Middle-Aged Alcohol and Drug Abuse

Couple working through Middle-Aged Alcohol and Drug Abuse

Middle-Aged Alcohol and Drug Abuse mortality rates are on the rise, but this bucks the image of it mainly affecting the younger generations. In general, alcohol and drug abuse are thought to be the most problematic among younger generations, as statistics on the prevalence of substance use typically reflect this.

For instance, in 2014, only 5.4% of middle-aged Americans ages 45-64 were dependent on or abused alcohol in the past year compared to 12.3% of those ages 18-25. And only 1.6% of middle-aged Americans were dependent on or abused illicit drugs compared to 6.6% of the younger generation. [1]

However, in the past couple of decades, an alarming trend of all-cause mortality among white non-Hispanic, middle-aged Americans has increased. The suspected culprit? Substance abuse and related causes. More specifically, researchers suspect this increase in mortality is primarily due to drug and alcohol overdoses, suicide, and cirrhosis and other chronic liver diseases. [2, 3]

This increase in mortality among white middle-aged Americans is particularly unexpected in this day and age. With advances in healthcare and overall increased lifespan, the expectation is one of increased longevity, not decreased.

It is important to note that in the research cited, no similar increase in all-cause mortality was seen in other age groups, ethnic groups, or rich countries. Furthermore, the researchers note that the increased mortality was most pronounced among those white middle-aged Americans with lower educational attainment. [2, 3]

Contributing Factors Middle-Aged Alcohol and Drug Abuse

The increase in midlife morbidity and mortality among white Americans is only partly understood. However, the following factors are thought to contribute to morbidity risk in this population. Many of which are interrelated and may be linked to substance use: [2, 3]

  • Chronic pain
  • Opioid use and the opioid crisis (More than 16,000 people died from prescription opioid overdoses in 2013)
  • Inability to work
  • Decline in physical health
  • Decreased liver function
  • Psychological distress and decline in mental health
  • Decline in ability to conduct activities of daily living, for example walking, climbing stairs, standing, sitting, shopping, and socializing with friends
  • Financial and economic insecurity

Economists Anne Case and Angus Deaton have dubbed those currently middle-aged a potential “lost generation,” whose future is less favorable than those generations who preceded them.

They note that as this cohort ages into Medicare, they may be in worse health than the currently elderly if this epidemic is not brought under control. This could be a substantial drain on Medicare and disability funds in coming years. [2, 3]

Man staringFurthermore, the economists compare this epidemic to the AIDS epidemic and note that with public awareness, behavioral change, and drug therapy, the AIDS crisis was brought under control.

Similar strategies that are both preventative and treatment-focused are needed to help this population overcome this crisis. [2, 3]

Health care providers often overlook substance abuse and misuse among older adults. It is important to acknowledge that as middle-aged Americans grow older diagnosing a substance abuse issue may be more difficult.

Frequently, symptoms of substance abuse in older individuals sometimes mimic symptoms of other medical and behavioral disorders common among this population, such as diabetes, dementia, and depression.

Because middle-aged Americans are growing older, and because the number of older adults with substance abuse problems is expected to grow, it is important for public health officials and policymakers to monitor the treatment needs of this population closely. [4, 5]

About the Author:

Chelsea Fielder-JenksChelsea Fielder-Jenks is a Licensed Professional Counselor in private practice in Austin, Texas. Chelsea works with individuals, families, and groups primarily from a Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) framework. She has extensive experience working with adolescents, families, and adults who struggle with eating, substance use, and various co-occurring mental health disorders. You can learn more about Chelsea and her private practice at ThriveCounselingAustin.com.


  1. Substance Abuse and Mental Health Services Administration. (2016). Behavioral Health Barometer, United States, 2015. Retrieved from https://store.samhsa.gov/shin/content//SMA16-BARO-2015/SMA16-BARO-2015.pdf on 2018, July 25.
  2. Case, A., & Deaton, A. (2015). Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences of the United States of America, 112(49), 15078–15083. http://doi.org/10.1073/pnas.1518393112
  3. NIDA. (2016, January 28). Saving a “Lost Generation”: The Need to Prevent Drug and Alcohol Abuse in Midlife. Retrieved from https://www.drugabuse.gov/about-nida/noras-blog/2016/01/saving-lost-generation-need-to-prevent-drug-alcohol-abuse-in-midlife on 2018, July 25.
  4. Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (June 17, 2010). The TEDS Report: Changing Substance Abuse Patterns among Older Admissions: 1992 and 2008. Rockville, MD
  5. Center for Substance Abuse Treatment. (1998). Substance abuse among older adults (Treatment Improvement Protocol [TIP] Series 26, DHHS Publication No. SMA 98-3179). Rockville, MD: Substance Abuse and Mental Health Services Administration.

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on October 8, 2018
Reviewed by Jacquelyn Ekern, MS, LPC on October 8, 2018

Published on AddictionHope.com

About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.