A Caregiver’s Guide to Preventing Senior Substance Abuse in San Francisco

When Ruth’s husband died, she was 67. She had never been one to shy away from having a drink, but as the weeks and months went by, her family and friends seemed to notice her drinking more and more. When asked about it—always delicately—she laughed and said that she’d earned it.

Senior Substance Abuse San FranciscoWhen Ruth’s husband died, she was 67. She had never been one to shy away from having a drink, but as the weeks and months went by, her family and friends seemed to notice her drinking more and more. When asked about it—always delicately—she laughed and said that she’d earned it.
This seemed to be a good explanation to her concerned circle. After all, she had spent the last five years taking care of her increasingly frail husband, and, they rationalized, she was cutting loose. She was a little lonely and a little sad. So what was the harm?
The problem is that the drinking continued, as it does. It became habit, and it became abuse, and all the while, her family and friends continued to rationalize and make excuses. By the time they finally solidified their resolve and confronted her, she had damaged her never-great health.
This isn’t a story to scold Ruth or her loved ones. Senior substance abuse is a growing problem, and one that, despite its prevalence and ruinous impact, is dramatically underreported. It hurts the individual and their family, who are both devastated by seeing a loved one suffering and hit with the weight of guilt. Senior substance abuse has a rippling effect throughout the generations.
That doesn’t mean there is no hope. Understanding how to recognize the signs of senior substance abuse and how to get help can save a life.
More than that: it can give someone—many someones—their life back.

Understanding the Causes and Reality of Senior Substance Abuse

When we say that that senior substance abuse is an underreported and growing problem, we mean it. Over 1 million adults over the age of 65 have substance abuse problems involving recreational drugs and 978,000 have an alcohol abuse problem and 150,000 abuse illicit drugs other than alcohol.
However, substance abuse doesn’t have to involve recreational substances; many prescription medications can be both abusable and addictive and seniors are particularly vulnerable. It is estimated that the number of seniors abusing or misusing prescription drugs will jump to 5.7 million by 2010, up from 2.7 million in 2006, an alarming increase caused by a variety of complex and often overlapping factors.
In part, the heightened risk of prescription drug abuse comes from increased exposure—87% of seniors take at least one kind of legal drug. Thirty-eight percent take 5 or more over the counter, and in some long-term care facilities, 85% of seniors are taking 10 or more drugs. This leads to a huge possibility of misuse. Medication management technology can help with that, as can home visits and caregiver/family attention, but there is always the chance to get confused. Confusion can easily lead to addiction of some medications. Such misuse is unintentional, but it can have the same symptoms of abuse, and become essentially indistinguishable.
But the prevalence of prescription drug use is just one cause of senior substance abuse (though it, of course, can aid and abet the other causes). Older adults also have a variety of psychological, physiological, and environmental risk factors that increase vulnerability to drug abuse:

  • Recent retirements (loss of purpose)
  • Death of loved one
  • Death of friends
  • Isolation/Loneliness
  • Health problems (physical or mental)
  • Financial difficulties
  • Family troubles (often related to money)

Getting older can be stressful, especially if you have economic troubles. In San Francisco, with its high rents and soaring cost of living makes it especially hard. For the city’s high number historically-marginalized communities (African-Americans, Hispanics, LGBTQ), a lifetime of stolen opportunities adds up and these populations and cause additional stressors.
That’s why it is so important to recognize the signs.

Recognizing the Signs of Senior Substance Abuse

One of the tricky parts of recognizing the signs of drug or alcohol abuse in older adults is that some of the main symptoms might also be signs of dementia, balance loss, or other things we associate with aging. These signs include:

  • Memory loss or slippage
  • Mysterious bruising
  • Changes in sleeping habits
  • Mood swings, especially toward irritability
  • Chronic pain
  • An unusual desire to be alone
  • Hygiene issues
  • Lack of interest in usual activities
  • Failing to stay in touch with loved ones

Now, you might say: this could be anything! It could be depression, it could be Alzheimer’s, it could be another sort of illness. But, as you also might recognize…none of these are good. If you notice these symptoms, it is crucial to see a doctor.
If there aren’t any other plausible or explicable causes, substance abuse could be the problem. If it is, or you suspect it might be, it is important to get help as soon as possible.

Where To Get Help for Senior Substance Abuse in San Francisco

One of the hardest things to do in life is to talk to someone about their abuse problem. Denial, excuses, and anger are usually the first reactions, along with bargaining and rationalization. Every situation is different, and we can’t tell you the best way to handle an intervention.
But these locations can. They can offer advice, counseling, and in many cases, rehab.
San Francisco Department of Public Health- Substance Use Disorder
For recipients of Medi-Cal, the SFDPH offers a “full range of specialty Behavioral health services provided by a culturally diverse network of community Behavioral health programs, clinics and private psychiatrists, psychologists, and therapists.”
Golden Gate For Seniors
A unique program in San Francisco designed specifically for seniors, Golden Gate offers “a residential recovery facility designed to help men and women 55 years of age and older achieve a more meaningful life free from drugs and alcohol.” The average stay is 6 months.
Drug and Alcohol Rehab Centers For Seniors in California
Throughout California, there are rehab programs and services designed for the elderly. This list lets you search by county. No matter where you are in the Bay Area, you can find something.
San Francisco Rehab Programs
The OnTheWagon database provides information about more than 50 addiction treatment programs in San Francisco. These aren’t designed for older adults, but there is a variety of cultural-and-religious-specific organizations and programs, which many people might find more comfortable.  
These organizations understand the unique and essential role of caregiver and family involvement. You not only can contact them from that role, but are encouraged to. Your involvement often leads to a much better outcome. So get involved.

The First Step To a Clean Life Starts Today

We understand that people have different financial abilities. Some addiction treatments are luxurious rehab centers while some are church groups that welcome anyone. We want you to find a group and a program with which you are comfortable, both emotionally and financially.
While you are looking, remember that the IOA offers Home Care and Support Services that can help you find the program your loved one needs. We also recognize that substance abuse is often a symptom, a cause of, and an exacerbator of depression and even suicidal tendencies. Please let loved ones know about our Friendship Line. Sometimes just having someone to talk to can be an enormous help.
That’s what it takes to help a senior suffering substance abuse. It takes concern. It takes dedication. It takes a desire and willingness to not ignore the problems and not to let excuses—yours, or your loved one’s—prevent you from action.
By taking action, you can give them the greatest gift of all: a chance to live out their life on their own terms, not at the crippling and degrading greed of a substance. You claim that time, and that is something you’ll never regret.
At Institute on Aging, our programs and services help older adults, their families, and caregivers explore aging together, through good times and bad, as an adventure and a journey. Connect with us today to learn more.

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