Overview of Alcohol
and Other Drug (AOD) Problems in the Elderly
35 million people in
the U.S. are 65 or older (13%). This number will increase to 20 percent
by 2030, or approximately 70 million people (baby boomers). Alcohol
or other drug problems (AOD) are present in an estimated 10 percent
of all cases treated by geriatric mental health facilities. It is estimated
that 17% of the over-65 adults have an alcohol-abuse problem. Drug and
alcohol problems in seniors are underestimated, underdiagnosed and undertreated
in the U.S.
Barriers to Help for Elderly with
AOD Problems
There are many factors
playing into the problem of underdiagnosis and lack of treatment of
drug and alcohol problems in the elderly. Here are some of the factors:
00nbsp;Ageism, the tendency
to assign symptoms of substance problems in the elderly to problems
associated with being old rather than exploring drug or alcohol use
as a cause.
00 Lack of knowledge of drug and alcohol
disorders, and their signs and symptoms, on the part of the elderly
themselves, their significant others, and their physicians and other
medical service providers.
00 Diagnostic indicators of AOD problems
do mimic common medical problems often present in the elderly:
-Memory
loss, cognitive impairment
-Depression, anxiety
-Neglect of hygiene, appearance
-Poor appetite, nutritional deficits
-Sleep disruption
-Hypertension
-Seizures
-Impaired balance and gait, falls
The AOD problem in
seniors is compounded by interaction of alcohol with over-the-counter
(OTC) drugs often taken by seniors along with drugs prescribed by their
physicians. The elderly older adults make up 13% of the population but
account for almost 30% of all prescribed drugs.
Thus an individual
could be taking a sedative drug such as Ambien or Lunesta, prescribed
by a doctor to promote sleep, another doctor prescribed pain reliever
for arthritis pain, such as Vicodin, and an OTC drug for head cold congestion,
such as Benadryl (an antihistamine). All three of these drugs have central
nervous system depressant effects, that is, sedative effects that can
cause drowsiness, confusion, memory loss, staggering, falls, and depression.
These symptoms could easily be mistaken for Alzheimer00 disease.
In addition to these
factors, seniors do experience natural age-related changes that contribute
to AOD problems:
-Decrease
in lean body mass (more fat) and body water, meaning that there is
significantly less body fluid to dilute the AOD introduced into the
body.
-Decrease
in metabolic efficiency to detoxify alcohol (less of the enzyme,
dehydrogenase that breaks down alcohol in the body), and lessened
efficiency of the liver to metabolize other drugs (e.g., benzodiazepines).
Due to these changes,
a senior should be prescribed about half the usual adult dose of an
anxiety reducing drug such as Xanax. Similarly, a person who drank
2 martinis before dinner for many years, may find that amount to cause
serious intoxication as he/she ages, and may need to take half that
amount.
Elderly.AOD.summary
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