rarely admit they have a problem. They rationalize that they are experienced, wise, and able to handle any situation. This way of rationalizing is especially true for people addicted to prescription medications. The symptoms of addiction are often less evident in older people than they are in younger people. For example, many older adults addicted to alcohol or drugs indulge at home, so they are less likely to drive a vehicle and to risk arrest while intoxicated. Also, many older persons live alone, making it difficult for others to notice problems with drinking or with drug abuse. Furthermore, many older persons are retired, so common determiners of a SUD, such as work absenteeism or poor job performance, are poor determiners of addiction.

Substance use disorders in older adults often go unrecognized, even by health professionals. Symptoms of addiction are mistaken for diseases common to old age, such as high blood pressure, dementia, stroke, Parkinson’s disease, and sleep disorders. Moreover, most of the medical and psychological screening tests for addiction are designed for younger adults, making the tests inadequate for older adults.

For young people, the American Academy of Pediatrics recommends the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model as part of routine pediatric primary care. Many experts emphasize that early exposure to drugs places children at significantly higher risk for later addiction, making prevention during childhood and adolescence far more effective than treatment after substance-use patterns emerge.

Data from the University of Michigan’s Monitoring the Future survey showed that adolescent substance use was notably higher in the mid-2010s, with 2015–2016 rates for illicit and cannabis use well above those seen later in the decade. Use then declined by 2020, followed by an unprecedented drop during the COVID-19 pandemic, and according to a 2023 National Institute on Drug Abuse (NIDA) report, these lower levels have largely persisted. However, fentanyl-contaminated counterfeit pills continue to drive elevated overdose deaths among teens despite lower overall drug use.

Despite declining rates, though, individuals ages eighteen to twenty-five continue to experience the highest rates of SUDs, according to the National Center for Drug Abuse Statistics. Some have struggled with substances since adolescence, while others begin using during this period due to life transitions such as moving away from home, starting college or work, managing finances, and adjusting to new responsibilities. For many, alcohol and drugs become a tempting escape from these pressures and are more likely to be misused in this age range.

Substances and Behaviors

Using a working definition of addiction as “a physiological or psychological dependence on a substance or behavior to the extent that its withdrawal causes extreme distress to the user,” addictions in older adults are the same as those in younger people. However, two substances, alcohol and prescription medications, and two behaviors, gambling and watching television, appear to be particularly troublesome for older adults.

Alcohol is the drug most often abused by older adults. A 2017 study published in JAMA Psychiatry found that 3.8 percent of Americans over sixty-five engaged in "high-risk drinking"—a 65-percent jump over the period of the study, which was from 2001 to 2013. In many cases, alcohol addiction leads to other problems. Older adults addicted to alcohol are three times more likely to already have or to develop another mental disorder. Furthermore, according to the National Survey on Drug Use and Health published in 2025, 2.9 million adults ages 65 and older met criteria for past-year alcohol use disorder, and Centers for Disease Control and Prevention (CDC) data showed that people 65 and older accounted for 40.9 percent of all alcohol-attributable deaths between 2022 and 2023.

Prescription medications rank as the second most commonly abused substance among older adults and include sedatives, antidepressants, sleeping pills, and pain relievers, especially the narcotic analgesics. The National Institute on Drug Abuse reported that people aged sixty-five years and older received over 30 percent of all medications prescribed by doctors in the United States, yet this group makes up less than 15 percent of the US population. According to NIDA, some 18 percent of adults aged sixty years and older abuse prescription drugs. Older adults take prescription medications three times more frequently than the general population and are more likely to disregard dosing directions, often choosing to self-medicate instead. To compound the problem, NIDA reported that, in general (for some drugs), older adults receive prescriptions with higher doses and with longer dosage times than younger adults receive.

Gambling is a common pastime among older adults, and participation has grown steadily as this age group has expanded throughout the 2010s and 2020s. Research across North America has consistently shown that a small but meaningful percentage of adults who gamble—particularly older adults—experience problem or pathological gambling behaviors. Because older adults now make up one of the fastest-growing segments of gamblers, the overall number of those addicted to gambling has also increased. Various community and clinical settings have reported that a notable minority of adults aged 55 and older show signs of at-risk or problem gambling, underscoring the need for screening and support within aging services and primary care.

Television watching, too, can become an addiction, according to many mental health professionals. Most older adults watch television regularly, more so than any other age group. For many older adults, especially those living alone or with limited mobility, television is a companion, and watching television is an activity that helps them cope with their problems. Watching television is considered an addiction when a viewer cannot stop watching at a chosen time, when they want to but cannot watch less, when they complain that watching replaces other activities and takes up too much time, and when they are uneasy and experience withdrawal symptoms when not watching for a time.

Some adults carry an addiction into their later years. Most baby boomers with an addiction to illicit drugs, for example, continue a pattern of abuse that began for them in the 1960s and 1970s. However, not many individuals with substance use disorder live to old age because of the devastating physical effects of lifelong addiction.

Other adults switch addictions when they get older. Studies of the chemistry of addiction are helping to explain why some people and not others become addicted. A seminal study prepared for the National Academy of Sciences in 1983 identified certain personality traits that can contribute to the onset of addiction. A person with an addictive personality, for example, might have been addicted to heroin when young but may have switched to prescription drugs later in life.

Other adults become addicted only in their later years. Many older persons turn to substances and behaviors that become addictions as a way to cope with growing older. The factors that contribute to addiction at any age are complex, but certain circumstances and elements are unique to older people.

In general, as people reach their sixties, they are more vulnerable to compulsive behaviors such as gambling. Older people experience many more types of loss than do younger people—loss of physical and mental capabilities; loss of older family members, of spouses, and of friends in the same age group; loss of earning power; and loss of status in society, especially following retirement and estrangement in a society that reveres youth. Older adults deal with more serious medical conditions, such as heart disease, Parkinson’s disease, hearing loss, and dementia. Following retirement, many people are unsure how to spend their time and are unaware of social opportunities and community resources. Boredom and loneliness plague many older people.

The consequences of addiction are, in many cases, more serious for older people than for younger people. The aging body processes substances differently from the young body. The level of alcohol or drug use, for example, considered light or moderate in the younger body, is often dangerous to the organs and systems of the older body. Recovery from substance abuse takes longer in the older body. Older people, on average, are more likely to be taking more medications than younger people and, thus, risk serious problems when combining medications with alcohol or illicit drugs. Finally, financial losses are more difficult to recoup for persons, such as older adults, who often live on fixed incomes.

Addiction affects a person’s self-esteem, coping skills, and relationships, which, when combined with the other losses common in later life, can lead to other serious mental illnesses. Clinical depression, although not specifically a disease of age, afflicts many older people. The link between clinical depression and addiction is well established.

Treatment for addictions in older people is similar to treatment for younger people, with the exception that most older individuals receive treatment for co-occurring disorders (two or more diseases present at the same time). On the positive side, health professionals report that once older adults enter treatment, they achieve greater success than any other age group.


Bibliography

“Alcohol and Older Adults Ages 65+.” National Institute on Alcohol Abuse and Alcoholism, 19 Aug. 2025, www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics-z/alcohol-facts-and-statistics/alcohol-and-older-adults-ages-65. Accessed 21 Nov. 2025.

Bamberger, Peter A., and Samuel B. Bacharach. Retirement and the Hidden Epidemic: The Complex Link between Aging, Work Disengagement, and Substance Misuse and What to Do about It. Oxford UP, 2014.

Chhatre, Sumedha, et al. "Trends in Substance Use Admissions among Older Adults." BMC Health Services Research, vol. 17, 2017, doi:10.1186/s12913-017-2538-z. Accessed 21 Nov. 2025.

Colleran, Carol, and Debra Jay. Aging and Addiction: Helping Older Adults Overcome Alcohol or Medication Dependence. Hazelden, 2002.

“Drug Abuse Statistics.” National Center for Drug Abuse Statistics, 2025, drugabusestatistics.org/. Accessed 21 Nov. 2025.

Elinson, Zusha. "Aging Baby Boomers Bring Drug Habits into Middle Age." Wall Street Journal, 16 Mar. 2015, www.wsj.com/articles/aging-baby-boomers-bring-drug-habits-into-middle-age-1426469057. Accessed 21 Nov. 2025.

Nakken, Craig. The Addictive Personality: Understanding the Addictive Process and Compulsive Behavior. Hazelden, 1996.

“Reported Drug Use Among Adolescents Continued to Hold Below Pre-Pandemic Levels in 2023.” National Institutes of Health, 13 Dec. 2023, www.nih.gov/news-events/news-releases/reported-drug-use-among-adolescents-continued-hold-below-pre-pandemic-levels-2023. Accessed 21 Nov. 2025.

Ruiz, Pedro, and Eric C. Strain. The Substance Abuse Handbook. 2nd ed., Wolters, 2014.

Span, Paula. "Alcohol Abuse Is Rising among Older Adults." The New York Times, 14 Sept. 2017, www.nytimes.com/2017/09/14/health/alcohol-abuse-elderly.html. Accessed 21 Nov. 2025.

Span, Paula. "Why Are Older Americans Drinking So Much?" The New York Times, 31 Mar. 2024, www.nytimes.com/2024/03/30/health/seniors-alcohol-consumption.html. Accessed 21 Nov. 2025.

“Substance Use Among Youth.” Centers for Disease Control and Prevention, 22 Nov. 2024, www.cdc.gov/youth-behavior/risk-behaviors/substance-use-among-youth.html. Accessed 21 Nov. 2025.

"Substance Use in Older Adults." National Institute on Drug Abuse, July 2020, nida.nih.gov/publications/drugfacts/substance-use-in-older-adults-drugfacts. Accessed 21 Nov. 2025.

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