In this episode of Specifically for Seniors, host Laurence I. Barsh sits down with Dr. Lee Tannenbaum, a physician and healthcare leader whose career has been devoted to improving addiction treatment across the lifespan. Together, they confront a growing but often invisible crisis: substance misuse among older adults. While addiction in the United States is frequently portrayed as a youth-driven epidemic, this conversation reveals a more complex and urgent reality—one in which seniors are increasingly vulnerable to alcohol misuse, cannabis overuse, and the abuse of prescribed medications.
As Americans live longer and face deepening isolation, many older adults find themselves navigating chronic pain, grief, and the challenges of polypharmacy. These factors not only increase the risk of addiction but also complicate diagnosis and treatment. Yet the healthcare system, still largely calibrated to younger populations, often fails to recognize or respond to these issues with the nuance they demand.
Dr. Tannenbaum, Senior Medical Director at ARS Treatment Centers, shares insights from decades of experience designing methadone and buprenorphine-based treatment programs, shaping policy, and managing clinical operations through crises like COVID. He and Laurence explore how addiction trends have shifted over the past decade, which substances are driving the most harm, and how mental health challenges intersect with substance use—particularly in aging populations.
They discuss how addiction manifests differently across age groups, regions, and racial demographics, and why older adults are frequently misdiagnosed or overlooked. Dr. Tannenbaum outlines the substances most commonly misused by seniors—alcohol, prescription medications, and increasingly, cannabis—and explains how confusion, falls, and even death can result from unrecognized dependence. He also highlights the role of grief, chronic illness, and social disconnection in triggering substance misuse later in life.
The conversation turns to the clinical blind spots that caregivers and providers often miss, the cultural and systemic barriers that prevent older adults from accessing care, and the need for treatment centers to adapt their models to better serve aging populations. Dr. Tannenbaum offers a detailed look at treatment protocols for seniors, including approaches to managing alcoholism and benzodiazepine dependence in private practice.
They also examine the political landscape, including the impact of recent federal initiatives like the Executive Order titled “Ending Crime and Disorder on America’s Streets,” and how such policies affect harm-reduction strategies and medication-focused treatment approaches. Dr. Tannenbaum shares his concerns about governmental overreach and the erosion of programs like needle exchanges that have proven effective in reducing harm.
Listeners are invited to explore more of Dr. Tannenbaum’s work at addictioncoa.com, and to tune into his podcast, co-hosted with his daughter ,You Don’t Have Struggle (https://open.spotify.com/show/51NIjdp4uhQ1wQ9e1dyYCb) where they delve deeper into addiction medicine, treatment innovation, and the evolving challenges of care.
This episode is a call to action: to recognize that addiction doesn’t retire at 65—it evolves. And if our systems are to meet the moment, they must evolve too.
Dr. Tannenbaum's Book
The Addiction Conspiracy: Unlocking Brain Chemistry and Addiction So You Don't Have To Struggle (https://a.co/d/hDQzAfW)