by Lisa Cerullo, M.A.
Social Work Intern
Center for Addictive Diseases

"Grandma, your vote counts too…why didn't you vote?" little Jimmy asked his grandma Ellie at the family picnic. She didn't go to the polls yesterday for the primary elections. Grandma Ellie said she did not feel well enough to go out last night. The entire family knew why grandma did not vote even though she keeps current on the political issues. She passed out from her too many cocktails she has every night. Since Grandpa Joe died last year and she retired from her job at the flower shop, grandma has been so lonely and depressed. She just watches TV, sleeps in her chair and waits until the evening rolls around for her "cocktail hour" to start. She seems lost, lonely and has forgotten the joys of life. She seems to escape her depression through her evening of drinking.

Substance abuse is increasing among the elderly
Grandma Ellie is really not alone.  A recent Substance Abuse and Mental Health Services Administration (SAMHSA) report estimates the number of adults age 50 and older will reach 97 million by 2010, and the number of older adults with substance abuse problems will increase from 2.5 million in 1999 to 5.0 million in 2020. Furthermore, about half (48 percent) of adults age 50 and older admitted to substance abuse treatment were admitted for abuse of alcohol only. The drug most commonly abused by Americans remains alcohol, although there has been tremendous growth in abuse of both prescription painkillers and other medications that can be addictive. Illegal drugs use was prevalent among approximately 1.25 million people age 55 and older during 2003, a rise of 12 percent over the previous year.

Baby Boomer's Age
The statistics will grow as the ranks of the baby boomers age, due primarily to the sheer numbers of that generation.   It is likely the incidence of use will be higher among the boomers, who as a group have a history of higher rates of illicit drug use, such as marijuana, in their younger years.

No one really thinks of grandma and grandpa having a drug or alcohol problem. And, if there is a problem some people exhibit the attitude: "Why deal with that? She's already 75. Who cares if she keeps drinking? Let her enjoy her golden years.  She's worked hard all her life."

Side of effects of combining alcohol/illegal drugs with prescribed medicine    
Older adults typically begin abusing alcohol and medications following a major life change, such as the death of a spouse, a divorce, or retirement. Given that the average person 65 years old and older takes at least two medicines a day, there is plenty of cause for concern. Keep in mind that over-the-counter medicines and herbal or "natural" remedies can also cause harmful interactions when combined or mixed with alcohol and other drugs.  As we age, we become more sensitive to the effects of alcohol, requiring less to become intoxicated.

Aging also affects how drugs are absorbed, processed (metabolized) and released (excreted) from our bodies. Changes in metabolism affect how quickly and well a particular medication or drug works. A slower metabolism can also cause drugs to have a more powerful effect on the body's systems and remain in the body for a longer period, thereby increasing the drugs' capacity for harm. Kidneys may be less efficient in removing drugs from the body, which can cause medicines taken regularly to build to harmful levels.

Medical conditions such as high blood pressure, ulcers, angina (chest pain) and diabetes, all common in older adults, can become worse with alcohol use. Many types of medication, prescription and over-the-counter, can cause drowsiness and affect coordination. Mixing medications with alcohol and/or illicit drugs can lead to falls, broken bones, serious injuries and car accidents.

Older adults are much more at risk for these harmful side effects because, as we age, our motor skills diminish and we lose coordination. We lose bone density, making falls and accidents a more serious threat to our health and well-being. Memory loss, particularly short-term memory, can sometimes cause an older person to forget his or her medication or to take too much unintentionally. If the person is also using alcohol or illicit drugs, this can cause especially harmful effects, particularly if the person has taken too much medication.

Outpatient Service: The Center for Addictive Diseases
If you, a friend, or family member is experiencing any of these symptoms or problems call your physician. Main Line Health provides an excellent program for outpatient recovery for any alcohol or drug problem. The Center for Addictive Diseases located in Exton and Drexel Hill, Pennsylvania, offers an outpatient program designed for seniors. This program consists of group members over the age of 60 years who are recovering from some form of alcohol or drug abuse. The program is age-specific, supportive, non confrontational and aims to build or rebuild the person's self-esteem.

The Center's clinical staff members are experienced in working with older adults and their families. The linkage with Main Line Health provides available medical and psychiatric services, if needed.  Call The Center for Addictive Diseases at 1-800-227-3898 to make an appointment. Medicare and most other health insurance plans are accepted.

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