Term Paper on "Elderly Drug and Alcohol Abuse"

Term Paper 8 pages (2180 words) Sources: 1+

[EXCERPT] . . . .

Elderly Substance Abuse

Stereotypes of elderly people include the crotchety grandfather, the kindly grandmother or a gentle older person who tells stories of years gone by. The elderly are associated with concepts such as infirmity, illness and wisdom. Furthermore, as baby boomers retire, the "post-60" years are being seen as times of continued activity and productivity. More advances are therefore being made to address the diseases that previously plagued those in the post-retirement years.

Not enough attention, however, has been given to a serious problem that is plaguing a growing segment of the elderly population today - substance abuse.

This paper examines the extent of substance abuse in the elderly. The first part of this paper looks at the extent and symptoms of alcohol abuse among the elderly. The second part then examines the incidences and symptoms of drug abuse. The third part then evaluates different therapy programs and treatment options for elderly substance abuses.

In the conclusion, this paper argues that substance abuse among the elderly is caused by a confluence of reasons, ranging from physical symptoms to neglect. Because of this, it is important for family members and caregivers to recognize and act upon the early symptoms of substance abuse.

Alcoholism

Conventional wisdom previously stated that the elderly population has lower rates of alcohol use, compared with the rest of the population. However, more older adults are showing alcohol-related problems. These problems include alcohol abuse, more mild forms of alcohol dependence and other medical problems that are exacerbated by the use of alcohol. Previous studies have estimated that up to 20% of elderly adults have some form of alcohol-related problems (Ondus et al. 1999).

Benshoff et al. (2003) have noted the difficulty of diagnosing alcohol abuse among the elderly population. While the National Household Survey revealed that the cohort over 65 years old had the lowest alcohol-related problems, these figures could be skewed. The elderly cohort is often a "hidden" population, and they often do not engage in social behavior that will highlight alcohol use, such as drunk driving. Second, this population is more likely to see alcohol use as a moral failing, and is therefore less willing to report alcohol problems.

Researchers believe that up to two-thirds of elderly alcohol abusers are "early onset" drinkers, who begin alcohol abuse prior to age 65 and continue their consumption. Because this population has survived rigors related to alcoholism in their earlier life, they already exhibit significant health and mental complications. Genetics may account for the survival of people in this category, as do people who learn to moderate their consumption (Rigler 2000).

In contrast, late onset abusers who begin drinking after age 65 usually do so in response to a life change that is seen as negative. Many late-onset alcohol abusers turn to drink after the death of a spouse. Other reasons include retirement, a perceived decline in their status in the community and other health setbacks. The upside to being a late-onset drinker compared to early-onset ones, however, is the stronger "societal connections" the former group, making for an easier diagnosis. Also, late-onset drinkers generally have not suffered physiological problems associated with long-term alcohol abuse (Rigler 2000). Further studies have shown that heavy late-onset drinkers show higher suicide rates, as suicide is often associated with depression.

This distinction affects the signs for diagnosis and possible consequences that an elderly person could suffer from alcohol abuse. In general, aging results in an increased sensitivity and decreased tolerance to alcohol. The rate of alcohol absorption is moderated by one's body mass. As a result, older adults may misjudge and overestimate the amount of alcohol that they could tolerate. This problem is complicated by the decreased absorption rate in the gastrointestinal system of older adults. As a result, the ingested alcohol remains in the body longer, and at higher concentrations (Benshoff et al. 2003).

These factors combine to worsen the cumulative effects of alcohol on the body of an elderly drinker. Their excretory and nephritic systems are exposed to alcohol for longer periods, leading to illnesses such as cirrhotic liver disease and kidney failure. The figure for cirrhosis of the liver among the elderly population is twice that of the general population (Benshoff et al. 2003).

Analysts believe that figures for gastro-intestinal diseases could also be affected by alcohol consumption.

There are also secondary health and safety issues associated with alcohol use. Elderly alcoholics who spend a significant portion of their fixed income on alcohol often neglect their other basic needs, leading to malnutrition and poor health. People who are under the influence of alcohol are also prone to alcohol-related injuries, such as slips and falls (Benshoff et al. 2003).

Many hospitals and nursing home facilities note that alcohol consumption may be a factor in a growing number of these injuries, as more elderly people insist on living alone.

Given these problems, diagnosing and recognizing the symptoms of alcohol abuse is even more critical. Mersy (2003) notes that a history of convictions for DWI and "poorly explained trauma" should raise a caregiver or primary care physician's suspicions. The American Society of Addiction Medicine (ASAM) recommends that men who consume four drinks per occasion or 14 drinks per week could have addiction problems. For women, generally with smaller body masses, the figures are three drinks per occasion or seven drinks per week. Though these figures could vary even more for the elderly population, they provide a useful starting point for evaluating a person's drinking issues.

Other screenings could determine early signs of alcoholism. Caregivers and primary care physicians could determine, for example, whether an elderly person is trying to cut down on their drinking and if he or she is using alcohol as an "eye-opener" in the morning. Expressions of guilt about drinking or annoyance at questions regarding their drinking are further red flags (Mersy 2003).

Blow (2003) notes that many of the criteria normally used to assess drinking problems in the general population do not apply to the elderly. For example, since many elderly people are retired, the criterion of "failure to fulfill major role obligations at work, home or school" is not as significant. However, an alert caregiver can recognize emotional withdrawal and other secondary symptoms, such as unexplained injuries from falls.

In summary, recognizing the symptoms of alcohol abuse among the elderly is a challenging task. However, the elderly population faces significant physical and mental health risks when it comes to the abuse of alcohol. To make the problems worse, it takes much less alcohol to cause health risks such as cirrhosis, kidney failure and high blood pressure. These problems make the proper diagnosis of alcohol abuse even more important, especially for the elderly population.

Substance abuse issues

While there are difficulties in diagnosing alcohol abuse among the elderly, analysts believe that diagnosing drug abuse is a far worse problem. Levin and Kruger (2000) liken drug abuse among the elderly population as an "invisible epidemic" (1). Adding to the difficulty is the fact that many elderly adults take a bevy of medicines, making diagnosis difficult. Furthermore, the symptoms of drug abuse often mimic symptoms of depression, dementia and many other illnesses commonly associated with aging.

Prescription drug abuse is a growing porblem among the elderly, as this population consumes 25 to 30% of all prescription drugs. Commonly-abused prescription drugs include analgesics, cardiovascular drugs, laxatives and anti-anxiety medicines. Additionally, Ondus et al. (1999) found that elderly individuals were much more likely than their younger counterparts to be prescribed with psychoactive drugs such as benzodiazepine.

Prescription drug abuse has significant health risks. Analysts estimate that detrimental drug reactions are three to seven times more likely to occur for older adults. An estimated 17% of hospital admissions for adverse drug reactions were for elderly patients. While experts believe that intentional prescription drug abuse is rare, there is certainly a high rate of over-use (Benshoff et al. 2003).

This over-use could stem from factors like multiple physicians, who could unwittingly prescribe drugs with harmful interactions. Patients could also be confused about their medications, and could take more than necessary.

There is some good news. While individuals over the age of 65 consume the majority of prescription drugs, they use fewer illegal drugs than any other age group. However, as more "baby boomers" reach retirement age, healthcare experts believe that illicit drug among the use may pose additional challenges for healthcare workers (Ondus 1999).

Symptoms of drug abuse can be difficult to detect, as many elderly patients have numerous drugs in their system. One sign of drug abuse can be seen when a patient shows an increased tolerance to their medications, often leading to a vicious cycle wherein a patient takes the drug in greater doses. Abuse of benzodiazepine is correlated with higher anxiety levels, as the drug often stops working as a patient builds a tolerance. Many elderly drug mis-users and abusers also report dizziness and periods of blackouts (Blow 2003).

Drug abuse can also cause a number of symptoms among the elderly.… READ MORE

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