Substance Abuse and the Elderly free essay sample

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 have a better prognosis for recovery because they have not suffered the physical and psychological ravages of long-term alcohol and drug problems (Brennan Moos, 1996 The increased use of alcohol has resulted in injuries related to falls, is significant cause of hospitalization, nursing home placement, decreased mobility among older adults (Lord, McLean, Stathers, 1992), accounts for about 40% of accidental injuries in this population. As we age the body metabolize alcohol faster and alcohol can interact with prescription and over-the-counter medications. Alcohol is especially dangerous for those who take sleeping pills, pain pills, or anti-anxiety medications. The effects of alcohol cause brain damage. The symptoms are similar to Alzheimer’s disease: confusion, short-term memory loss, diminished verbal ease, and loss of problem solving skills. The symptoms decrease after three to four weeks of abstinence. However, unless abstinence is maintained, the person may become permanently demented. One report found that 10% of patients over 60 who were diagnosed with Alzheimer’s disease had brain damage caused by alcohol. The elderly are the fastest growing segment of the driving population. A person’s crash risk increases beginning at the age of 55. By age 80, it exceeds that of the young, beginning driver. Age and alcohol interact to increase driving risk. This could mean the responsibility of their transportation falls on a family member. How can family and friends help and support the persons with substances issues? If youre concerned about an elderly friend or relative, make an appointment with a health care professional, such as a doctor or nurse for a medical evaluation and attend the appointment with them. Be sure to discuss his or her recent and long-term drinking and drug use problems with the health care professional. Be sure to review the list of prescriptions and over-the-counter medications used on a daily basis by your family member. Help with decision making. Many older alcoholics and persons with substance abuse problems are unable to process information or effectively communicate decisions. Help set up community services in the home, if needed. Elderly people may benefit from such community services as home care, nutritional programs, transportation programs and other services. Drug use can disrupt family life and create destructive patterns of codependency, that is, the spouse or whole family, out of love or fear of consequences, inadvertently enables the user to continue using drugs by covering up, supplying money, or denying there is a problem. It is reported that family members feel that the issue of the user becomes their problem. There is a feeling of being drawn two ways, toward the user and their family. The structure of the family can be changed because of the usage of the senior. The substance problem becomes the family problem. The caregiver is trying to take care of the user and their family. The concern is what are they doing? Are they alright? Are they drinking? Are they eating? Do they have food to eat? Should I go and check? Making sure the elderly person is taken care of can cause problems in the whole family structure. What can be done about this issue? Fewer than one in five existing substance abuse programs in the United States offers services specifically designed for older adults, according to a University of Iowa investigation. The study, which appeared in the September issue of the International Journal of Geriatric Psychiatry, suggests substance abuse in the older population is a particularly serious health concern. Either people are not getting the necessary care or they may be receiving improper care by visiting treatment facilities without elderly-specific programs in mind. As the elder population continues to increase, the number of elderly with substance abuse problems will increase considerably, said Stephan Arndt, Ph. D. Substance abuse and alcoholism may go undiagnosed and untreated or be inappropriately treated because of the lack of treatment. Professionals may also fail to investigate problems that may be indicative of an substance abuse disorder (forgetfulness, emotional instability, or physical illness) due to making the assumption that problems are a natural part of aging (Norton, 1998). Additionally, they might assume that elderly consumers deserve to be able to over-consume alcohol as part of their right to a blissful retirement (Bleechem, 2002). When making treatment referrals several difficulties can occur including: lack of individualized treatment approaches; lack of accessibility; and over-reliance on the self-help model. Koch and Rubin (1997) cautioned that substance abuse treatment providers have had a history of providing one size fits all treatment that may not effectively meet the needs of individual consumers. For various reasons substance abuse in the elderly population has not been viewed as a serious or widespread problem. Researchers have rarely addressed the unique issues faced by this group of individuals, traditional care providers have been slow or reluctant to identify problems and few elderly-specific treatment resources have been developed. To adequately provide services for the elderly with substance abuse problems appropriate screening instruments can be used in identifying substance use, abuse, and dependence in the elderly and therefore increase the likelihood of developing an effective treatment plan. Above all, future research should center on unique, elderly-specific identification, intervention and treatment strategies. All around us are many elders that alcohol has robbed of hope, dignity, and the ability to cope. Life events such as the loss of loved ones, the onset of age-related health problems, and the failure of caregivers to recognize and confront drug and alcohol may contribute to the development and continuation of the abuse. Potential solutions involve creating more specialized programs for older adults or modifying current programs to better accommodate the special needs of elderly clients. Substance abuse in the elderly needs individualized and age appropriate reatment just as other populations receive. At this time there is not specialized elderly treatment in the Grand Rapids area. Following is a list of resources regarding this issue.