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Substance Abuse and Addiction Health Center

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Substance Abuse in Older Adults - Topic Overview

Many people think alcohol and drug abuse happen only to teens and younger adults. But all ages can have problems with drugs and alcohol, including older adults.

Older adults may use illegal drugs, use prescription or over-the-counter medicines in harmful ways, 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 abuse in older adults may be overlooked, because:

  • Older adults are more likely to drink or use drugs at home rather than in public.
  • Older adults may not have duties that are affected by substance abuse, such as going to school or work.
  • Signs of abuse are similar to those found in health problems that many older adults have, such as depression and dementia.
  • Caregivers of older adults may be aware of the problem but may not want to talk about it.


Alcohol abuse is dangerous for all people, and it can be very dangerous for older adults. Older adults:1

  • Usually need less alcohol to become drunk (intoxicated) than someone younger.
  • Stay drunk longer, because their bodies process alcohol more slowly.
  • May have vision and hearing problems and slower reaction times. Alcohol can make these problems worse, which means alcohol-related falls, car crashes, and other kinds of accidents are more likely.
  • May be more likely to mix alcohol and medicine because they are taking so many medicines. Mixing alcohol with many over-the-counter and prescription medicines can be dangerous or even fatal.

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

Experts suggest that adults 65 and older have:1

  • No more than 1 standard drink camera.gif a day.
  • No more than 2 drinks on any drinking occasion, such as New Year's Eve or weddings.

Some older adults should not drink alcohol. Women who are small may want to ask their doctors what amount of alcohol is safe for them.

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