Why is drug abuse rising among baby boomers?

The scourge of drug addiction is typically associated with younger people, but studies show substance abuse has steadily increased among baby boomers.

Boomers are those born between 1946 and 1964 in the years following World War II, making them 59 to 77 years of age as of 2023. As a result of the post-war baby boom, they were the most populous generation in the United States for many years. As of 2022, there were more than 68 million members of the baby boom generation residing in the U.S.

Whether they were the hippies of the 1960s counterculture or purveyors of the straight and narrow, baby boomers were immersed in some of America’s most dynamic social changes. Their ranks included the idealistic youths who led the civil rights movement, the teenagers dispatched to fight in the jungles of Vietnam and the student protesters who irked authority figures with campus sit-ins. They were the generation who urged those over 30 to make love and not war.

As baby boomers reached adulthood, the older members of this Woodstock generation of so-called “flower children” took part in a surge of drug experimentation that blossomed as part of anti-establishment sentiments and the search for self-discovery.

Casual use of marijuana, LSD, psilocybin mushrooms, amphetamines (uppers), barbiturates (downers), opioids and other mind-bending substances became commonplace, and a popular motivation was the civil unrest and rebellion against the status quo of the era. By the late 1970s and ’80s, cocaine use became part of the mix in the drug culture among baby boomers.

The boomers were and remain a diverse group, and not all boomers dallied in drugs. Many boomers abstained from drugs and shunned a dangerous countercultural lifestyle of experimentation. Nonetheless, the generation is tied to a decades’ long change in attitudes about drug use and the relaxation of drug laws.

Some members of the baby boomer generation, however, have continued to use drugs as they’ve grown older, causing unique public health challenges. The widely publicized scourge of opioid and prescription drug addiction that has led to thousands of deaths over the past few decades also has had an increasing impact among the boomer demographic.

Drug overdoses are a leading cause of death among Americans. The U.S. recorded more than 109,000 drug overdose deaths in 2022, with fentanyl accounting for most of them, according to the federal Centers for Disease Control and Prevention.

Although most of the focus has been on abuse by younger people, older Americans also have been caught up in the cycle of addiction and abuse, experts report.

“Until a few years ago, even as the opioid epidemic raged, health providers and researchers paid limited attention to drug use by older adults; concerns focused on the younger, working-age victims who were hardest hit,” says a recent New York Times report. “But as baby boomers have turned 65, the age at which they typically qualify for Medicare, substance use disorders among the older population have climbed steeply.”

A Stanford University School of Medicine psychologist and addiction researcher told the newspaper that boomers “have habits around drug and alcohol use that they carry through life.”

A 2020 study found that between 2013 and 2018, rates of opioid use disorder (OUD) among older adults more than tripled overall in the U.S. and continue to increase. The study was conducted to determine the prevalence of substance use disorders among Medicare beneficiaries. The American Journal of Preventive Medicine study utilized data from the National Survey of Drug Use and Health.

“Trends between 2013 and 2018 indicate that estimated opioid use disorder prevalence has increased greatly over the study period in all sociodemographic subgroups of older adults, highlighting an urgent challenge for public health professionals and gerontologists,” the study says.

The rate of abuse, the study found, soared from 4.6 cases of OUD per 1,000 Medicare beneficiaries to 15.7 per 1,000 beneficiaries by 2018. Opioid use disorder was most prevalent among those between the ages of 65 and 69, and women had the highest rates of affliction.

A separate study found that about 1.7 million Medicare beneficiaries were estimated to have a substance use disorder. Of that number, the study found that 77% had alcohol use issues; 16% had a prescription drug condition; and 10% were users of marijuana. Of those who had a substance use disorder, only 11% received treatment for their condition, the study found.

One key finding was that Medicare beneficiaries with substance use disorders were more than twice as likely to have serious psychological distress as those without substance use disorders. Another troubling finding was that the percentage of those who contemplated suicide was much higher among Medicare beneficiaries with substance use disorders than without.

The study’s key conclusion was that “few Medicare beneficiaries who need substance use disorder treatment receive it. Reducing Medicare coverage gaps and stigma may help meet this need.”

Why do older Americans abuse drugs?

Older Americans are vulnerable to substance abuse for a variety of reasons that range from their exposure to drugs in their youth to the inevitable aches and pains of growing older.

The more we age, the more changes in life we’ll face, and as people age, they may experience many situations that increase their risk of drug abuse. Among those changes are being lonely and lacking purpose in retirement, coping with the death of a spouse or loved one, dealing with chronic pain and facing financial challenges. Drugs are a common crutch used to reduce stress and can easily lead to addiction and abuse.

Another issue is that older Americans have more access to drugs than previous generations, experts say. Prescription drugs are a key part of Medicare coverage for those 65 and older, and thanks to the internet and technological innovations, overnight delivery is just a mouse click away. It’s important to note that not all baby boomers abuse drugs. However, studies show that the risk of drug abuse is higher for this population than for younger generations.

How does opioid abuse impact older Americans?

Opioid use disorder significantly impacts older Americans in a variety of ways. OUD among older adults can cause serious physical, mental and social consequences as with other age groups. However, these consequences may be compounded by age-specific factors such as higher rates of chronic illness, polypharmacy (taking multiple medications at once), cognitive decline and social isolation.

Older adults often have more chronic conditions than younger individuals, and opioid use can worsen these conditions or make them more difficult to manage. Additionally, older adults may be more prone to the harmful effects of opioids, including respiratory depression, falls leading to fractures (due to dizziness or sedation), constipation and confusion. Overdose is also a risk as opioids can interact negatively with other medications commonly used by older adults.

OUD also can contribute to the development or worsening of mental health disorders such as depression, anxiety and cognitive impairment. The chronic use of opioids can also lead to changes in the brain’s reward system, causing psychological dependence and addiction. As a result, older adults with OUD may experience increased social isolation due to the stigma associated with substance use disorders. They may also struggle with strained relationships with family and friends due to their opioid use.

Another obstacle older adults may face is getting treatment for OUD due to limited mobility, lack of transportation or lack of providers who are skilled in managing substance use disorders in this population. They may also have trouble navigating the health care system and finding resources for help.

It doesn’t help that older adults are often prescribed multiple medications, increasing the risk of harmful drug interactions. Opioids can interact with other medications (like sedatives) in ways that increase the risk of overdose or other harmful effects.

OUD in older adults is often underdiagnosed because symptoms can be mistaken for age-related conditions or side effects of other medications. This can lead to a lack of appropriate treatment and worsening of the disorder.

Drug abuse among older Americans is a serious public health concern. It requires strategies for prevention, early detection and effective treatment that are tailored to the specific needs of this population.