By Angela Linden, MSS, LCSW, CCDP
Director of Clinical Services Center for Addictive Diseases

The Pennsylvania Behavioral Health and Aging Coalition presented a conference in June of this year calling attention to the growing problem of older adults and substance abuse. This is a unique population with difficult needs and issues. We are faced with an aging population who present with physical and behavioral health issues impacting the aging brain.

Dr. David Oslin of the University of Pennsylvania School of Medicine and Hazelton Research Co-Chair on Late Life Addictions reports that few individuals with alcohol disorders or problem drinking seek help. Less than 5 percent of older adults suffering from addiction problems seek help, and 44 to 75 percent of those who seek treatment, drop out in the early stages. Less than 6 percent of patients in alcoholism treatment programs are age 55 or older. The disconnect between the beliefs and expectations of patients and providers cause barriers to quality care. There continues to be a stigma related to treatment in this population.

Robert Rawlings of Rawlings Consulting Services estimates that approximately 3 percent of the adult population suffer from a combination of addictive and psychiatric disorders in any given year (Mental Health: A Report of the Surgeon General, 1999). Added to this is the increase of older adults suffering from gambling problems. These unhealthy behaviors in seniors can lead to a higher incidence of suicides. A major problem seen in the older adult population is the interactions of alcohol with prescribed and over-the-counter drugs.

There are age-related changes to the body that alter the effects of alcohol. An increase in body fat and a decrease in body water content result in a decrease in gastrointestinal tract function. This means that less alcohol does more.

Treatment providers need to work to help older adults learn that changing behaviors will help to eliminate health concerns. If the positives that can be gained from treatment are emphasized and some control is given to the patients, the outcomes will improve. Screening for these problems needs to be part of any assessment in any venue that older adults present themselves. We all need to be looking at relationships with families, health problems, money issues, leisure resources and the lost sense of purpose in life.

Main Line Health’s Center for Addictive Diseases (CAD) has an ongoing group for seniors that deals with the disease of addiction in an age-appropriate way. We also have special training that allows us to assist in treating issues related to gambling in a sensitive manner.