From Our 2015 Archives
Seniors: The New Face of Addiction
By R. Scott Rappold
Reviewed by Arefa Cassoobhoy, MD, MPH
Dec. 2, 2015 -- Meet Jerry. He's 75. He's a happily retired grandfather. He's still married after 50 years.
And he's an alcoholic.
After a lifetime of working, a stint in rehab and daily Alcoholics Anonymous meetings weren't part of his retirement plans. Sure, he drank, but so do lots of people, and he never found himself drinking to the point of dire consequence.
But it took a perfect storm of crises -- involuntary retirement from his job, the death of his mother, his wife's surgery -- to send him into a downward spiral of vodka in the morning, vodka with lunch, vodka all afternoon, sleep, and repeat.
"My higher power was my bottle of vodka. Alcohol controlled my life," says Jerry, of central Pennsylvania, who asked that his last name not be used.
Addiction experts say stories like Jerry's are becoming all too common as baby boomers hit retirement age. Research shows that about 40% of people over 65 drink, despite the facts that the body's ability to break down alcohol decreases with age and that alcohol can have dangerous synergy with many medications commonly taken by seniors.
The number of people over 50 with substance abuse problems -- including alcohol and drug abuse -- is expected to increase from 2.8 million to 5.7 million by 2020. And it's in many ways a hidden epidemic, one that often goes unrecognized by doctors and families of seniors.
Today Jerry is 6 years sober, and looking back on his life, he wonders why his drinking never raised any red flags. The doctor he knew for years never asked, and he never volunteered the information.
It wasn't until he was putting away a liter and a half of vodka a day, when his kids wouldn't let him be around his grandchildren, when the job he loved no longer wanted him, that he reached the point where he needed help. He had lost 50 pounds and was having trouble walking. But drinking offered him a way to cope, and things didn't seem so bad after a morning of vodka and watching the squirrels play in his yard.
"It was major life changes in a very short period of time. That definitely pushed me over the edge," he says. So he checked himself into Caron Treatment Centers.
Joseph Garbely, MD, medical director for Caron's Pennsylvania facility, says the problem has become so acute that its Pennsylvania facility now has a specialized program for seniors. The 10 beds are always full, and 14 more are planned as part of an upcoming expansion. According to a 2013 survey by the Substance Abuse and Mental Health Administration, there were at least 1,700 facilities offering senior-specific substance abuse programs out of about 18,000 total facilities.
"There are stages-of-life issues. There's often loss of independence because of some physical limitation. There's also loss of people you're close to, whether it be family or friends. There's a sense of isolation that can occur because they're retired, not going to work," Garbely says.
And when seniors fight the loneliness with alcohol, they may find that the one or two drinks they were able to have most of their lives suddenly gets them intoxicated. Or the alcohol may affect their medication in dangerous ways.
Garbely says the effects of benzodiazepine meds, such as alprazolam (Xanax) and diazepam (Valium), can become amplified with alcohol, as can painkillers, with potentially fatal consequences. Taking blood pressure medication, such as beta blockers, along with alcohol can lead to unsteadiness and falls.
And while alcohol is the main issue, other seniors are seeking treatment for addiction to these legal medications. A recent study found more older adults are being treated for addition to opioid painkillers -- by 2012, those ages 50 to 59 made up the largest age group in opioid treatment programs in New York City. Illicit drug abuse is rarer among seniors, though not unheard of. Garbely had one patient who started using crack cocaine after retirement.
A recent nationwide survey of people with elderly parents commissioned by Caron revealed that most expect the family doctor to be asking about their parent's medication and alcohol use. But, Garbely says, "doctor visits have been reduced to minutes when they used to be a half hour or an hour, when you could actually get to know the patient and find more about the patient."
The survey also showed that half of the grown children didn't think substance abuse was a problem among the elderly, even while 37% reported seeing their parent practice risky habits, including having three drinks or more in one sitting, or drinking and driving.
"There's not really people looking at seniors and questioning what's happening with them. Could they possibly be engaged in some dangerous behaviors through their substance abuse?" Garbely says.
A Different Approach to Recovery
If an AA meeting is being held in the daytime, it's a good bet attendees are primarily older folks, says Wayne, who also declined to give his last name in line with AA's anonymity policy.
"We like to have our meetings during the daytime rather than the evening. We want easy access to the meeting room, no stairs or an elevator for the handicapped," says Wayne, 74, of Arizona, an organizer with Seniors in Sobriety, a network of senior-friendly meetings and events.
His drinking started well before retirement, and he's been in AA for 30 years. But many of the people who attend the meetings have developed drinking problems more recently. Since Seniors in Sobriety began 12 years ago, it has expanded to hundreds of senior-specific AA groups in many states.
"There's more recognition of it. People used to say, 'Grandad drinks too much, but he's too old to do anything about it, so let him have his booze,'" Wayne says. "That was not unusual, and now people are starting to realize there are programs for people of any age."
For Jerry, the meetings have been crucial not only to stay away from alcohol, but for the social interaction. He is active in an alumni group from the treatment center. If he and his wife travel, they find AA meetings on their route.
Sobriety hasn't made everything better about his golden years. He recently broke his foot. But he feels better about the future than he ever did in his vodka days. Many seniors aren't able to get out and go to meetings, or they lack the strong family support he enjoys.
"I don't regret where I am today. But I somewhat regret I got to that point, but I can't change that," he says.
"You've got to look at the positives in life. If you look and go 'poor me,' you're not going to survive."
SOURCES: News release, Caron Treatment Centers. Joseph Garbely, MD, medical director, Caron Treatment Centers. Jerry, last name withheld, recovering alcoholic. Wayne, last name withheld, organizer, Seniors in Sobriety. WebMD Health News: "Many Seniors Toast to Retirement Too Often," "This is Killing More White, Middle-Aged Americans." National Institute on Alcohol and Alcoholism, "Older Adults." Han. B, Addiction, January 2009. National Institute on Aging, "Alcohol Use in Older People."