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Elderly in crisis turn to alcohol, drugs to cope

By Kate York

Marietta Times, September 19, 2003

Where do you turn when your partner in life is gone, your children are busy with their own families, and there is no job to get you up and out the door each morning?

For an increasing number of America's senior citizens, the answer is drugs and alcohol.

Experts estimate about 10 percent of the 30 million senior citizens in the country abuse alcohol, while up to 20 percent abuse illegal or prescription drugs.

The substance abuse often begins at an age when many are most vulnerable.

"I started drinking more than I ever had before after my wife passed away," said 71-year-old Marietta resident Henry, who asked that his last name not be used.

"I wasn't drinking huge amounts, but it was every day, and I was dependent on it. I really had nothing else to do, and I wanted something to make me feel better."

Henry was able to get help when his adult children noticed the change in his personality from affable and easygoing to moody and depressed and thought there might be more to it than grief.

Alcoholism or other substance abuse in seniors isn't always so easy to diagnose, making it even more dangerous. It's an issue that those who work in substance abuse hope people will recognize so those who suffer can get help.

"It's a hidden problem," said Ron Rees, executive director of the Washington County Mental Health and Addiction Recovery Board. "If the person is retired, they're not in a workplace where their actions can be observed. They may not see anyone on a daily basis. And if they do, those behaviors can be confused with other medical problems."

The elderly are also much less likely to commit crimes while under the influence, one of the leading ways abusers are led to seeking treatment, he said.

There are two primary areas of elderly substance abuse, said Charlie Hasse, director of Behavioral Health Services at the Center for Chemical Dependency at Marietta Memorial Hospital.

"There is abuse of prescription and over-the-counter drugs and then abuse of alcohol or interactions between alcohol and prescriptions," Hasse said. "It's estimated that 20 percent of over-the-counter medication is purchased by the elderly and 33 percent of prescriptions are used by the elderly."

Illegal drug use is also on the rise as those in the baby boomer generation, who used more illegal drugs than their parents, take those habits with them as they grow older.

In many cases, abuse of prescription drugs may be unintentional, Rees said.

"Sometimes people may intentionally abuse the drugs they have for legitimate reasons, but sometimes they're on different drugs from different doctors and the mix is a bad one," he said. "Sometimes elderly people may forget which medications they're on, or accidentally take the wrong amount or even an old medication."

Pamela Sheppard, 31, of Marietta realized her grandmother was taking a dangerous mix of pills several years ago after multiple visits to the family physician.

"She wasn't feeling well pretty much all of the time, was rapidly losing her memory and just slipping away," Sheppard said. "We thought it was just an aging issue, but ultimately we began to watch her more closely and discovered she was taking too many pills at once and a medication her doctor had told her to discontinue."

Detection of the problem took some time, she said.

"She was living alone and while we would visit it was impossible to monitor everything," Sheppard said. "It made us realize how easily this can happen."

Marietta Memorial Hospital has conducted sessions with seniors citizens during which a pharmacist reviews seniors' medications and plans to continue the programs, Hasse said. The sessions may help eliminate confusion, he said.

Health ramifications of substance abuse are even more severe for the elderly than for younger people since they have weakened immune systems and an increased risk for illness or infection. For instance, the mortality rate from cirrhotic liver disease is 45 percent for the elderly and only 22 percent in the general population, according to the U.S. Department of Health and Human Services.

Seniors typically become dependent on alcohol or drugs because of severe life changes, said Rees.

"There are so many challenges in the later years," he said. "They may have health difficulties, have lost their spouse, have financial problems or be very isolated socially. That makes them a lot more vulnerable to substance abuse than they would have been at other points in their life."

When the elderly abuse alcohol it is in smaller quantities than when young people abuse alcohol, Hasse said.

"When you get older, you can no longer tolerate large quantities of alcohol," he said. "It might not appear to be too much, but if they're drinking one or two drinks a day there may be a problem."

Even in such small amounts, if the person stops drinking after doing so on a daily basis, they will likely suffer symptoms of withdrawal, including a change in blood pressure and mental confusion, Hasse said.

"This is sometimes discovered if they come into the hospital because they had never before stopped for long enough to see if there were symptoms of withdrawal," he said. "In that case, we sometimes have to put them in detox before they can have surgery because it affects the amount of anesthesia they need."

Local experts say involvement is the key to detecting substance abuse in the elderly, whether by going along on a doctor's appointments, making sure they are involved in community activities, or just being present often enough to notice their habits and any changes in behavior.

"The more involvement people have with their senior citizens the better it is for everyone," said Rees. "In most other cultures, senior citizens are revered for the knowledge they have. In American culture, they don't get the honor they deserve."

Elderly in crisis, telltale signs:

  • Difficulty walking.
  • Memory changes.
  • Seizures.
  • Injuries or falls.
  • Malnutrition.
  • Poor hygiene or self neglect.
  • Liver function abnormalities.
  • Confusion.
  • Rapid mood changes.
  • Difficulty with words.

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