Addiction: Too Old for Treatment?

Q & A with addiction counselor and author Brenda J. Iliff, MA

Q: Are more adults becoming addicted later in life, or is addiction among older adults just being recognized more?

A: Both observations are true. There are many more drugs out there today with more potential for misuse and dependence, especially painkillers. And older adults are more active today than in past generations, so problems with alcohol or other drugs are not as hidden. People are more aware of addiction and its signs. We are seeing a disturbing trend: According to the federal Substance Abuse and Mental Health Services Administration, 17 percent of adults over age 60, or approximately eight million women and men, misuse alcohol and and/or prescription drugs.

When speaking of older adults, I am not referring only to age. Generally, we consider the active older adult to be age 55 to 70 or 75, and the older adult to be 75 and up. But some 55-yearolds are physiologically more like 90-year-olds due to long-term alcohol use, and, conversely, some 90-years-olds are more like 60-year-olds.

Q: Are older adults more prone to certain types of addiction?

A: Definitely. Alcohol and pills. In fact, we're hearing a new term for many in their 70s and 80s who develop problems with alcohol or other drugs: "accidental addicts." It's not unusual for older folks going to their medical professional for help with physiological concerns that come with normal aging to receive prescription pain medications or sleeping pills or antianxiety medications. And before they know it, they get hooked on the pills. Or, they mix their prescription medications with alcohol and forget how many pills they've taken. Plus, the effects of alcohol on a person change drastically with age. The one or two drinks a day they had for years may become a concern with age because the body metabolizes alcohol differently given decreased body mass and diminished organ function.

Q: What prevents older adults from getting help with addiction?

A: Stigma weighs heavily. This is the generation that pulled themselves up by their bootstraps. So it's usually others—adult children or neighbors, for example—who see the problem and intervene. Or sometimes it's the legal system, as the result of a DUI offense. Families can be reluctant to intervene because it's difficult to distinguish between the signs of aging and those of alcohol or other drug dependence. Is Mom falling down because her eyesight is failing, or is it because she is drinking too much? Is Dad's confusion related to dementia or misuse of prescription medication?

Q: What’s the first step in finding help for an older adult?

A: First, educate yourself about the warning signs of addiction among older adults, such as losing interest in activities that used to bring pleasure, neglecting personal appearance, increased depression or hostility, or drinking in spite of warning labels on prescription drugs. Second, consult a professional, preferably a health care provider who is knowledgeable about the needs of older adults. This is a generation that will follow the doctor's orders. To prepare for the consultation, make a list of medications used, write a brief life history of the older adult, and summarize the present situation. Be sure to identify how drinking or drug use is affecting his or her quality of life and what has changed.

When researching treatment providers, ask about programming designed specifically for older adults. Treatment, as well as detox, is typically a slower process for older adults than it is for younger populations, and there are different issues at play. For example, at Hazelden we sometimes see older patients who are the caregivers at home for their loved one. They need a very flexible treatment schedule to work around their caregiving role, be it residential, day, or outpatient treatment. Others may need time set aside during the day to rest. Our programming allows for that flexibility and freedom.

The good news is that older adults respond quickly when they get the right help, and they get to rediscover their life at age 55, 65, 75, or older. Life for them is no longer diminishing; it's unfolding.

Brenda IliffBrenda J. Iliff is the executive director of Hazelden in Naples, Florida, a part of the Hazelden Betty Ford Foundation. She has more than 20 years of experience in the addiction field, as both a clinician and health care executive, and is the author of A Woman's Guide to Recovery.
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