CONTENTS

Table of Contents
Introduction

1. Overview
2. Recognizing Alcohol Misuse and Abuse in Older Adults
3. Alcohol and Aging
4. Diagnosing Alcohol Problems in Older Adults
5. Recognizing Other Forms of Substance Abuse
6. Prevention and Early Intervention Strategies
7. Treatment
8. Outcomes and Cost Issues in Alcohol Treatment for Older Adults
9. Legal and Ethical Issues

Supplements
Resources

At Any Age, It Does Matter:
Substance Abuse and Older Adults (for Professionals)

Projections of Future Growth of the Problem

Alcohol use was less common in the 1930s, 1940s, and 1950s than it has been since the 1960s. Many of those who are now 60 and older, influenced by prevailing cultural beliefs, never drank at all. Younger birth cohorts tend to have increasingly higher rates of alcohol consumption and alcoholism.³⁷ Thus, the prevalence of alcohol problems in old age may increase, especially among women, for people now entering their 60s.⁴ A recent study in Sweden found that the male-to-female ratio among older alcohol abusers admitted for addiction treatment decreased from 7.8:1 to 3.4:1 in the span of a decade.³⁸

It will be increasingly difficult for older adults’ substance abuse to remain a hidden problem as the demographic group known as the “Baby Boom” generation ages in the coming years. Census estimates predict that the older adult population will more than double to 80 million by 2050.³⁹

In addition, life expectancy in the United States has increased. In 1950, it was 68 years, and by 1997, it had reached 79.4 years for women and 73.6 years for men.⁴⁰

If current trends in alcohol use continue, within the next 20 years, more than 3 million people 65 years and older will be binge drinking, with nearly 1 million of them heavy alcohol users. The figure below illustrates this projected trend.

Projected Number of Older Binge Drinkers

Not only are adults in general living longer, substance abusers are also living longer than ever before.⁴¹ Thus, more Americans face chronic, limiting illnesses or conditions such as arthritis, diabetes, osteoporosis, and senile dementia. It is likely they will become more dependent on others for help in performing activities of daily living.⁴²

Drinking status has been shown to affect general health, physical functioning, pain, vitality, mental health, role performance, and social functioning.²⁰ Taken together, these factors raise the prospect of tomorrow’s health services facing a “potentially preventable ‘tide’ of alcohol-induced morbidity.”²¹