Drug & Alcohol Problems After Age 60
Drug abuse is usually associated with youth, but studies indicate that a significant number of older Americans are drug dependent, and the problem is expected to get worse with the aging of the baby boom generation. Researchers have tentatively identified at least two scenarios: early onset and late onset addiction.
The typical early onset individual has a lifelong history of heavy alcohol consumption which begins to cause problems when, as a result of the aging process, the body can no longer handle the level of alcohol it once did. The late onset type may drink only a little, or not at all, in early life, but changes in health or lifestyle in later years lead them to abuse alcohol or other drugs as a way of managing sleeplessness or chronic pain.
Late Onset Common for Women
Men are more likely than women to develop drug problems as they age, and 75 percent have the early onset type. At least half of older women who develop drug problems, on the other hand, show no early signs of being vulnerable.
Late-onset problems among women are common and serious enough to require a concerted preventive effort, according to a report prepared by the National Center on Addiction and Substance Abuse at Columbia University (CASA). The study found that 10 percent of women over age 60 drank more than the recommended one drink a day, 7 percent consumed enough to put themselves at risk of alcohol abuse and nine percent were dependent on psychoactive prescription drugs.
Whether late or early onset, male or female, seniors who abuse drugs often have other health problems as well, including ulcers, urinary incontinence, hypertension, congestive heart failure, liver disease, kidney dysfunction, dementia, loss of interest in life, anxiety and depression. Excessive drug use also puts seniors at risk of automobile accidents, falls and suicide.
Unfortunately, most late-life drug problems either go undetected or are swept under the rug by family members embarrassed by Grandma's problems or by physicians not wanting to deprive her of one of life's remaining pleasures.
A major factor behind alcohol problems is a lower tolerance for alcohol that comes with age. Because they have a steadily decreasing lean body mass with increased fat content and a lower volume of water in the body, seniors show the effects of alcohol much more quickly than do younger persons. At any age, women are more vulnerable to the effects of alcohol and also become addicted sooner than men. After age 60, even two or three drinks a day can amount that would normally be considered moderate and often leads to dependence.
Alcohol problems also frequently creep up on either males or females who are taking prescription or over-the-counter medications that interact negatively with alcoholCeven at levels that caused no problems in their 40s and 50s.
The person with few social contacts who drinks alone is vulnerable to alcoholism; so is the one who drinks to relieve stress or depression. An individual troubled about illness or the loss of a spouse has good reason to feel depressed, and alcohol, a depressant, will only make the depression worse.
The early signs of alcoholism are similar to what family and friends may associate with aging and memory loss, trouble sleeping, upset stomach, lack of energy, irritability, self-neglect, falls and accidents. When a family physician doesn't recognize the tell-tale patterns and treats isolated symptoms by prescribing sleeping pills, tranquilizers or anti-depressants, the result may be dual addiction. The Columbia University report refers to a Atreacherous spiral staircase of stress, alcohol abuse, depression and psychoactive drug abuse.
Frequently abused or misused by older Americans are anti-anxiety, sedative and anti-depressant medications, narcotic analgesics and even over-the-counter pain medications such as acetaminophen and ibuprofen.
Dependence can occur more quickly than seniors realize. and efforts to discontinue the drug may prompt severe withdrawal symptoms.
Prevention, Detection Needed
Family physicians are usually in the best position to detect alcohol and drug problems. They need to recognize the early signs of substance abuse, think twice about the prescription of psychoactive medications for their older patients and, at the very least, monitor their use closely. Family, friends, pharmacists, social workers, nurses and home health aides all play a role in prevention and early detection.
When detected soon enough, drug problems of seniors can be successfully treated. In fact, studies suggest that older adults respond better than younger ones to treatment programs that are tailored to their needs. Treatment must usually be slower paced and less confrontational. An older adult, retired and with fewer family responsibilities, may not benefit from work and social skills training or even family involvement in therapy. She may need help, however, with issues such as social isolation, financial pressures, illness and the loss of a spouse. One study found that seniors did better in programs with an individual focus, flexible discharge rules and extensive mental health aftercare.
Rather than denying an older person Aone of life's remaining pleasures,and successful treatment can be a breakthrough to a longer, more satisfying life.