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Signs of drug and alcohol abuse in elderly adults

Published October 7, 2024 · 7 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals.

Substance abuse in adults over 65 is underdiagnosed because symptoms overlap with aging and medical conditions.

Why it is missed

Falls attributed to aging rather than intoxication. Confusion attributed to dementia rather than substance use. Social isolation reduces observation by others. Physicians may not screen elderly patients. Shame prevents disclosure.

Signs

Unexplained falls or injuries. Increasing confusion. Social withdrawal. Neglecting self-care. Prescription medications running out early. Drinking alone increasing. Interactions between alcohol and medications.

Getting help

Talk to their primary care physician. Geriatric addiction specialists exist. Treatment programs adapted for older adults. Lower doses of medications needed. Co-occurring medical conditions must be managed simultaneously.

Authoritative sources

This article references guidelines from: NIDA · SAMHSA · CDC

Frequently asked questions

Do elderly people get addicted?

Yes. Substance abuse in adults over 65 is increasing. Prescription opioid and alcohol misuse are most common.

Why is elderly addiction overlooked?

Symptoms overlap with aging and medical conditions. Falls, confusion, and withdrawal mimic other geriatric issues.

Is treatment effective for older adults?

Yes. Age-adapted treatment produces good outcomes. Lower medication doses and co-occurring condition management are important.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.