Substance Use and Older Adults

Substance Use and Older Adults

Senior men walking in fall leaves

Substance misuse in Vermonters age 65 and older is increasing and the older adult population is continuing to grow. There is an increased need for awareness of unhealthy substance use, identify risks, and treatment and recovery services.

As we age, changes in the body such as lower water content, less-efficient metabolism and excretion and increased brain sensitivity may cause alcohol and other drugs to have a stronger effect.


aging and alcohol brochure
In Vermont, 5% of older adults engage in chronic drinking (more than 60 alcoholic drinks per month for men and more than 30 for women), 10% engage in high risk drinking (four or more drinks on an occasion for men and three or more for women) and 25% engage in at-risk drinking (three or more drinks on an occasion for men and two or more drinks for women), all of which are higher than U.S. rates

These high rates of risky drinking have led to the doubling of alcohol use disorders in this population from 2001-2013 (from 1.5% in 2001/2002 to 3.1% in 2012-2013).

For older adults who have dementia or are taking medications that interact with alcohol there is no safe level of alcohol use. Among the highest risk medications to take with alcohol are prescribed medications for pain, sleep or anxiety. Over 1/3 (37%) of older Vermonters report taking these medications, and 22% of those drinking at a risk level take these medications regularly.

Alcohol could alter the effect of some medications either preventing the desired effect or dangerously magnifying it.

aging and medications brochure cover and image of older adult discussing health with older adult health care provider

Most older adults are on prescription medications and many take multiple prescriptions. This can create the possibility of complex drug interactions. Symptoms of misuse can be mistaken for symptoms of chronic medical conditions or aging.


Cannabis use has increased among all age groups in Vermont, including older adults. Half of older adults that use cannabis also drink alcohol at a risk level.

Treatment & Recovery Services

Alcohol and other drug treatment and recovery services should be age-specific, embedded in medical settings and integrated with other health and social services.

Get help

Screening, Brief Intervention and Referral to Treatment  
Older Adult Substance Use Screening  
Guide for Screening Older Adults  
Screening and Brief Intervention for Substance Misuse Among Older Adults: The Florida BRITE Project  
Vermont Data Briefs  
SAMHSA Older Adults and Alcohol Misuse Issue Brief  
SAMHSA Older Adults and Medication Misuse Issue Brief  
Vermont Department of Disabilities, Aging and Independent Living (DAIL)  
ADAP Presentations: "Substance Use Screening for Adults" & "How Much is Too Much: At-Risk Drinking and Medication Misuse in Older Adults"