Seniors and Substance Abuse: The Invisible Epidemic
Laura never imagined it could happen to her, but it did.
At age 70, she was diagnosed with a substance abuse disorder. Having always been a social person, once retired, Laura enjoyed having more time to meet up with friends and attend the many activities offered at her community’s clubhouse. She was not much of a drinker, though, and when she and her husband shared a bottle of wine over dinner, Fred would typically consume most of the bottle. But all that changed after Fred’s death. Laura found herself feeling lonely and isolated, as she could no longer bear socializing with her usual group of friends who still had their spouses. She consoled herself by drinking wine at dinner, as she and Fred had typically done.
Among seniors age 60 and older, the Substance Abuse and Mental Health Services Administration (SAMHSA) recently reported that about 17% are abusers of alcohol and drugs, and this number is expected to double by 2020.-Rita MiliosBefore long, Laura had joined others like herself in the senior (65+) population that the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the American Geriatrics Society describe as “risky drinkers”, those who regularly consume more than seven drinks per week or more than three drinks in a single day. Statistically, about 9% of people age 65 and older drink more than 30 drinks a month and more than 4 drinks in any one occasion.
According to a Census Bureau report in 2010, there were 40.3 million people age 65 and older living in the U.S., more than recorded in any previous census. Between 2000 and 2010, the population among those 65 years and over increased at a faster rate (15.1 percent) than the total U.S population (9.7 percent).
Among seniors age 60 and older, the Substance Abuse and Mental Health Services Administration (SAMHSA) recently reported that about 17% are abusers of alcohol and drugs, and this number is expected to double by 2020.
Clearly, we have an epidemic of substance abuse among seniors.
Common Substances Abused by Seniors and the Associated Problems
Problems stemming from alcohol consumption, including interactions of alcohol with prescribed and over-the-counter drugs is one of the fastest growing problems facing seniors today.
Alcohol was the most frequently reported primary substance of abuse for seniors. But people 65 and older also consume more prescribed and over-the-counter medications than any other age group in the United States. About 17 to 23 percent of drugs being prescribed to seniors fall into the category of benzodiazepines, which affect the central nervous system and are often prescribed to reduce anxiety or to help with sleep problems.
Prescription drug misuse and abuse is prevalent among older adults not only because more drugs are prescribed to them but also because, as with alcohol, aging makes the body more vulnerable to the effects of drugs. Older people can more easily feel “high” from drinking or taking prescription drugs, and this can lead to a greater risk of injury from accidents, such as falls or auto accidents.
Other risks associated with mixing alcohol and prescription drugs include:
- Risk of stomach bleeding
- Excessive drowsiness
- Potential liver damage
- High blood pressure
- Memory loss
- Increased risk for stroke
- Increased risk of depression
Our Overly-Abusing yet Under-Diagnosed Senior Population
Despite the fact that we are in the midst of an epidemic of senior substance abuse, there has been surprising little alarm raised by doctors and other clinicians who regularly see seniors as patients. Because of insufficient knowledge, limited research data, and hurried office visits, healthcare providers have, until relatively recently, often missed or dismissed red flags that could indicate substance abuse among seniors.
Another reason that clinicians may fail to suspect or adequately check for substance abuse issues when evaluating their senior patients is that the symptoms of substance abuse can mimic the symptoms of other serious physical conditions, such as heart disease, diabetes, dementia or depression that are commonly seen in this population. Grief, which naturally has a higher prevalence in an older population, can create symptoms that are very similar to substance abuse as well. So sorting through the different symptoms and coming up with an accurate diagnosis of substance abuse in seniors is extremely challenging for health professionals.
Stereotyping and ageism are other barriers to spotting alcohol problems in older adults, and are present in the attitudes of both medical professionals and seniors themselves.
The use of alcohol, more so than the use of prescription drugs, may be minimized among health professionals. There is an unspoken but pervasive assumption that there is not as much urgency to treat older adults for alcohol misuse because they are nearing the end of life (so why not let them enjoy this indulgence?). The overuse or misuse of prescription drugs is taken more seriously.
Seniors, too, have changed their views regarding the stigma of alcohol and drug use. Older seniors, born between 1930 and 1950-60, who may have been influenced by Prohibition and a stricter moral code, are less likely to misuse drugs or alcohol than their younger counterparts, who were influenced in their younger years by the “cultural revolution” of the 60s.
How Seniors can Help Themselves
The National Institute on Aging offers the following sensible lifestyle suggestions for seniors who may be faced with a problem of alcohol misuse:
- Remove alcohol from your home
- Eat food when you are drinking—don’t drink on an empty stomach
- Avoid drinking when you are angry or upset, or if you’ve had a bad day
- Avoid people who drink a lot and the places where you used to drink
Further intervention may be needed for alcohol abuse or for prescription drug misuse or abuse:
- Seek counseling
- Attend 12-Step or other support group meetings
How Family Members can Help
Seniors should also make their families aware if they are struggling with an alcohol or drug abuse issue.
Families can help by:
- Providing emotional support and an opportunity to talk
- Helping the senior family member access information and resources
- Encouraging and assisting seniors in accessing the help of counselors or a support group (ex: driving them to meetings; attending meetings with them)
The senior years should be a time of fulfillment and enjoyment. While health issues and lifestyle changes must be accommodated, there is no reason to let substance abuse interfere with this valuable time in one’s life.
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