by Eric Brown, MSW, LCSW

Much as been written in the past several years concerning the incidence of alcohol abuse among older adults.  In addition, the issue of screening for alcoholism among older adults (and the general population) has been raised.  In looking in more detail at these two important phenomena, we see data which clarify the need and support our efforts to improve treatment prevention and screening methods for this population.

"Alcohol related problems affect increasing numbers of older adults (55 and over)", according to studies reported in the Alcohol Health and Research World (Nov. 1997).  While "only" a reported 3-5% of this age may be diagnosed as alcoholic, in the context of the growing numbers of Americans living past 55, this becomes a significant number.  It becomes more significant when we look at the millions of dollars spent on the physical and mental health problems alcohol creates in this population.  In addition, the toll it takes on the spouses, family, friends and colleagues is great.

The research describes two types of older adult problems drinkers: early onset and late onset.  Late onset drinkers, the majority being women, first develop drinking problems later in life.  Early onset drinkers develop problems earlier during adolescence or adulthood and maintain them later on into their lives.

Compared with early onset drinkers, late onset drinkers are generally in better health, have a wider array of social contacts and are less likely to have been treated for alcohol abuse.  Later onset drinkers (1/3 to 1/2 of problem drinkers) also may have a better prognosis, possibly because interventions are more effective before severe problems rob them of their physical and social resources.  More so than early onset, late onset drinkers' alcohol abuse may be more tied to acute stressors in their lives.  The early onset drinkers' problems are more a result of long term, "habitual drinking" regardless of the magnitude of stressors than immediate reactions to a stressor. 

The term "Life Context" is used to describe some of the typical factors which impact on an older adult's propensity to developing an alcohol problem.  Life Context refers to environmental factors which affects the person's sense of well being and support.  These keys factors include:

• Social and family resources
• Health
• Finances
• Home and neighborhood
• Employment/career

When any one or more of these factors are "out of sync" drinking to escape or self medicate becomes a real possibility.  Once this occurs these Life Context factors often worsen. The problem drinker sees social, and family support eroding.

Of further significance is the reality that older adult problem drinkers used avoidance and resigned acceptance as ways to cope.  While some of this is typical of all older adults, problem drinkers tended to avoid talking with anyone about their problems.  The more they internalized and the more isolated they became, the more alcohol was seen as a source of escape and relief.  This makes it very difficult for friends and family to "reach" the alcoholic, that is, get them help!  Many have the fatalistic outlook that "I am getting older, my life is going nowhere. I might as well drink to oblivion".  Breaking through this powerful attitude is very difficult.

The above clinical factors point to the need for specialized programs for the older adult alcoholic.  The literature (and our own experience) supports the notion that these patients respond to treatment approaches tailored to their needs.

Hence the Center for Addictive Diseases began to offer several years ago what has been a very effective recovery tool for this age group.  It is weekly group therapy facilitated by therapists with experience and concern for this Older Adult population.  An individual evaluation appointment can be made by calling our intake center at 1-888-227-3898.

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