2010/06/21 00:00:00
By Nanette Lavoie-Vaughan
Memory loss, disorientation, shaky hands, mood swings, depression, and chronic boredom are a normal part of aging for many. However, these behaviors sometimes signal something far more serious: substance abuse.
Alcohol or drug abuse is a silent epidemic among the elderly. The National Council on Aging estimates 3 million of the 35 million Americans over the age of 60 are alcoholics, and 12 percent of people over the age of 65 have a drinking problem. Eighty-three percent of seniors take prescription drugs, and more than half of those prescribed medications potentially are addictive painkillers and sedatives.
Several factors contribute to the risk for substance abuse in the elderly. Because of age-related changes in metabolism, the two to three drinks someone consumed at 40 might act like six to seven drinks at age 65. In addition, many seniors are battling chronic pain because of underlying medical conditions, and some turn to alcohol or drugs to deal with depression, grief, and social isolation.
Despite the knowledge that seniors are at higher risk for substance abuse, the problem remains under-diagnosed. Our parents’ generation believes the overuse of alcohol and drugs is a character flaw and something to keep hidden. As a result, many seniors hide their drinking and drug use or only admit to social drinking and prescribed-medication use. Health care providers and family members might attribute symptoms of substance abuse to aging or medical problems, or they might be reluctant to broach the subject with seniors.
If you suspect your parent might be abusing alcohol or prescription medications, look for the following signs:
- Chronic use of mouthwash or breath spray: Your parent may try to cover the smell of alcohol with breath deodorizers, mints, or gum.
- Frequent trips to the bathroom: Alcohol consumption can increase urination, or the bathroom also might be where prescription drugs are kept or alcohol is hidden.
- Unexplained falls: Both alcohol and prescription drugs can cause dizziness, unsteadiness, and lack of coordination.
- Fluctuations in blood pressure: Chronic use of alcohol or sedatives can cause blood pressure to drop suddenly or elevate gradually. If your parent already has high blood pressure, this can increase his or her risk of a stroke or a heart attack.
- Nausea and vomiting: Alcohol and prescription pain medication irritate the lining of the stomach and can cause ulcers and gastritis.
- New onset of incontinence: Alcohol use increases urination, and impaired coordination and urinary urgency can precipitate incontinence.
- Poor response to treatment for underlying medical conditions: Alcohol and drug use can affect treatment for diabetes, hypertension, gout, stroke, and dementia.
- Change in weight: Weight gain might result from the extra calories consumed from alcohol, and weight loss can result from loss of appetite or forgetting to eat because of cognitive impairment.
- Change in behavior: Agitation, irritability, and disinhibition are more common with the consumption of alcohol and prescription painkillers and sedatives.
Any of these signs should be cause for concern, and an honest and open discussion with your parent is essential to recognizing and treating the underlying problem. Make an appointment to talk with your parent’s health care provider, who should have access to specific screening tools for elder substance abusers for proper diagnosis and referral for treatment.
If your parent has a substance abuse problem, there are geriatric-specific treatment programs at most major hospitals and substance abuse treatment centers. The good news is older adults have greater attendance at therapy sessions, better medication adherence, and lower relapse rates than their younger counterparts.
To learn more about treatment of substance abuse in the elderly, visit www.aarp.org and www.ncoa.org.
About the Author: Nanette Lavoie-Vaughan is an adult nurse practitioner and professional consultant. She is a featured speaker at national professional conferences and writes about geriatrics for multiple publications.
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Copyright Nanette Lavoie-Vaughan and Military Officers Association of America. All rights reserved.
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