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 who counsels older adults in treatment.

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 addiction 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.

However, when treatment is provided older adults tend to do very well, at least as well or better than their younger cohorts. Older adults tend to comply with requests to go to treatment, and they finish treatment at a greater rate than younger adults. And, because more people are living far longer lives, the flawed argument that someone is too old to change or too old for treatment is even more flawed.

It's never too late to get help. Physicians, treatment centers, and other helping professionals can provide resources for getting help. To get a free copy of the Hazelden pamphlet, How to Talk to an Older Adult Who Has a Problem with Alcohol or Medications, call 1-800-I-DO-CARE or read it online.

--Published July 16, 2001