Doctors Don’t Discuss Alcohol and Drug Use with Older Adult Patients, Putting Patients at Risk, Warns Caron Treatment Centers

Caron Treatment Centers’ survey conducted by The Harris Poll on the behavior and attitudes around alcohol, marijuana and mental health of Older Adults reveals concerning trends

Wernersville, PA & Boca Raton, FL – February 29, 2024 – A survey from Caron Treatment Centers reveals only a fraction of adults age 55 and older (38%) say they talk with healthcare providers about their substance use, including alcohol, drugs, and prescription medications, despite having a high level of trust with their healthcare professionals when it comes to the medication they prescribe. The online survey of 772 U.S. adults ages 55 and older on their behavior and attitudes around alcohol, substances and mental health was commissioned by Caron – a leading, internationally recognized nonprofit dedicated to addiction and behavioral healthcare treatment, research, prevention and addiction medicine education – and conducted by The Harris Poll in June 2023.

“The use of alcohol and substances, including some prescription medications, can have catastrophic health consequences for adults over the age of 60. From increasing the risks of falls to potentially deadly drug interactions to developing a substance use disorder, alcohol and other substances put our seniors at risk. However, our survey shows that healthcare providers aren’t openly asking patients about their use – and seniors aren’t forthcoming. Providers need to talk to their older adult patients about their use of alcohol, substances and prescription medication,” said Ming R. Wang, M.D., FASAM, an addiction medicine physician and an associate medical director at Caron Treatment Centers.

As reported in the New York Times, substance use is seen with increasing frequency among seniors, resulting in increased hospitalizations and complications.

“Older adults are more likely to be on multiple medications for several different medical conditions,” explained Barbara Krantz, D.O., MS, DFASAM, MRO, medical director of Older Adults Program, Withdrawal Management and Chronic Pain for Caron. “This puts them at a greater risk of having an interaction or experiencing a side effect, especially when combined with alcohol. We also see the layering on of medications to treat the side effects, which can create additional issues. Many baby boomers also have long histories with drugs, cannabis and alcohol, and they have brought those habits with them into old age. Finally, our bodies also become more susceptible to the effects of alcohol and drugs with age.”

“The good news is that older adults seem generally knowledgeable about the harm alcohol, substance use and prescription medication can present,” continued Krantz. “The bad news is they trust their healthcare providers and pharmacists to monitor and manage alcohol and drug-drug interactions, all while healthcare providers are neglecting to ask key questions about usage.”

Adults age 55 and older have a baseline of trust of with their healthcare providers

In the survey, nearly three-quarters (72%) of adults age 55 and older self-report taking prescription medication for a medical condition, and among those who do, the most often cited medications are taken to manage blood pressure (64%) or cholesterol (53%).

There is an inherent trust between older adults and their healthcare providers when it comes to medications. 83% agree the medication their healthcare provider prescribes must be for a good reason. While nearly all adults (92%) age 55 and older perceive prescription medication as potentially addictive, nearly half trust their healthcare provider would not prescribe them a medication they could become addicted to (46%).

Despite the apparent trust they have with their healthcare professionals when it comes to medications, only 38% say they talk with their provider about substance use, including alcohol, drugs, and prescription medications. Men are significantly more likely to be open with their healthcare provider (43%) in discussing these topics compared to women (33%).

Marijuana and anxiety

Adults age 55 and older also appear comfortable with the idea of using non-pharmaceutical, plant-based substances to manage anxiety. Two thirds of older adults in the U.S. agree marijuana works to treat anxiety (66%), even though there is no medical research to support this belief. Adults aged 55-64 are more likely to agree with this statement compared to those 65 or older (72% vs. 62%).

Almost 20% of adults age 55 and older drink enough to be of concern

On average, adults aged 55 and older who drink alcohol consumed 4.5 alcoholic beverages in the last week. A serving consists of 12 ounces of beer, five ounces of wine, or one and a half ounces of hard liquor. This is well within the general guidance to consume no more than seven alcoholic beverages per week. 84% of adults aged 55 and older reported drinking seven or fewer drinks in the past week; 11% didn’t drink at all, and 43% had only one or two drinks.

There is a significant minority who drink more than that. One fifth of adults aged 55 and older agree regularly drinking two or more alcoholic beverages in one day is not a big deal (20%), and this is reflected in their habits. 17% reported drinking more than seven drinks in the past week.

Results show men tend to drink more. On average, men reported drinking 5.3 drinks in the past week, while women reported 3.6. Only 11% of women reported drinking more than 7 drinks in the past week, compared to 21% for men.

Despite reporting that they have not cut back on their drinking because of health reasons, people aged 65 or older drink significantly less than those 55 to 64 (an average of 3.9 drinks per week versus 5.4). Around 18% of those between 55 and 64 drank more than seven drinks in the past week, versus 13% for those 65 or older. Those 65 or older were also more than twice as likely to have not drank at all in the past week. Either there is a cultural divide between the two age cohorts, or those over 65 have begun scaling back on their consumption of alcohol.

“While it is encouraging that many older adults seem knowledgeable and self-regulating in maintaining a healthy relationship with alcohol, marijuana and prescription medication, there is a small but significant minority who may be headed for trouble,” explained Dr. Wang. “This survey shows that healthcare professionals need to prioritize proactive discussions on these topics with their older adult patients.”

Warning Signs in Older Adults

For families of an older adult, there are things to watch for if a problem with alcohol or substance use is suspected:

• Sudden changes in behavior
• Changes in daily routine
• Disrupted sleep
• Changes in self-care and personal hygiene
• Changes in social activities
• Forgetting more
• Falling asleep during normal activities
• Increased anxiety
• Mood swings, including angry outbursts
• Aberrant behaviors

Many of these issues are also normal symptoms of getting older, which is why it is sometimes so hard to catch. The key is to look for a sudden shift in behavior, but it is often hard for caretakers to tell there is a problem. Typically, the family wonders if there is something going on, but they don’t act until something more severe happens, such as a fall, and the person ends up in an emergency room.

“I encourage people to act on their concerns, because earlier intervention can be lifesaving. Equally important is to hold a doctor accountable who shrugs off an issue as simply a sign of getting older,” concluded Dr. Wang. “The good news is that older adults are much more likely to successfully enter recovery than those younger. It is never too late to make a change for the better.”

If you or someone you know is suffering from or at risk of an alcohol addiction, take the next step and reach out to a Caron specialist at www.caron.org.

About the survey

The “Older Adults Alcohol and Substances” study was conducted online within the United States by The Harris Poll on behalf of Caron Treatment Centers. Interviews were conducted from June 6 to 8, 2023, among 772 U.S. adults ages 55 and older. Data were weighted where necessary by age, gender, race/ethnicity, region, education, marital status, household size, household income, and propensity to be online, to bring them in line with their actual proportions in the population.

Respondents for this survey were selected from among those who have agreed to participate in our surveys. The sampling precision of Harris online polls is measured by using a Bayesian credible interval. For this study, the sample data is accurate to within +/- 4.0 percentage points using a 95% confidence level. This credible interval will be wider among subsets of the surveyed population of interest.

Caron Treatment Centers

Caron Treatment Centers is an internationally recognized nonprofit dedicated to addiction and behavioral healthcare treatment, research, prevention, and addiction medicine education. Our mission is Recovery for Life and during our almost 70 years Caron has helped thousands of individuals struggling with behavioral health issues, including substance use disorder, begin to manage these brain diseases and find hope. Anchored by two medical centers on our Pennsylvania and Florida campuses and headquartered in Wernersville, Pennsylvania, Caron provides a comprehensive continuum of care that includes medical stabilization and detoxification, residential, partial hospitalization, intensive outpatient, outpatient programs, as well as Recovery support, family and alumni services. Caron also provides concierge signature treatment for executives, healthcare professionals and older adults and offers Neurorestorative Health Care at our Keele Medical Center in Palm Beach County, Fl. In addition to our Pennsylvania and Florida campuses, Caron provides services in Wyomissing, Pa, Philadelphia, Washington, D.C., Atlanta, and New York City. Caron accepts several major insurance plans and provides financial assistance for those who qualify. For more information, please visit caron.org or @CaronTreatment.

Media Contacts:

Kristin Campbell-Salamone - Corporate Director of PR & Communications, Caron Treatment Centers
kcampbell-salamone@caron.org
215-292-5526

Katie Kennedy - Senior Vice President, Gregory FCA
caron@gregoryfca.com
610-731-1045