Spotting Substance Abuse in Seniors

Studies show that as many as 17 percent of American seniors may have alcohol abuse problems or alcoholism, yet this group is greatly underrepresented in addiction treatment programs.

Studies also show that when seniors do participate in addiction treatment programs, they show greater than average treatment compliance, are more likely to finish a recommended course of treatment and more likely to avoid relapse. Treatment for seniors works, but too many seniors never get the treatment they need.

Why Don’t More Seniors Get the Help They Need?

A number of factors reduce the likelihood of drug rehab participation, such as:

• Family members and even doctors often misattribute certain indicators of substance abuse in seniors, such as memory loss or confusion, aches and pains, and falls as normal signs of aging.

• Seniors less frequently run afoul of law enforcement, and so the courts rarely intervene.

• Seniors are often out of the work force and thus, beyond the reach of employee assistance programs or concerned coworkers.

• Seniors are more likely to be socially isolated. As a result, they may abuse alcohol or prescription medications without anyone’s awareness.

• Family members may feel reluctant to intervene, thinking that “it’s too late” or they are “too old to change.”

• Family members or even doctors may feel that seniors “deserve to enjoy themselves” in their old age.

• Seniors may feel greater embarrassment than younger adults about their drug or alcohol abuse. Many seniors grew up within a social context that viewed alcohol or drug abuse as “immoral” or a “weakness of character” rather than a health condition.

• A lack of mobility may deter treatment participation (seniors may need assistance in getting to and from treatment sessions).

• Seniors may feel their impaired hearing or vision makes participation in drug rehab treatment impossible.

The Consequences of Continuing Alcohol or Drug Abuse by Seniors

Although some health professionals and family members may enable continuing drug or alcohol abuse through tacit support, alcohol and drug abuse by seniors can greatly reduce health, well-being and quality of life. Letting a senior “enjoy herself” in her old age is not a kindness.

Some consequences of alcohol and drug abuse by seniors include:

• Physical injuries – The abuse of alcohol or prescription medications can lead to diminished coordination and an increased likelihood of injury from falls. Since bone strength is greatly reduced in older adults, falls can lead to broken bones, decreased mobility, and a reduction in overall health and well-being.

• Mental health problems – Seniors who abuse prescription drugs or alcohol are at a greater risk of depression and other mental health disorders. Seniors who abuse alcohol are at an increased risk to commit suicide.

• Cognitive declines – The abuse of alcohol and prescription medications can lead to memory problems, confusion and in some cases, irreversible cognitive declines. These symptoms of substance abuse are often misdiagnosed as signs of normal aging. Many cognitive declines associated with substance abuse are reversible with abstinence.

• Nutritional deficiencies – The abuse of alcohol or prescription drugs is often associated with a decrease in the quality and often quantity of nutritional intake. Alcohol and certain drugs can also compromise the body’s ability to absorb or process certain vitamins and nutrients.

• General health declines – The abuse of alcohol is associated with increased gastrointestinal problems, which are a common cause of hospital visits among older adults. Alcohol reduces cardiovascular and liver health and functioning, and is associated with increased risks for a host of cancers. The greater the consumption of alcohol, the greater the risk of cancer.

• Sexual dysfunction – Alcohol abuse lowers testosterone levels in men, which can lead to erectile dysfunction in older men.

Seniors are more susceptible to the effects of alcohol and prescription drugs. They do not metabolize these psychoactive substances as well or as quickly as younger people, and they are more likely to mix alcohol or psychoactive medications with other medications that can result in dangerous drug interactions. What may not seem like excessive drinking in an older adult may in fact be enough to cause significant intoxication and serious health consequences.

Learning to Spot Substance Abuse in Seniors

Once in treatment, seniors tend to stay committed to their long-term recovery. Convincing a senior who is abusing drugs or alcohol to get addiction treatment can lead to increased health and cognitive functioning, a decrease in the risks of mental health disorders, and in many cases, to additional years of life.

If an older adult you know and love is drinking too much or abusing medications, you can and should intervene.

Two Kinds of Older Alcohol Abusers

There are, in broad terms, two kinds of older alcohol abusers. The first type is a lifetime heavy drinker or alcohol abuser who continues to drink heavily into older age. This type of alcohol abuser often has a medical history that includes episodes of alcohol-related medical care or addiction treatment. This type of older alcohol abuser is more likely to receive intervention in older age.

The second type of older alcohol abuser is the late-onset alcoholic. These older drinkers tend to start drinking after a major life change, such as retirement, the loss of a spouse, new care-giving roles or a loss of mobility due to health deficits. Isolation, especially after the death of a spouse, is a risk factor, as is retirement and a sudden increase in free time for drinking.

Older women who abuse alcohol are frequently late-onset alcoholics. Family members and health professionals are more likely to misinterpret signs of substance abuse in late-onset alcoholics as normal signs of aging.

Signs of Substance Abuse by Seniors

• Weight loss or a sudden change in eating habits
• Unexplained bruises or frequent falls and physical injuries
• Walking with reduced coordination
• Increased mental confusion or memory problems
• Increased time spent in isolation
• A reduction in personal hygiene
• Depression or persistent sadness
• A decrease in interest or participation in hobbies or activities that used to be enjoyed
• A change in sleeping patterns
• Chronic pain
• A reduction in efforts made to stay in contact with family members
• A change in personality
• Fatigue

Investigate signs of substance abuse and if warranted, help an older adult you love get the addiction treatment he or she needs to enjoy a healthy and fulfilling life as a senior citizen.