Substance Abuse and the Elderly
Substance abuse in the elderly exists just as in any other population. Many seniors develop substance abuse problems due to circumstances or situations due to the aging process. A report by the Center for Substance Abuse Treatment/Substance Abuse and Mental Health Services Administration indicates that 17% of adults age 60 and older are affected by alcohol abuse and abuse of legal drugs. The report also states that a third of those seniors who abuse substances did not have a substance abuse problem in their earlier years. People usually think of substance abuse as using illegal drugs and young people as the most common abusers. People do not think of seniors as abusers of drugs. As a result, the issue of substance abuse by seniors has been under-researched and the number of seniors who use substances is much higher than reported. In 2000, an estimated 568,000 persons aged 55 or older had used illicit drugs in the past month and over 5 million were "binge" alcohol users, including more than 1 million who were heavy alcohol users. The number of substance users among older adults is likely to increase in the coming years due to the aging of the "baby boom" generation. (NHSDA Report, 2001) Reports states that more than one substance may be used by seniors, alcohol seems to be the primary substance. A recent report estimates that 4.4 million older adults (over age 50) will be in need of substance abuse treatment by the year 2020. The study also states almost a 50% increase from 1988 to 1997 in the number of alcohol related hospitalizations among older people 6. Emergency room visits shows a 58% increase in alcohol mentions for patients 55 or older. (TEDS, June, 07, 2004) Levin and Kruger (2000) called substance abuse among older adults an "invisible epidemic", stating that older adults, relatives, and caregivers tend to downplay the existence of any substance abuse problems. They also state that the symptoms of alcohol and drug abuse are often mistaken for the symptoms of aging problems such as dementia, depression, or other problems commonly seen in older adults. Accepting that the family member is suffering from one of the issues that beset the elderly is easier then saying they have a substance abuse problem. Traditionally, substance abusers over the age of 65 have been identified as early onset or late onset abusers (Benshoff & Roberto, 1987). More recently these categorizations have been conceptualized as chronic or situational (National Institute on Aging, 2002). Early onset abusers began drinking or drugging behavior before the age of 65 and continued to consume thereafter. Jung (1994) asserted early onset abusers frequently have significant physical and mental health problems, usually associated with their substance abuse history. Rigler (2000) reported that about two-thirds of elderly individuals with alcoholism problems are early onset drinkers, noting those individuals who survive the hardships of alcoholism problems in earlier life often have major mental and physical health complications. Late onset abusers are individuals who begin their substance abuse after 65 usually in response to a negative life situation or event such as retirement, death of a spouse, decline in status in the community, or health setbacks. (Rigler, 2000). The question is, do individuals begin drinking after the loss of a spouse because of grief, or because the death resulted in the loss of a control mechanism? Does increased drinking after retirement result from hopelessness? Does a major health crisis trigger increased alcohol usage as a coping tool or as a way to supplement pain medication Nearly all newly acquired substance abuse problems are alcohol related in the elderly over 65 years old. (Peterson 1988). Brennan and Moos (1996) reported that, in comparison to early onset drinkers, late onset drinkers typically have fewer physical and mental health problems. Therefore late onset drinkers tend to...
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