The prevalence of substance abuse amongst seniors may be less obvious than those of younger adults, but this problem is very much a reality with an aging population, with clear and profound effects on both mental and physical health. Substance abuse can come about through over-consumption of alcohol; misuse or over-medication with over-the-counter (OTC) or prescription drugs; long-term use of illegal drugs. Because most seniors are retired or living on their own, it is difficult to detect substance abuse, as they are not out and about, causing problems in public.
People who have lifestyles of smoking, drinking, and doing drugs in youth usually continue doing so as they get older. However, some seniors may start drinking for the first time for relaxation; to allay boredom or feelings of loneliness; gain momentary relief from financial problems. Some are not capable of coping with day-to-day living and are lacking in home skills like cooking. In addition, they may have issues with self-care and lack mobility. Others need medication for chronic pan, creating a situation of drug tolerance and over-medication.
Having a drink of alcohol a day is not necessarily a danger, and may have healthful benefits. However, there are individual judgments on what is considered “in moderation”. In medical terms, one drink a day constitutes: 12 oz. can of beer, one-4 oz. glass of wine, or one-1 oz. shot of hard liquor. Obviously, a bottle of wine is not “one drink”.
Social and economic impact – Excessive drinking can have negative effects on self-esteem; cause problems with interpersonal relationships; or add to other existing loss a senior may be experiencing. If a person is feeling lonely or depressed due to the loss of a loved one, alcohol can interfere with symptoms of depression. Those who smoke also tend to drink, and this may cause further financial strain on a senior who is already feeling the pinch of a downward economy.
Physical consequences – Alcohol abuse can cause organ system damage such as cirrhosis of the liver, psoriasis, chronic obstructive lung disease, falls or malnutrition. People who smoke and drink excessively tend not to eat very well, and this results in malnutrition. As excessive drinking affects the entire nervous, a senior may have muscle problems, clumsiness, deterioration of the spinal cord, ulcers or high blood pressure.
Mental impairment – Experts estimate 5-10% of dementia is caused by alcohol abuse. Other signs include mood and sleep disorders, sometimes thoughts of suicide. Alcohol may help a person fall asleep faster, but decreases the total amount of sleep during the night. This results in anxiety and irritability, and feeling tired and sluggish during the day. As it is, older people tend to be light sleepers and often wake up early, so lack of quality sleep interferes with daily functioning.
Vitamin deficiencies – People with a long history of alcohol abuse need to take multivitamins daily because excessive drinking depletes the body of B vitamins.
Interactions with medications – Over half of commonly used OTC drugs interact with alcohol. While alcohol can slow down the metabolism of some drugs, having a stronger effect on the body, other medications can weaken drugs such as blood thinners or oral diabetes medications, etc. Since alcohol can increase the effects of sedatives, it can also decrease alertness and mobility in seniors. Frequent use of alcohol with medications can cause intestinal bleeding, especially for those taking aspirin or arthritis drugs. In cases of intestinal bleeding, Vitamin K supplementation may be necessary.
Seniors often self-medicate to ease emotional or physical illness. They may misuse OTC or prescription medications, or develop a tolerance to certain drugs, having the need to use more and more to get the same effect. Commonly misused drugs are sedatives, pain relievers, diet aids, decongestants, and other OTC products. Misuse of these drugs can cause mental and mood alteration, bring about liver and kidney disease, or injuries from falls. In addition, seniors may use illegal drugs and this compounds the dangers of substance abuse.
Seniors may not always admit they have a problem with substance abuse, but if they exhibit signs of memory loss/anxiety/ depression, they may have an issue. If they are fatigued or weak, sleep deprived or confused, these are also symptoms. High blood pressure, upper abdominal pain, loss of appetite and weight are also indications of substance abuse.
Recovery from substance abuse is more of a process than a cure, so a senior being withdrawn from either alcohol or drugs need to be monitored from time to time. Detoxification takes 8-10 weeks, and there are drugs to deal with withdrawal symptoms. To help a senior overcome substance abuse, there is support from organizations like Rational Recovery, Alcoholics Anonymous, or Narcotics Anonymous. Rehabilitation includes time management, keeping busy to avoid drug-seeking situations, and day programs to keep seniors active.