Why Age-Specific Treatment?
Why Age-Specific Treatment?
Anyone can develop an addiction to drugs or alcohol, regardless of their age. The National Institute on Drug Abuse stresses that once addiction develops, professional help is almost always needed to send it into remission.1
Age-specific addiction treatment programs are more effective than a one-size-fits-all approach. This is due to the cultural differences among age groups and the different types of challenges, needs and issues common to each generation.
Here, we look at the differences between young adults and midlife adults in terms of substance abuse, addiction and recovery and why age-specific addiction treatment may be the ideal choice for you.
The Most Commonly Used Drugs Among Young Adults
Heroin abuse and binge drinking are at historic lows among young adults.
According to the 2015 Monitoring the Future survey, 17.2 percent of high school seniors engaged in binge drinking, compared to 31.5 percent in 1998.
Additionally, just 38 percent of seniors reported being drunk in the past 30 days, compared to more than 53 percent in 2001.
However, young adults abuse prescription painkillers at a much higher rate than midlife adults.
During their peak use, fewer than eight percent of Generation X and Baby Boomers abused prescription painkillers in the past month, while around 22 percent of 18- to 25-year olds reported past-month use in 2015.
Addiction Risk Factors for Young Adults
Young adults between the ages of 18 and 25 account for the highest prevalence of substance use disorders, with an estimated 7.5 million young adults needing treatment for a drug or alcohol addiction in 2015, according to the National Survey on Drug Use and Health.2 The risk factors for addiction in young adults are generally different than those for midlife adults.
Trauma, especially trauma in childhood, changes the brain in important ways, and it often leads to substance abuse as a way to cope with the resulting fear, nightmares, flashbacks and anger. Young adults who have experienced trauma, such as physical or sexual abuse, are around four times more likely than their trauma-free counterparts to engage in substance abuse.
Mental illnesses like anxiety and depression impact young adults’ social and emotional functioning. A study of college students published in the journal Qualitative Social Work found that the mental health problems of today’s young adults are more severe than those of past generations.3 The number of young adults diagnosed with depression increased from 10 percent to 15 percent between 2000 and 2015, and suicide is the third-leading cause of death among people aged 15 to 24. Drugs and alcohol may seem to reduce symptoms of mental illness initially, but they always make the illness worse in the long run.
A growing body of research suggests that an increase in depressive disorders among young adults may be due to heavy technology use. A study by Baylor University found that college-age women spend an average of 10 hours a day on their phones, and their male counterparts spend an average of eight hours a day looking at their personal devices. Excessive cell phone use can become a behavioral addiction that increases the risk of developing a substance use disorder.
Chronic stress among young people is often due to the pressures of school and work. Poverty, illness, relationship problems, and other issues can lead to chronic stress, which can be devastating to physical and mental health. Many young people use drugs or alcohol to relax and reduce stress, but substance abuse ultimately reduces the ability of the body to cope effectively with stress
The number of young adults diagnosed with depression increased to 15% from the year 2000 to 2015
Addiction Risk Factors for Midlife Adults
According to the 2015 National Survey on Drug Use and Health, 2.3 million adults over the age of 40 are in need of addiction treatment. That number is expected to reach 5.7 million by 2020, according to a study by the U.S. Department of Health and Human Services and other organizations.4
Midlife adults abuse drugs and alcohol for different reasons than young people do, and age-specific addiction treatment better addresses the underlying issues behind substance abuse among older adults. A number of unique risk factors increase the chances of a midlife adult developing a substance use disorder.
Older adults who first used alcohol or drugs when they were between 17 and 20 are twice as likely as those who started using between the ages of 21 and 32 to develop a substance use disorder after they turn 50. Those who began using alcohol or drugs before the age of 16 are four times more likely to develop an addiction later on.
Alcohol is the main substance of abuse among midlife adults. Aging bodies may play a role in the development of an addiction. Older adults have less body water than young people, and this reduces their tolerance and increases their sensitivity to alcohol. Additionally, alcohol is metabolized more slowly in older people, resulting in a higher blood alcohol content for a longer period of time.
Midlife adults are more likely than young adults to experience life events involving loss, and these events can lead to substance abuse as a way to cope with the grief of losing a spouse or parent. Other kinds of loss can also trigger substance abuse, including the loss of a marriage through divorce. Retirement can leave older adults feeling isolated, bored and aimless, which may also contribute to substance abuse.
Older adults may begin grappling with chronic illness as they age, and this can lead to depression, isolation and a loss of mobility that can lead to substance abuse as a coping mechanism. Additionally, older adults on psychoactive medications like painkillers or sedatives can become addicted to those medications if they’re not taken exactly as prescribed by a physician.
Older men are more likely than their female counterparts to develop an alcohol use disorder, while older women are more likely than older men to become addicted to prescription drugs used to treat depression, anxiety or pain.
Among older adults, alcohol abuse far outnumbers most other types of drug abuse, including painkiller and heroin abuse. However, prescription drugs like hypnotics and sedatives that are prescribed for anxiety, seizures or insomnia are commonly abused by older populations.
Twenty-three percent of all drugs prescribed to older adults are benzodiazepines, which are sedatives that include drugs like Valium and Klonopin. These drugs are highly addictive, and using them with alcohol increases the risk of developing a substance use disorder.
These medications also pose a higher risk of injury due to falls, and they can cause problems with memory that may be incorrectly attributed to dementia.
Signs and Symptoms of Substance Abuse Among Different Age Groups
While some signs and symptoms of substance abuse are universal among all populations, others are more likely to occur among specific age groups.
Older adults are more likely than younger adults to use drugs or alcohol in secret.
They may observe rituals surrounding drinking, and they may drink even though they’re taking prescription medications that shouldn’t be used with alcohol.
They may complain of illnesses that appear to have no cause and which are unable to be diagnosed, and they may experience memory loss and confusion as a result of substance abuse.
Older adults are likely to respond with denial when confronted about their drug abuse.
Young adults who are abusing drugs or alcohol may have frequent mood swings, and they may be hostile or defensive when confronted about their use.
They’re likely to spend time in isolation when they’re not using, and they may begin neglecting duties at work and school.
Their group of friends may change, and they may experience changes in sleep and appetite.
A gradual decline in personal hygiene is another common sign of drug abuse among young people
On Denial: Why Different Populations Avoid Treatment
Nearly 22.7 million Americans had a drug or alcohol addiction in 2013, but only around 10 percent of them sought professional help. There are a number of reasons why people resist treatment, but some are more common than others among certain populations.
In general, older adults are more likely than younger adults to hide their substance abuse, and they’re less likely to seek help for an addiction. Midlife adults may resist treatment due to deeply held beliefs that addiction is a moral failing, largely stemming from the attitudes toward addiction in the mid-20th century and beyond. Older adults may feel like they’re already set in their ways, and many can’t imagine a life without drugs or alcohol. Some older adults feel like their substance abuse is a private matter and don’t wish to “air their dirty laundry” to strangers in treatment. Others don’t believe that treatment can work for them.
Denial in Younger Adults
Younger adults may resist treatment out of fear of what others, such as friends and family will think. They may be afraid of losing friendships or their job. Many are uninsured and unable to afford treatment. Despite these issues, young adults account for the highest number of treatment admissions, according to the National Institute on Drug Abuse. Currently, around 30 percent of young adults between the ages of 20 and 29 with a substance use disorder enter treatment, compared to just 11.7 percent of adults between the ages of 35 and 39 and 10.4 percent of adults aged 50 to 59.
One reason why young adults are more likely to enter treatment is that young people today have closer relationships with their immediate family, and their parents are more likely than parents of generations past to get involved and see that they get help for an addiction. Another reason is that young adults’ attitudes toward substance abuse and addiction are more permissive than older adults’, and they’re far less likely to stigmatize addiction or feel shame about getting help.
How Treatment Differs By Age
An age-specific addiction treatment program will address a wide range of issues common to people of a certain age.
Mid-life and Older Adults
Older adults typically benefit from a slower pace of treatment and non-confrontational types of therapy. Because midlife adults are often beginning or continuing on a spiritual journey, treatment for this age group may include non-religious spiritual teachings and practices, including meditation and yoga. Treatment for midlife adults with a spouse and children in the home will likely include family therapy to help restore function to the household. For retired empty-nesters, treatment may emphasize developing a greater sense of purpose in life and finding hobbies to stay busy. Twelve-step programs are common in addiction treatment programs, and this spiritually focused program is attractive to many older adults.
Young adult treatment focuses heavily on developing coping skills and practical life skills. In 2016, the number of young adults living with their parents surpassed other living situations for the first time in more than 130 years, according to Pew Research, and this can leave young people without the essential skills they need to succeed on their own. Life skills classes are common in young adult treatment programs, which may also emphasize educational and vocational rehab to help individuals find and maintain employment or return to school.
Since young adults abuse opioids at a much higher rate than older adults, a young adult treatment program is likely to offer medication-assisted treatment, which is the gold standard for treating opioid addiction. Medication-assisted treatment is a combination of medication and therapy that’s been shown to be effective for reducing illicit drug abuse, improving the chances of finding and maintaining employment, and helping to promote long-term recovery.
Twelve-step alternatives are popular in treatment programs for younger populations, who may not be as receptive as older adults to the 12-step model. More secular support groups like Smart Recovery may be more suitable for young adults.
How Treatment Works
Addiction treatment works by addressing the multiple needs of an individual. During treatment, a variety of therapies are used to address the:
- Underlying causes of the addiction
- Brain changes and dysfunctional thought and behavior patterns resulting from the addiction
- Legal, financial, health and relationship problems stemming from the addiction
Traditional Therapies and Cognitive Behavioral Therapy
The most commonly used traditional “talk” therapy in any addiction treatment program, regardless of age, is cognitive-behavioral therapy, or CBT.
CBT is an evidence-based treatment for addiction and mental illnesses like anxiety and depression.
It addresses faulty thought patterns that contribute to the unhealthy behaviors that accompany addiction. Changing dysfunctional patterns of thinking and behaving is an important foundation for long-term recovery.
The principles of cognitive-behavioral therapy are used in a variety of other traditional talk therapies that may be part of a young or midlife adult treatment plan, including:
- Family therapy, which helps individuals in treatment repair damaged relationships and restore peace and balance to the household
- Dialectical behavior therapy, which is used to treat trauma, which is a common underlying cause of addiction
- Motivational interviewing, which helps people identify their own personal reasons for wanting to recover from an addiction
- Acceptance and commitment therapy, which helps to treat trauma and fosters emotional regulation
Other traditional therapies used in treatment include pharmacotherapy, or the use of medication to treat addiction or symptoms of mental illness, and psychoeducational classes, which provide education and practical skills for issues surrounding addiction and mental illness.
Holistic Treatment in Recovery
The Substance Abuse and Mental Health Services Administration stresses that a holistic approach to treatment is crucial for successful recovery. Complementary therapies round out the treatment plan and help engage clients in the program. These therapies don’t treat addiction on their own, but they enhance self-awareness, promote emotional healing and offer hands-on experiences that facilitate meaningful change.
Many traditional and complementary treatment therapies take place in a group settings, which has been shown through extensive research to be highly effective for treating addiction.
Complementary therapies commonly used in high quality treatment programs include:
- Art therapy, which involves creating, viewing and talking about art. Art therapy helps to heal emotional wounds, and it reduces shame and stress.
- Adventure therapy, which is more common in young adult treatment programs. Adventure therapy takes place in the outdoors and involves a variety of hands-on activities that are physically and mentally challenging.
- Horticultural therapy, which is more common in midlife adult treatment programs. Horticultural therapy involves growing and tending to plants as a metaphor for self-care, and it reduces stress and promotes growth and change.
- Meditation, which promotes mindfulness, enhances spirituality, increases self-awareness and reduces stress.
- Yoga, which increases body awareness, reduces stress and promotes physical and mental balance and flexibility.
Group therapy promotes healthy relationships and provides a high level of peer support during early recovery. In an age-specific treatment program, group members are more likely to have issues and problems in common, which enhances feelings of camaraderie and belonging within the group. Young adult treatment groups will have a different focus and energy than midlife adult treatment groups.
Treatment Works No Matter The Age
Whether you’ve just turned 18 or you’re headed for 60, treatment can help end an addiction to drugs or alcohol. It’s never to late or too early to get help with an addiction. Many high quality addiction treatment programs offer age-specific treatment along with gender-specific groups.
Treatment helps transform your life on all fronts so that you no longer have a need to use drugs or alcohol. Treatment can help you find purpose and meaning in recovery, and improve your health and quality of life for greater happiness and well being.