Alcohol is a culturally acceptable drug that is commonly overused and misused to cope with difficult life changes.  When people use a substance to change their mood, cope with problems or feel differently, they are at risk for abuse and addiction.  We know that alcoholism and addiction are diseases - not weaknesses or conditions that can be willed away.  Addiction requires treatment. 

The consequences of substance abuse in later life are much greater than in younger years, and if the abuse continues, all other problems (symptoms of illnesses, trouble in relationships, trouble with sleeping, changing moods, etc.) are likely to become more acute. 

Whatever the drug, dangerous substance misuse / abuse by older adults in our culture goes under-estimated, under-identified, under-diagnosed and under-treated.  This happens because of confusion of symptoms with other problems, lack of education, denial, ageism, myths, stigma and limited research and data.

The good news is that older adults have a higher recovery rate than any other group. 

Assure them that they have a treatable disease. Be supportive and not judgmental.  Suggest that they talk to their doctor and also contact support groups to obtain information, assistance and peer support.

Our most powerful weapon against substance abuse problems is education. Know these facts:

• Alcoholism is a disease.  Addiction is a disease.  People who are addicted are not “bad” people, they are sick people who need to get well.
• Denial is a strong force and also a primary symptom of addiction
• Intervention, withdrawal and after-care for older adults require careful planning due to the sensitive physical nature of the aged body system, and the need to mobilize effective support.
  
  

Substance use is an problem when:

• An individual denies that their use of the substance is causing problems
• It interferes with a person’s ability to function, perform tasks or carry out responsibilities
• Relationships are disrupted or destroyed
• It causes physical, cognitive, behavioral or mood problems
• It becomes a central activity or part of a daily routine
• It distracts from reality – is used as an escape
• An individual depends on the substance to get through the day

Symptoms of substance abuse and addiction problems include:

• Bumps, bruises or falls that are unexplained or suspicious
• Slurred speech, impaired balance
• Memory loss, black outs or vague recollections
• Depressed mood, anxiety, hostility
• Behavioral changes and mood swings
• Empty bottles of alcohol or medications
• Isolation or withdrawal
• Medical problems – complaints of gastrointestinal disturbances, fatigue, insomnia, malnutrition, hypertension, flaring symptoms of chronic illnesses
• Drinking in spite of warning labels on prescription drugs
• Often has the smell of liquor or mouthwash on his/her breath
• Neglect of personal appearance and dramatic weight fluctuations

In younger populations, intervention techniques may emphasize relationships and circumstances that will be removed with continued abuse of a substance. This approach is not suggested for most older persons. Remember that multiple losses are common and may have triggered the misuse / abuse of a substance.  Reframing recovery as an opportunity to regain community, health, relationships and support is much more effective. 

The stigma of addiction is particularly acute among older persons and language should be tempered accordingly.  Words like “alcoholic” or “addict” are labels that an older adult may consider offensive.  Peer support is more difficult to find for older persons in recovery but worth the search.

Education is another effective intervention tool.  Many older persons have no idea about the age- related changes that make their bodies more vulnerable to the effects of alcohol, drugs and medications.  They may not be aware of the negative interactions of drug and alcohol combinations; they fall into the problem completely by accident.  This makes the likelihood of denial particularly acute.