Hints, Tips & Advice

Substance Abuse in the Elderly (Part 1)

In terms of significant problems, substance abuse among our elderly is of epidemic proportions and it is one of the fastest growing health concerns we currently face. With approximately 35 – 40 million people in the US over age 65, and nearly 17% of those dealing with some form of substance abuse (this does not include the untold numbers of unreported abuse cases), and that figure expected to double by the year 2020, it can clearly be seen that an epidemic is at hand. (www.hazelden.org/web/public).

  Our elderly are not only abusing alcohol. Prescription and over-the-counter (OTC) medications in our society are out of control and causing significant medical issues through the combination of the above substances (alcohol and drugs). For example, “laxatives can cause chronic diarrhea, leading to sodium and potassium imbalance and cause heart rhythm irregularities.” (www.oasas.state.ny.us/AdMed/FYI/FYIInDepth-Elderly.cfm).

  The combination of medications can easily go unnoticed and certainly uncorrected, especially if the elder senior lives alone or has family that either does not notice the effects of the abuse. Also, sometimes we can be afraid to confront the elder.

  In referring to individuals who were born between 1946 and 1964 (the leading edge of the baby-boom generation), Frederic Blow, professor in the Department of Psychiatry at the University of Michigan and a Huss Research Chair on Older Adults and Alcohol/Drug Problems at Hazelden’s Butler Center for Research said, “These individuals have had more exposure to alcohol and illegal drugs, and there is more acceptance among them about using substances to ‘cure’ things. We expect to see an increase in drug and alcohol use; and more use means more problems.”

  As glum as the facts and statistics make it sound, there is hope. Dr. Blow states, “There is less shame and guilt associated with substance abuse now and more acceptance of treatment as a way to make things better.”

  One problem is the natural change in our bodies as we age. This tends to make elders more susceptible to the affects of alcohol and drug abuse. For example, as we age we become more sensitive to alcohol, and the affects of alcohol and drugs are heightened as we age do to less and less water in our bodies, thus creating a less soluble situation for these substances as they make their way through our systems.

    The Center for Substance Abuse Treatment has published a list of signs that may indicate substance abuse in our elderly:
•   Memory trouble after having a drink or taking medication
•   Loss of coordination (walking unsteadily, frequent falls, etc.)
•   Changes in sleeping habits
•   Unexplained bruises
•   Being unsure of yourself
•   Irritability, sadness, depression
•   Unexplained chronic pain
•   Changes in eating habits
•   Wanting to stay alone much of the time
•   Failing to bathe or keep clean
•   Having trouble concentrating
•   Difficulty staying in touch with family or friends
•   Lack of interest in usual activities

  With our elder folks consuming nearly 25% of the prescription medication, it is clear that we have a significant problem that must be addressed immediately. In next week’s Weekly Message, we will look at some of the suggestions for how best to identify and reduce this problem of substance abuse in our elderly.

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