Epidemiology of Alcohol and Drug Use in the Elderly

Yuan-Pang Wang; Laura Helena Andrade


Curr Opin Psychiatry. 2013;26(4):343-348. 

In This Article

Abstract and Introduction


Purpose of review Alcohol and drug abuse among older adults is a topic of growing public health concern. The authors review the recent epidemiological surveys of this emerging trend and outline some public health challenges for the coming future.

Recent findings Relevant studies showed that prevalence of substance use disorders is increasing among American and European elders. Although treatment admissions involving use of alcohol have slightly decreased, rates involving misuse of prescription medications and illicit drugs have increased. As older adults were less likely than younger adults to recognize substance use as problematic or to use treatment services, elders were as likely to benefit from treatment as younger people. Healthcare settings should be prepared to treat this population.

Summary There is robust epidemiological evidence showing that alcohol and drug abuse among the elderly are current health problems in developed regions. The number of older adults will increase in less developed regions in the next decades, but it is unclear whether this population subgroup will also seek treatment for substance use to a greater extent. Investigations of the sexual difference and cross-cultural variation can help tailor effective interventions. Routine screening programmes to address the needs of the ageing substance-using population are recommended.


The number of persons aged 60 years and over in the world has exceeded 700 million, totalling more than 10% of the population. The majority of older individuals are concentrated in developed countries.[1] Decrease in fertility, increase in life expectancy and the ageing baby-boomer generation (individuals born during the postwar period of 1946–1964) are the main reasons for this changing demography. By 2050, the proportion of older adults in less developed regions will also rise extensively.

Among health problems and burden of diseases for the next decades,[2–5] two categories of substance use problems are major concerns among older adults: alcohol and psychoactive prescription drugs. Although the use of illicit drugs is low in this age group, it appears to be an emerging issue.

Apart from the belief about using substances for 'healing' purposes, individuals from the baby-boom cohort have had more exposure to alcohol, tobacco and illegal drugs in their youth and tended to be more lenient about substance use. In the same period, psychoactive medications became available as a widespread method to deal with anxiety, pain and stress in response to life's pressures. When more people abuse alcohol and drugs in their later years, it is likely to be associated with more problems and needs for treatment.[6,7]

Press media largely reported increased admissions and visits to emergency room by older people due to substance misuse. This rise of seniors seeking treatment for drug use prompted the National Institute of Health to circulate an alert in 2012 about improper use of substances, strengthening public awareness of substance use disorders (SUDs) in the elderly.

Apart from low recognition, this substance-using population might also be underserved. The magnitude of the problem can only be understood if national survey data are analysed to provide more precise estimates of substance abuse and dependent individuals in need of help. The aim of this article is to review recent trends on the epidemiology of alcohol and drug use in the elderly, and to consider how best to leverage the available information to plan and implement effective interventions for this looming public health problem.