Alcohol and substance abuse

Substance abuse disorders are medical conditions that are diagnosed when a patient’s drinking or use of other substances causes distress or harm. In the United States, about 18 million people have an alcohol use disorder, classified as either alcohol addiction—perhaps better known as alcoholism—or alcohol abuse.

Alcohol abuse disorder is prevalent, affecting as much as 10% of adults. Despite the high prevalence of alcohol abuse, the condition frequently remains undiagnosed and untreated. This is particularly true among the mentally ill where the incidence of concomitant alcohol use disorders may be as high as 20%.

As people age, they may become more sensitive to alcohol’s effects. The same amount of alcohol can have a greater effect on an older person than on someone who is younger. Over time, someone whose drinking habits haven’t changed may find she or he has a problem. Just like men, older women can have problems with alcohol. In fact, they are more sensitive than men to the effects of alcohol.

Heavy drinking can make some health problems worse. It is important to talk to your doctor if you have problems like high blood sugar (diabetes). Heavy drinking can also cause health problems such as weak bones (osteoporosis). Older adults are more likely to have health problems that can be made worse by alcohol. Some of these health problems are:

  • Stroke
  • High blood pressure
  • Memory loss
  • Mood disorders

In 2010, an estimated 2.4 million people 12 or older met criteria for abuse of or dependence on prescription drugs. (source: NIDA) The impact of addiction can be far reaching. Cardiovascular disease, stroke, cancer, HIV/AIDS, hepatitis, and lung disease and mental health can all be affected by drug abuse.

Persons aged 65 years and older comprise only 13 percent of the population, yet account for more than one-third of total outpatient spending on prescription medications in the United States. Older patients are more likely to be prescribed long-term and multiple prescriptions, and some experience cognitive decline, which could lead to improper use of medications.  Alternatively, those on a fixed income may abuse another person’s remaining medication to save money.

The high rates of comorbid illnesses in older populations, age-related changes in drug metabolism, and the potential for drug interactions may make any of these practices more dangerous than in younger populations. Further, a large percentage of older adults also use over-the-counter (OTC) medicines and dietary supplements, which (in addition to alcohol) could compound any adverse health consequences resulting from prescription drug abuse.


  • Alcohol Use Disorders
  • U.S. Department of Health and Human Services; National Institutes of Health: National Institute on Alcohol Abuse and Alcoholism. Older Adults and Alcohol: You Can Get Help. May 2013. NIH Publication Number 11-7350.
  • U.S. Department of Health and Human Services; National Institutes of Health: National Institute on Drug Abuse. Prescription Drugs: Abuse and Addiction. October 2011. NIH Publication Number 11.