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Elderly drug and alcohol abuse often undetected 

Memory loss, disorientation, shaky hands, mood swings, depression and chronic boredom are often normal to the aging process.

These behaviors can, though, signal something less benign. Grandma or Grandpa may have a substance abuse problem.

Such was the message last week in a Colorado Springs symposium entitled "Breaking the Silence: Older Adults, Alcoholism and Substance Abuse."

"We like to think of Grandma and Grandpa in terms of Norman Rockwell, apple pie, turkey dinners and spoiling the grandchildren," said author Carol Egan, director of older adult services at the Henley-Hazeldon Center in West Palm Beach, Florida.

"The reality, though, is often darker. Drug and alcohol addiction is far more common in over-60 Americans than most people think."


According to Egan:

Three million of the approximately 35 million Americans aged 60 and over are alcoholics;

10-12 percent of people 65 and older have a drinking problem, as do 50 percent of nursing home residents;

Widowers 75 and older have the highest alcoholism rate of any age group or population sector;

21 percent of hospitalized people aged 50 and over are alcoholics;

70 percent of elderly hospitalizations for illness or injury are alcohol-based (as compared to 25 percent for the population at large).

Use of illegal drugs is rare among the elderly, but they ingest staggering quantities of prescribed and over-the-counter medication. Eighty-three percent of people 60 and over take prescription drugs, 50 percent of them potentially addictive sedatives like Valium and Librium. Women 60 and over take an average of five prescription drugs at a time, and for longer periods than men.

Addiction is typically the consequence of taking these drugs in too high and frequent doses.

"Aging and retirement lead to enormous emotional challenges," said Egan, a nationally-recognized expert on alcohol and drug abuse among older people. "Many elders struggle to find a sense of purpose. Many are mourning the loss of spouses and friends. A little alcohol and maybe some over-the-counter medications, and you have a potentially dangerous situation."


A hidden problem

The elderly are one of the fastest-growing sectors of American society.

One in eight Americans is presently 60 and over, but one in three will be so by 2030.

The first wave of baby boomers will turn 60 this decade, and this year will produce a demographic milestone: for the first time, there will be more people 65 and older than 14 and under.

Why, then, is the problem of elderly addiction so hidden?

Egan offers several reasons.

"For one thing," she said in an interview, "retired elderly aren't subject to detection mechanisms like poor job performance or absenteeism, and they're not driving around amassing DUIs.

"For another, the children of addicted elders often grew up in normal, functional families. Mom and Dad never drank immoderately, and they don't do so now. The bodies of elders, though, metabolize alcohol less efficiently. Two-to-three drinks at age 65 can be the same as six-to-seven drinks at age 45. It doesn't take an increase in drinking to acquire a drinking problem.

"Elders, meanwhile, belong to a generation that typically views chemical dependency as a shameful character flaw. They are far more inclined to hide their problem than to seek help. Even the children don't know."

Compounding the problem, substance abuse among the elderly is grossly under-diagnosed. "Relatives and medical professionals are too ready to attribute memory loss, disorientation and shaky hands to the onset of Alzheimer's or Parkinson's disease," Egan said.

She cited a recent study by the National Center on Addiction and Substance Abuse at Columbia University wherein 400 primary care doctors were provided with symptoms of early alcohol addiction in older women.

"Seventy-eight percent of those doctors gave a diagnosis of depression. Only four even considered alcoholism," Egan said. "Doctors aren't catching it."

Organizations like the National Council on Aging and the American Association of Retired Persons are trying to bring the problem into the open.

Treatment centers and programs designed specifically for older adults are proliferating, said Egan, but even seniors willing to seek help run into the problem of paying for it.

"Medicare," she observed, "does not reimburse non-hospital facilities for substance abuse problem -- even though it covers treatment for injuries and illnesses caused by substance abuse.

"Given that the cost of alcohol-related hospital care for the elderly exceeds $60 billion annually, this is backward thinking."

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