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January 16, 2010

Alcohol abuse in our elderly neighbors: a hidden epidemic


I recently stopped in at the CVS in Rossmoor and found myself in line behind an elderly gentleman buying two 175-mililiter bottles of Popov vodka (on sale for $9.99 each) and an elderly woman buying a 1.5 liter bottle of Merlot (on sale for $5.99), along with thank you cards and milk. This is not at uncommon sight when I occasionally stop in at one of Rossmoor's pharmacies: an elderly person, presumably a resident at the senior community, stocking up on alcohol, usually a discount brand in large bottles.


My Rossmoor friend Gilbert Doubet agrees that what I observed is noted amongst residents themselves:

"Your comment about booze consumers at the local discount drugstores is a commonly exchanged observation in Rossmoor. In the local RiteAid/CVS checkout lines, there’s often a person ahead of me with half a shopping basket full of jumbo size whiskey bottles."

He explains the sad reasons behind his neighbors' use--or misuse--of alcohol:

"Some self-medicate due to loneliness," he writes. They’ve outlived their friends. Oddly, older people have difficulty making new ones, abandonment (by their uninterested or faraway adult children), chronic pain, boredom, an inexplicable disinterest in volunteerism, and a generational prejudice against more benign alternatives like marijuana. Many mix alcohol with meds, then drive around under the influence of both. A surprising proportion drive without licenses."

Doubet says though that "Rossmoor drinking is not as bad as it was 15 years ago when I moved here as a juvenile delinquent."

Google "alcohol abuse and elderly" and you'll come up with a number of articles about what is described as a "hidden" or "unreported epidemic." In this article from the famed Hazeldon addiction treatment center in Minnesota, you can read about a woman in her late 70s who was a teetotoler most of her life, enjoying only an infrequent sip of wine on special occasions. "But after her children moved away and her husband and many of her close friends died, Eva turned to the bottle for escape and compansionship."

The article continues:

Recent census data estimates that nearly 35 million people in the United States are 65 years or older. Substance abuse among those 60 years and older (including misuse of prescription drugs) currently affects about 17 percent of this population. By 2020, the number of older adults with substance abuse problems is expected to double.

As demographics change, attitudes about and use of alcohol and drugs change as well. "In January 2006, the leading edge of the baby-boom generation (those born during the population swell of 1946-1964) will turn 60," said Frederic Blow, professor in the Department of Psychiatry at the University of Michigan and a Huss Research Chair on Older Adults and Alcohol/Drug Problems at Hazelden's Butler Center for Research. "These individuals have had more exposure to alcohol and illegal drugs, and there is more acceptance among them about using substances to ‘cure' things. We expect to see an increase in drug and alcohol use; and more use means more problems."

There are, of course, health risks associated with alcohol abuse among the elderly. Some older people may not be aware that recommended limits are lower than for younger people. Older adults are more sensitive to alcohol and less able to metabolize it, both of which contribute to adverse effects at any level of drinking. Alcohol can exacerbate some medical problems, reduce a person’s ability to function, increase confusion the risk of falls, and negatively interact with medication.

Fortunately, there is growing awareness among the medical community about this issue, and less stigma and shame associated with it. So, if you're an older person and you believe you are imbibing too much, or if you have an older friend and relative about whom you are concerned, there is plenty of information out there about strategies to help.

The Hazeldon article says there is "good evidence" that older adults do as well as young people when it comes to treating substance abuse and that they may even do somewhat better. "Older adults can recognize all kinds of benefit from treatment," stressed Blow, the University of Michigan psychiatrist. "There are often direct health benefits, improved cognition, more independent living, more and better social connectedness, and new hobbies. The benefits are enormous."

11 comments:

Anonymous said...

my own parent is struggling with how to stay active and not drink too much in old age, but this pattern may have been the impetus for the "Rossmoron" nickname...

it could explain, well not everything, but maybe some of the swerving and slow driving.

Anonymous said...

Well, we as a society now ignore the elderly. Mobility means that families that used to reside for generations in the same town are now scattered across the U.S. My family is in that situation. We are here in CA because we have good jobs here, but my parents are back east. Frankly, they are lonely a lot of the time, even though they are still active. We have webcams to talk to them which helps tremendoulsy, but it's not like sitting down to dinner with them.

I guess I just wonder what lonely old folks are supposed to do. I fear that for my future, frankly. One of my kids has already announced that they wont' stay in CA, so I see my family being scattered apart as well.

Anonymous said...

The elderly gentleman at the CVS in Rossmoor might not just have an alcohol problem but he is also being ripped off. 175-mililiter bottle of Popov vodka for $9.99? You can get 750-mililiter online for $7.99 not on sale.

Anonymous said...

I assume that 175ml was meant to be 1.75 liter.

Anonymous said...

SM,

That is a beautiful photo at the top of your story. You really have a talent with graphics.

Loyal reader

Anonymous said...

I am pretty sure that if me body was failing me and I had a very short time left, I might have myself a couple cocktails in the early afternoon, morning or evening...

Anonymous said...

maybe a cocktail is better than all these meds people are taking...

Anonymous said...

Somehow I think the more "benign" alternative (that being Marijuana) would not be tolerated in Rossmore. Although a "clinic" has opened up in the city of Walnut Creek - on Oakland Blvd (right next door to Planned Parenthood). Since I work close by - with a window view, I have not seen one elderly "patient" enter the clinic. I have seen mostly 20 somethings X-large (males) in brand new trucks and sports cars. The place is littered with trash and orange "no trespassing" signs. A guard is there during business hours. I'm not against medical M. but this is a real scroungy scene. Need to send a journalist over to check it out. How did this get into our city?

Gilbert Doubet said...

I have to differ with the above commentator’s opinion.

I have lived in Rossmoor for 15 years and know more than a few seniors who use MMJ for chronic pain and other ailments.

I have also visited Walnut Creek’s C3 √álinic on more than one occasion, although as an observer rather than a patient.

During my visits, I was impressed with the clean surroundings, trained staff and professional manner in which the Oakland Blvd. C3 Clinic functions. I stayed a considerable time in order to form a more than cursory impression.

Patients who were on site during my visits were seriously ill people of all ages, a far cry from the stereotypical carefree, fun-seeking youth that critics often associate with MMJ dispensaries.

I have never seen any trash, let alone noticed that the C3 dispensary was “littered with trash” as the above writer describes.

As he says, there is indeed a guard in attendance. In fact, during my visits, there were usually two guards. The several I saw were friendly, clean cut and professional. Their presence is intended to discourage interlopers and disruptive types, neither of which were in evidence while I was there.

To further contradict the above writer, several Rossmoor residents use Walnut Creek’s C3 Clinic to legally obtain MMJ. As to the writer’s remarks about patients arriving in “brand new trucks and sports cars,” there’s no shortage of those vehicles in Rossmoor.

Moreover, one’s choice of transportation has little bearing on a patient’s right to appropriate medical treatment.

Regarding such treatment, at least one physician I know personally at Rossmoor’s Medical Center writes authorization letters enabling patients to acquire MMJ through the dispensary of their choice.

So does my neurologist.

So does the Walnut Creek pain management MD who operated on my 94-year old mother’s back. (She would want me to disclose that she uses no medication).

MMJ authorization letters are also written by Kaiser physicians, including one of Kaiser Walnut Creek’s most respected internists. That doctor was categorized as highly recommended in the prestigious Bay Area Consumer Checkbook’s Physician Survey Recommendations, a regular “consumer report” service based on Bay Area-wide responses from both patients and fellow doctors, available at most public libraries.

For a more accurate description of the C3 Clinic’s operational procedures and patient profile, one need only view streaming video of C3 Clinic management and the especially compelling remarks of chronically ill patients speaking before Walnut Creek city council at the Sept. 15 and Dec. 1 meetings (at http://www.walnut-creek.org/services/citizen/granicus.asp ).

MickeyMartin said...

What a sad story and horrific reality. I also have noticed the cart of "Black Velvet" phenomena amongst some seniors, and it has always saddened me. In the final years of one's life it can be a lot to deal with the reality of lost friends and loved ones. My mother lives in a retirement community and has expressed similar concerns. She has observed people turning to large volumes of alcohol to pass the time and drown their loneliness and sorrows. It bares to say that while this is a real issue, many seniors do not have these problems and live very full lives. Alcohol is a dangerous poison and one that often brings on more depression than one began with. It is a very slippery slope.

As for cannabis medicines, of course, a growing number of seniors are benefiting from the therapeutic values of cannabis. While most do not smoke, vaporization and food-based cannabis seems to be a great alternative and a helpful medicine. The stereotyping is unnecessary. People from all walks of life use cannabis as a medicine these days. Growing research finds that any number of ailments can be helped dramatically by cannabis. Here is a fair article highlighting some older patients using cannabis medicines and the issues that can occur by not properly researching and regulating the industry: http://online.wsj.com/article/SB10001424052748703626604575011223512854284.html?mod=WSJ_hpp_MIDDLENexttoWhatsNewsSecond

There are a group of seniors in Laguna Hills who have pursued the issue extensively. Here is an NPR story on that: http://www.npr.org/templates/story/story.php?storyId=111783991&ps=cprs

Bottom line is that cannabis is safer than alcohol by a long stretch. I would encourage folks to read the book Marijuana is Safer: So why are we driving people to drink: http://www.amazon.com/Marijuana-Safer-Driving-People-Drink/dp/1603581448/ref=sr_1_1?ie=UTF8&s=books&qid=1263946298&sr=8-1

I know the critics will come out in force. It is a sad day and age when we cannot see the hypocrisy in this issue and let seniors make more sensible choices on what they use to heal the pains of depression and ease their ongoing suffering.

Anonymous said...

Gilbert,

Thanks for setting me straight - I appreciate your insight into something (I obviously) know very little about - than being how C3 is run, and how elders and others are truly benefiting from MM.

I saw Walnut Creek Traffic court judge NOT honor a MM card, he actually ripped it up, and busted the guy for possession. Society has been down on MM - so it is ingrained in our thoughts. Society needs educating. Laws need changing. Thanks again for your input. I will butt out of the scene X-cross the street and not judge!