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Alcohol Abuse: An Older Problem Emerging

Substance abuse by older adults is not a new problem, but it is a problem on the rise. Currently, those who are 65 years or older comprise 13 percent of the population. In 30 years, this will rise to 21 percent.

Through a picture-lined hallway, a woman looks toward the empty family room. The pain of loss is more than the grieving widow can bear. She reaches for something that will dull the pain.<?xml:namespace prefix = o ns = “urn:schemas-microsoft-com:office:office” /> 
In a cluttered garage, a retired mechanic rearranges unused tools. The tedium of a day without his life’s work is more exhausting than the work itself. He reaches for something that promises to lift his spirits. 
Substance abuse by older adults is not a new problem, but it is a problem on the rise. Currently, those who are 65 years or older comprise 13 percent of the population. In 30 years, this will rise to 21 percent. Furthermore, the drinking behaviors of the “boomers,” who are swelling the senior adult ranks, will bring a much higher rate of substance abuse into this age bracket than previous generations. 
Illicit drug use is only a small part of the picture. Research cited by the U.S. Department of Health and Human Services suggests that alcohol abuse, and resulting interactions with over-the-counter and prescription drugs, is by far the most outstanding drug problem faced by older adults. 
It is clear from the research cited in government reports that alcohol abuse by older adults is under-diagnosed, under-treated and under-studied. The low funding priority to study and treat this problem results from a societal devaluation of our older people. In short, older adult alcohol problems thrive in an environment of ageism. 
Ageism allows us to operate out of a dangerous myth: that alcohol does not harm and may actually improve the quality of life for a person who is going to die soon anyway. Advanced age becomes a convenient basket in which to place any number of problems. Rather than addressing primary needs, society makes the condescending diagnosis that the person is simply getting old. 
Ageism is also implicated in the glacial rate at which the treatment community has embraced the notion that age has a tremendous effect on the process of alcohol metabolism. These effects make standard diagnosis and treatment protocols irrelevant to this population. 
Two primary changes occur in the aging process that tend to make alcohol consumption more problematic. A decrease in body water content and a decrease of metabolic activity in the gastrointestinal tract join to keep blood alcohol concentrations higher for a longer period of time. 
The well-known sobriety standard of one drink per hour does not apply as one gets older. Without taking age-related changes into account, the same rate of consumption can push an older person into abusive or even addictive use. 
Another important physical change concerns tolerance. An important diagnostic tool in assessing alcoholism relates to the increasing amount of alcohol needed to get the same desired effect. This is called tolerance. However, as a person ages, this trend reverses. An older person becomes more sensitive to alcohol’s effects and actually decreases in tolerance. 
Physiological concerns multiply quickly as age-related health issues are factored in. Alcohol can become dangerous when used with many prescribed medications. Alcohol can also render some medication ineffective, or cause unpredictable side effects. 
Diseases that are more common among older people can be exasperated by alcohol consumption. Diabetes and age-related mental impairments are just two such conditions that multiply negative consequences for alcohol use. 
Ageism is also directly responsible for society’s slow response to overcome the most significant barriers to intervention and treatment. For example, older adults drive less and often find it difficult to get to appointments or AA meetings. Only a handful of treatment facilities cater to the specific issues of older alcoholics. Even when treatment is available, older people living on fixed incomes find it more difficult to afford suitable treatment. 
There are 2.5 million God-given reasons to take this issue seriously today. And if not for those affected now, perhaps the tidal wave of cases on the horizon will be our wake-up call. Clearly, the consequences of inaction should move our nation toward thoughtful and comprehensive counter-measures. 
It is an age-old problem demanding new solutions. 
Steve Sumerel is director of the department of family life and substance abuse, of the <?xml:namespace prefix = st1 ns = “urn:schemas-microsoft-com:office:smarttags” />BaptistState Convention of North Carolina‘s council on Christian life and public affairs.