In 2023, an estimated 6.4 million Medicare beneficiaries had a substance use disorder, according to federal data highlighted by Arizona State University through Newswise.
Over the same period, overdose rates among adults 65 and older rose about 11% from 2022 to 2023, based on CDC estimates.
ASU shared the analysis ahead of the International Day Against Drug Abuse and Illicit Trafficking, warning that prescription drug and alcohol problems among seniors are rising in the United States while often going undetected.
The Scale of Addiction Among Older Adults
The 6.4 million figure covers Medicare beneficiaries with any substance use disorder, and opioids are a significant part of it: nearly 2 million Medicare beneficiaries have been diagnosed with opioid use disorder in recent years.
Alcohol addiction remains the most common problem by far. More than 1 in 10 older adults report binge drinking, a rate the National Institute on Alcohol Abuse and Alcoholism says has risen significantly since the early 2000s.
Despite the scale of the problem, experts say fewer than 40% of older adults with addiction receive appropriate treatment.
Why Overdoses Among Seniors Are Rising
Michelle Shiota, a psychology professor at ASU and director of its Substance Use and Addiction Translational Research Network, told Newswise that the body processes alcohol less efficiently with age, so the same amount has a stronger effect and takes longer to wear off. That can raise the risk of harm if someone keeps drinking or using at the pace they did when younger.
Shiota also pointed to narrowing routines. Responsibilities and activities that once capped substance use, like an early work meeting or caring for someone else, often fade with retirement and aging, removing a natural deterrent.
Chronic pain adds another path. Opioid addiction often begins with a prescription after an injury or surgery, and older adults are more likely to be managing painful conditions for which opioids are still frequently a first-line treatment.
Many other risk factors are the same at any age, including anxiety, depression, PTSD, trauma, genetic predisposition and stressors such as economic strain, unstable housing or food insecurity.
Why It Goes Undetected
Part of the reason so many cases go untreated is that the signs can resemble normal aging or dementia. Declining social engagement, slow or unsteady movement, cognitive difficulty, and low mood may point to a substance problem, depression, or early dementia, sometimes more than one at once.
Shiota said that when someone shows this pattern, it is worth asking whether substance use could be a contributing factor.
Warning Signs Families and Doctors Miss
According to Shiota, the key is starting a conversation rather than hunting for age-specific symptoms. Questions worth asking include: Has drinking or drug use increased over time?
Is it causing problems with health, responsibilities, or relationships? Is the person using to cope with boredom, loneliness, or unhappiness? If they took opioids for pain after an injury or surgery, have they kept taking them beyond the recommended time?
Shiota said doctors should be screening for problematic substance use, even though it is not yet required, and that families can keep the lines of communication open.
What This Means for Treatment Seekers
The encouraging part is that these conditions are treatable, and care can be tailored to older adults. Because symptoms overlap with dementia and depression, a thorough assessment matters.
Look for rehab centers experienced with older adults, co-occurring mental health conditions, chronic pain, and medication interactions. Much of this care is covered by Medicare, so ask about insurance coverage for addiction treatment before ruling out help on cost.
Finding the Right Rehab
Shiota’s advice for a first step is simple: talk to them, ask about their substance use, listen without judgment, and get them help if needed.
Rehab.com’s directory includes verified treatment centers nationwide. Call
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to speak with a treatment advisor about options for an older adult.
