Rehab Programs for Older Adults

When people think of substance use and addiction treatment, older people do not always come to mind. Addiction affects people of all ages, and can cause significant problems in older adults. Many older adults struggle with substance misuse and co-occurring mental health disorders, and may benefit from treatment programs that are tailored to their unique needs. Understanding what encompasses a rehab center for older adults, how these rehab programs can help older adults find recovery, and how to find these programs can help you begin your journey to recovery.

Substance Abuse in Older Adults

While older adults experience substance use disorders (SUDs) at lower rates than younger adults, the problems are still noteworthy in the population.¹ An estimated 903,000 adults over 65 years of age met the criteria for alcohol use disorder, with around 5.6 million older adults engaging in binge drinking in the prior month.¹ Certain types of drug misuse also appear to be on the rise in older adults.¹ Data shows that the rates of heroin use, cannabis, and opioids were on the rise in older adult populations.¹ Furthermore, many adults may be prescribed drugs that have high risk potential for abuse or have negative effects when taken with alcohol.¹

The reasons for increased substance misuse among older adults are complex, but in general, some of the reasons include:¹

• Social isolation.
• Stress over finances, such as living on a fixed income.
• Retirement, especially if it is involuntary.
• Loss of spouse or partner.
• Poor nutrition.
• Emotional and mental stress of getting older.
• A decline in physical conditions and medical conditions that come with aging.
• Cognitive decline, including Alzheimer’s dementia.
• Environmental changes due to relocation, such as moving to assisted living.
• Untreated trauma and/or underlying mental health conditions.

Older adults are impacted in different ways than younger people. For example, when older adults take benzodiazepines for sleep disorders or anxiety, they are more likely to suffer falls, car accidents, cognitive issues, and overdoses. Older adults have slower metabolisms meaning that it takes longer for the body to break down and clear medications, alcohol and drugs from the system. As a result, medications, drugs and alcohol stay in the body for longer periods and can have lasting effects, especially when combined with other substances.¹

Older Adults and Co-Occurring Mental Health Disorders

Around 11% of older adults with mental health disorders also have a substance use disorder.¹ Likewise, about 37% of those with a substance use disorder also have mental health disorders.¹ Overall, around 1.5 million adults age 50 or over have mental health and substance use disorder diagnoses.¹

The co-occurrence of mental health and substance use disorders makes detection of substance use disorders more difficult, as the symptoms of mental illness can resemble or mask the symptoms of a substance use disorder.¹ A treatment program needs to address both the substance use disorder and a person’s mental health disorder, to help both disorders.¹ Ideally, a treatment program will provide treatment for both conditions simultaneously.¹

Specialized Rehab for Older Adults

Specialized addiction treatment for older adults are programs designed to address the unique challenges older adults face when aging. By its nature, aging can be an isolating experience, and those without strong coping mechanisms may not be prepared for the challenges. Many older adults struggle with shame over the use of drugs and alcohol, considering it to be a moral failure due to their upbringing at a more conservative time in society.¹ Others frequently struggle with finances, as they cannot work more to add to a fixed income. Many older adults have also endured the death of many friends.¹

Some of the characteristics of programs that successfully treat older adults include:¹

• Non-confrontational therapy that addresses grief, isolation, and loss of loved ones as a person ages.
• An emphasis on rebuilding social networks for increased support.
• Treatment that considers the slower pace needed by older adults, including adaptions for hearing and/or vision loss.
• Personal care aides are sometimes used in these programs and are needed by older adults.
• Access to 24-hour medical and nursing care if needed.

While many older adults get treatment in all types of rehab programs, specialized programs are especially beneficial, with between 60-85% of those older adults getting treatment in these programs still maintaining abstinence from substances 12 months after completing treatment.¹ Specialized treatment is especially helpful for persons over the age of 75 and those who have co-occurring medical conditions or cognitive issues.¹

How Does Addiction Treatment for Older Adults Work?

One of the first steps in treating older adults for substance use disorder would be to initiate screening, brief intervention, and referral to treatment.⁶ Using such tools as SBIRT, older adults who are engaging in risky drinking practices but do not meet the level of a alcohol use disorder that requires formal addiction treatment.¹ At times, educating adults about more safe practices around the use of substances can lead to a decrease in risky behaviors.¹

In cases where the assessment reveals a more serious issue indicative of a substance use disorder, numerous types of treatment may be appropriate. This will depend on the overall assessment of a person’s individual needs and strengths.² Depending on the outcome of an assessment, a person may enter treatment for:

• Detox, which is the process of getting a substance safely out of a person’s system.⁴ With an older adult with an alcohol use disorder, medically supervised inpatient detox is usually advised due to the potential for complications.¹
• Inpatient treatment, offers 24/7, round the clock supervision, and can be particularly helpful for those who are medically frail, have suicidal ideations, or have a dependence on more than one substance.^{1, 3} Older adults who require a well-rounded continuum of care may end up in a residential or inpatient rehab program. Inpatient treatment is usually set in a hospital and can last from a few weeks to over a month.³ Residential treatment usually occurs at a rehab facility and can last from a few months to over a year. ³
• Outpatient treatment can also be a viable option for some older adults. Outpatient treatment varies in intensity, ranging from a few hours a week to 20 hours per week.³ Outpatient treatment involves the same types of treatment and intervention as inpatient treatment, but people can go home at night and on weekends.³
• Aftercare, or recovery support services, which can be helpful to older adults following inpatient or outpatient treatment. Recovery management can refer to ongoing support groups, home visits, and telephone calls.¹

Does Insurance Cover Rehab for Older Adults?

Adults aged 65 and older are eligible for Medicare, a public health insurance plan that may be able to help cover some or all of the costs of addiction treatment. When inpatient substance abuse treatment is determined to be medically necessary, then Medicare can provide coverage if the provider is certified as a Medicare provider.⁵ However, while Medicare can help cover costs, there may be restrictions. Facilities that are out-of-network or do not work with Medicare may not accept the insurance as payment. It’s important to check with your Medicare provider and with any potential rehab center to check your coverage before committing to treatment.

How to Find a Rehab for Older Adults Near Me

Once you’ve decided to commit to treatment, you’ll need to find a nearby program that specializes in treating older adults. A good first step is to make sure that any prospective program is a Medicare-covered provider. Medicare can help you cover the cost of treatment, and as such it’s a good idea to look for facilities that work with the public insurance plan. You may want to reach out to you doctor or a Medicare representative for help finding rehabs that accepted Medicare.

You may also seek to take advantage of the SAMHSA treatment locator, which can help you find addiction treatment for older adults near you. In addition, you can call American Addiction Centers’s free and confidential helpline, which is available 24/7, to speak to a referral specialist about services for older people that may be right for your situation.