SUBSTANCE ABUSE AMONG THE ELDERLY A REAL PROBLEM

Older adults are often overlooked when it comes to addressing the misuse
and abuse of alcohol and other drugs.

Even when adult children suspect that a parent is drinking a bit too much,
the attitude tends to be either "Why bother to change things now?" or "A
little alcohol won't hurt, and it may make the days a little kinder for mom
or dad." Denying or dismissing this problem is an unfortunate response to
an otherwise treatable problem.

"The truth is alcohol and other drug abuse among older people leads to
great physical and emotional deterioration and deprives them of the chance
to enjoy their later years," said Carol Colleran, director of Older Adult
Services at Hanley-Hazelden Center at St. Mary's in West Palm Beach, Fla.

Determining the incidence of older adults who abuse alcohol or other drugs,
particularly prescribed medications, is difficult. Given that about 10
percent of the general population has a substance abuse problem and that
older adults have numerous factors that put them at risk for alcohol and
other drug abuse/misuse, it's probably safe to say that about 10 percent of
the elderly population experience a substance abuse problem. Some estimates
suggest that the majority of older adult problem drinkers go undiagnosed.

The number of older adults who abuse alcohol and other drugs today is no
match for what's ahead. By the middle of this century it is estimated that
one-quarter of the population in the United States will be over 65. In
seven years, the leading edge of the baby boomers will be eligible for
Social Security, so an unprecedented number of individuals will face health
problems related to substance abuse and addiction.

What factors contribute to older adult abuse of alcohol and other drugs?
Older adults are more prone to unintentionally misusing prescription drugs
because of memory loss, impaired thinking or not understanding dosage
instructions.

Older adults also suffer from higher rates of depression, grief and loss,
physical pain, reduced mobility, poor social support and boredom. These
factors contribute to alcohol and other drug dependency, because older
adults may seek chemicals to help cope with physical and emotional problems.

Age-related changes, though perfectly normal, make older adults more
susceptible to chemical dependency and other negative consequences. One
example is the change in body mass and lowered efficiency in processing
alcohol or prescription drugs. The result: Older adults may drink less but
feel a greater effect. Drugs can build to a toxic level in bodies that
function more slowly.

When older adults increase alcohol consumption, negative consequences
result much more quickly. Chronic illnesses and use of medications
complicate the picture for older adults. Combining prescription drugs with
alcohol can be extremely dangerous, because alcohol can quadruple the
effect of a prescription drug.

Barriers to getting good care are plentiful for older adults. Physicians
often do not have time to ask the questions necessary to identify older
adults who are experiencing substance abuse problems. Family members often
don't want to confront elderly parents. Friends and neighbors don't want to
interfere.

What's more, older adults may well view their own drinking with shame and
guilt. They can be sensitive about confrontation and what they might view
as invasions of privacy. In addition, few treatment centers offer
elder-specific services that address the unique issues of older adults.