All medications sold in the U.S. can be divided into two categories:
Prescription drugs that require a prescription to be sold...
Nonprescription or over-the-counter drugs that do not require a prescription from a doctor
For seniors, substance abuse can occur quite innocently. It is extremely important that medications are taken as prescribed. If taking several meds, be sure to consult with physician to determine what side effects may occur as well as the interactions from other meds being taken. It is not a good idea to take meds without consulting with the doctors involved with your care.  All caregivers should be aware of all medications taken and how they are prescribed. Do not allow yourself or anyone else to decide to increase or decrease your meds without consulting with the prescriber.

Substance abuse, particularly of alcohol and prescription drugs, among older adults is one of the fastest growing health problems facing the country. Yet, even as the number of older adults suffering from substance abuse climb; the situation remains underestimated as a result of being under-identified, under-diagnosed, and undertreated. 17 percent of people in the United States over 65 years old have abused prescription medications, according to the Office of Alcoholism and Substance Abuse Services. The following areas of abuse should be of concern.

Problems stemming from interactions of alcohol with prescribed and over-the-counter drugs far outnumber any other substance abuse problem among older adults. 

 Reports further indicate that a far greater concern for drug misuse or abuse is the large number of older adults using prescription drugs, particularly benzodiazepines, sedatives, and hypnotics, without proper physician supervision.

Symptoms of drug abuse can be hard to recognize in older adults. This is because abuse symptoms are similar to symptoms of aging. For instance, confusion and memory loss are symptoms of both. Other factors responsible for the lack of attention to substance abuse include the elderly persons’ reluctance to seek professional help. The relatives of older individuals with substance abuse issues, particularly their adult children, are often ashamed of the problem and choose not to address it.  Older adults who "self-medicate" with alcohol or prescription drugs are more likely to characterize themselves as lonely and have less life satisfaction.  The reality is that misuse and abuse of alcohol and other drugs take a greater toll on affected older adults; because they may elevate their already high risk for injury, illness, and socioeconomic decline. 

Potential causes/triggers for drug or alcohol abuse in the elderly are:
Death of a family member, spouse, pet or close friend
Loss of income or financial strains
Relocation or placement in a nursing home

Trouble sleeping
Family conflict
Mental or physical health decline (depression, memory loss, major surgeries, etc.)
Signs of elderly drug abuse to look for include:
1)   Memory problems
2)  Changes in sleeping habits
3)  Unexplained bruises
4)   Irritability, sadness, depression
5)   Unexplained chronic pain
6)   Changes in eating habits
7)   Wanting to be alone often
8)   Failing to bathe or keep clean
9)   Losing touch with loved ones
10)  Lack of interest in usual activities
11)  Get a prescription for the same medicine from two different doctors.
12) Fill a prescription for the same medicine at two different pharmacies.
13) Take more of a medicine than they used to or take more than is instructed on the label
How to get help: Should you suspect that an older adult is abusing a prescription drug or alcohol, contact their doctor right away. Tell them about your concerns. The doctor will likely make an appointment to evaluate the person and determine a treatment plan or rehab facility. Questions you might ask your doctor to prevent abuse include:
·        Do I take any medicines that could cause a drug interaction?
·        What should I do if I feel like I’ve become dependent on a medicine?
·        What is the best way to organize medicines so I don’t make a mistake?
·        What are the symptoms for prescription drug abuse?
·        How do I know if I need help? 
-Center for Substance Abuse Treatment. Substance Abuse Among Older Adults. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1998. (Treatment Improvement Protocol (TIP) Series, No. 26.) Chapter 1 - Substance Abuse Among Older Adults: An Invisible Epidemic. Available from:
-National Association of Addition Providers