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Online counseling services are not intended to take the place of traditional face-to-face therapy, treatment, or help persons in crisis. See cautionary information.
If you are in crisis call 911, or 1-800-SUICIDE, or go to the Emergency Room of a hospital, or seeking other immediate help.
All services provided by Jan Williams, a licensed addictions counselor and member of the Licensed Clinical Professional Counselors of Maryland.
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Addictions counseling online has limitations and is not for everyone. See Cautionary Information for more.
Overview of Alcohol and Other Drug (AOD) Problems in the Elderly
35 million people in the U.S. are 65 or older (13%). This number will increase to 20 percent by 2030, or approximately 70 million people (baby boomers). Alcohol or other drug problems (AOD) are present in an estimated 10 percent of all cases treated by geriatric mental health facilities. It is estimated that 17% of the over-65 adults have an alcohol-abuse problem. Drug and alcohol problems in seniors are underestimated, underdiagnosed and undertreated in the U.S.
Barriers to Help for Elderly with AOD Problems
There are many factors playing into the problem of underdiagnosis and lack of treatment of drug and alcohol problems in the elderly. Here are some of the factors:
- Ageism, the tendency to assign symptoms of substance problems in the elderly to problems associated with being old rather than exploring drug or alcohol use as a cause.
- Lack of knowledge of drug and alcohol disorders, and their signs and symptoms, on the part of the elderly themselves, their significant others, and their physicians and other medical service providers.
- Diagnostic indicators of AOD problems do mimic common medical problems often present in the elderly:
- Memory loss, cognitive impairment
- Depression, anxiety
- Neglect of hygiene, appearance
- Poor appetite, nutritional deficits
- Sleep disruption
- Hypertension
- Seizures
- Impaired balance and gait, falls
The AOD problem in seniors is compounded by interaction of alcohol with over-the-counter (OTC) drugs often taken by seniors along with drugs prescribed by their physicians. The elderly older adults make up 13% of the population but account for almost 30% of all prescribed drugs.
Thus an individual could be taking a sedative drug such as Ambien or Lunesta, prescribed by a doctor to promote sleep, another doctor prescribed pain reliever for arthritis pain, such as Vicodin, and an OTC drug for head cold congestion, such as Benadryl (an antihistamine). All three of these drugs have central nervous system depressant effects, that is, sedative effects that can cause drowsiness, confusion, memory loss, staggering, falls, and depression. These symptoms could easily be mistaken for Alzheimer’s disease.
In addition to these factors, seniors do experience natural age-related changes that contribute to AOD problems:
- Decrease in lean body mass (more fat) and body water, meaning that there is significantly less body fluid to dilute the AOD introduced into the body.
- Decrease in metabolic efficiency to detoxify alcohol (less of the enzyme, dehydrogenase that breaks down alcohol in the body), and lessened efficiency of the liver to metabolize other drugs (e.g., benzodiazepines).
Due to these changes, a senior should be prescribed about half the usual adult dose of an anxiety reducing drug such as Xanax. Similarly, a person who drank 2 martinis before dinner for many years, may find that amount to cause serious intoxication as he/she ages, and may need to take half that amount.
