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Depression and Anxiety Special Report

Report on Substance Abuse and Aging

Alcohol and drug use is on the rise among older adults. Researchers are beginning to acknowledge the prevalence of alcohol and drug abuse among people over age 60, saying that it affects as many as 17% of older adults. Recent government statistics reveal that 12% of adults over age 50 report binge alcohol drinking over the past month and 3% say that they drink heavily on a frequent basis.

Many older individuals may be self-medicating with alcohol and drugs as a way of managing depression or anxiety symptoms, coping with loneliness or loss, or dealing with pain. While alcohol and drugs may temporarily ease a person's discomfort, many negative health consequences can develop from continually relying on them as a mental-health crutch. For instance, excessive drinking can lead to liver damage and failure, especially when combined with certain common medications such as acetaminophen (Tylenol). Use of aspirin by heavy drinkers can also cause bleeding in the gastrointestinal tract.

Taking antihistamines and alcohol together can dangerously lower blood pressure and cause problems with balance as well as confusion. The combination can also depress the central nervous system, slowing breathing and heart rate, which can be deadly. Taking large doses of prescription benzodiazepines such as diazepam (Valium) with alcohol also can be lethal. And alcohol and drug use can blunt the positive effects of medications for health problems such as diabetes and heart disease.

Finally, alcohol and drugs may have deleterious effects on the ability to drive safely, to work effectively, and to interact with friends and family. It even appears that substance abuse in older men with depression increases the risk of suicide.

Finding Support -- Substance abuse often goes undiagnosed in older people for a myriad of reasons. Older adults are more likely to hide their alcohol or drug use and refrain from seeking professional help. If they do seek support, healthcare providers may overlook the problem by mistaking the symptoms for dementia or depression. Also, many relatives may be embarrassed by the problem and choose to ignore it.

If you suspect that substance abuse is an issue for yourself or someone you love, don't be ashamed to speak up and reach out for support. There are a variety of treatment options today, from once-a-week counseling sessions and group meetings, to daily outpatient services, to residential or hospital-based programs where doctors can prescribe medications to ease withdrawal symptoms while patients learn how to manage their alcohol or drug addiction in therapy.

Bottom Line Advice: Despite the fact that it often goes unnoticed, alcohol and substance abuse is an increasing issue for seniors that can have serious consequences. Seeking out help is crucial to recovering and avoiding major health risks. All treatment options require considerable effort and motivation. But don't think that you won't be able to conquer a substance problem or that it won't be worth it: Research shows that older people can be as successfully treated as younger adults. What's more, you can go on to lead a healthier and happier life.

How to Tell If You Have a Problem

One way to tell if you have an alcohol or drug problem is to ask yourself the following questions, which are part of The Cage Questionnaire, a screening test used by doctors to determine if a substance is being overused:

  1. Have you ever felt you should cut down on your alcohol or drug use?
  2. Have people annoyed you by criticizing your alcohol or drug use?
  3. Have you ever felt bad or guilty about your alcohol or drug use?
  4. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (an "eye opener")?

Score 1 point for each yes answer. A score of 2 or more suggests you have a substance-use problem and should seek help.

Posted in Depression and Anxiety on March 4, 2009

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