Drug and Alcohol Problems among the Elderly

Education, Understanding Addiction

drug and alcohol problems among the elderlyA largely unnoticed but increasing trend is that of drug and alcohol abuse and misuse among older people. Between 2002 and 2010, hospital admissions related to alcohol more than doubled for men and women over 65, and alcohol-related deaths for those over 75 are steadily rising.

Part of this can be explained by the fact that the “Boomer” generation is aging, and long-term substance-abusers—those who survived—are now filling the ranks of senior citizenry. However, there is also the phenomenon of the late starter. Some may simply have, now that they’re retired, free time to experiment, and experimentation can often lead to problematic use. Others find themselves self-medicating or attempting to augment drugs that they need for pain, anxiety, depression, or other ailments that have developed over time. (The elderly constitute the largest group of prescription and over-the-counter drug users.)

Above and beyond the usual problems associated with substance abuse—for all demographics—there are numerous issues that affect older people more dramatically:

  • Alcohol and drugs may have dangerous interactions with prescription medications
  • Alcohol and drugs affect nutrition and sleep, both of which have increased importance for the elderly in terms of general health and quality of life
  • Alcohol- and drug-related accidents, such as falls, can have more severe consequences (broken hip, etc) for the elderly. This in turn has social costs, as medical care becomes more expensive
  • Alcohol and drugs can increase the likelihood of stroke, cardiovascular issues, balance problems, and liver failure

Furthermore, substance abuse can increase isolation for the elderly—a problem that becomes self-reinforcing as the isolation prompts further substance abuse. Anxiety, depression, cognitive impairment, and addiction are all potential consequences.

It is often difficult for older people to distinguish between the consequences of substance abuse and the symptoms of various physical issues as well as the side effects of legitimate medications. They also may feel embarrassment about discussing the issue, mistaking secrecy for privacy.

As with any age group, if the consequences of drug and/or alcohol use are considerable—or if they outweigh the perceived pleasure they provide—then an attempt should be made to moderate or quit altogether. If this proves difficult, treatment should be sought.

Lack of Emotional Sobriety Results in ‘Dry Drunk’

Understanding Addiction

lack of emotional sobrietyYou’ve poured the last of the liquor down the drain. You’ve stayed away from bars. You have quit hanging around with your drinking companions. Still, you are irritable with your family and friends. You snap at your work colleagues. You feel exhausted. You find yourself isolating, and therefore, depressed. This is the world of the “dry drunk.”

Sobriety means more than putting down the drink. It is more than what is called the “white knuckle” approach, which means depending entirely on will power and refusing to change anything in one’s lifestyle. This leads in turn to the “dry drunk,” a life of anger and resentment that a recovering alcoholic can ill afford. Hanging on to old ways of thinking prevents emotional sobriety.

Grieving the loss of alcohol

Alcoholics are not accustomed to recognizing their feelings and dealing with them. They have reached for the bottle instead, ignoring their emotional problems. For an alcoholic, giving up drinking is like losing a best friend. It is normal to go through the stages of grieving, just as one would do with the death of a loved one. Breaking through denial and acknowledging the feelings of anger and depression are a start in achieving emotional sobriety. This is a lifelong process, but a process worth doing in order to live a happy and sober life.

“Dry drunk” affects others

Because alcoholism is a physical, mental and spiritual problem, full recovery needs to deal with all those aspects. Each part needs attention, or the “dry drunk” occurs. It can affect not only the alcoholic, but also the alcoholic’s family and friends. An article in Psychology Today describes six situations that can cause relationship difficulties:


Anger towards family members, particularly when they threaten consequences if the drinking continues


Feeling annoyed about inability to drink like “normal” drinkers

Guilt and sadness

Despair of unreached goals and unfulfilled plans as a result of drinking

Facing the truth

Having to give up excuses and lies in order to admit and accept the drinking problem.


Emotional immaturity, leading to fear of functioning in the real world


Jealousy of people who follow through on pursuing their goals, coupled with failure to support family and friends who actually take steps toward their dreams.

The “dry drunk” is a normal but preventable part of recovering from the grips of alcoholism. Talking with other sober alcoholics and seeking professional help if needed will change the course.

Moderation for Extreme Personalities

Education, Understanding Addiction

Moderation for extreme personalitiesMany who have struggled with substance abuse also identify as having strong personalities, unable to moderate very well in numerous areas of their life.

One of the key challenges to achieving sobriety is finding balance in recovery, letting go of the drama and chaos that a life drinking and using supplied. Individuals who have serenity in their sober life generally learn extremes of any nature are not helpful.

Moderation, Balance and Harmony

The idea of harmony is as old as Aristotle’s Ethics and Khalil Gibran’s The Prophet, where virtue is described as the temperance of two opposites. Successes will be conditioned by failures, courage achieved by experiencing fear and facing it. Potentially the greatest risk to our natural ability to moderate is when we are too focused on what we believe we should do; having failed this standard the alcoholic or addict will resort to using drugs and alcohol to temper feelings of self-pity, shame or remorse.

It can be characteristic of alcoholics and addicts in early recovery to have a very polarized view of their life, mainly due to the ups and downs which take place as the body and mind adjust to life without drugs and alcohol. They are caught up in the past or planning the future, possibly devastated by what they perceive to be the loss of their social life while at the same time energized by finally being clean and sober. Individuals walking through life tightly wound up in the struggle to meet predetermined standards are rarely tuned into the pleasures of living in the moment.

Learning to Let Go and Just Be

Part of the process of recovery is learning to be gentle with yourself; letting go of the idea that things are a personal reflection or a value judgment about who you are. Be it fear of failure, criticism, mistakes, or something as simple as not knowing what the next indicated step is, having flexibility and acceptance, embracing failures with successes promotes a healthy awareness of what really is important, how we determine our value and value systems.

Practicing balance in recovery means allowing our self- worth to generate from within. Accepting we are not perfect and life will not always resemble what we think it should, we can then make healthier choices about what we really want.

A life based on recovery permits individuals to find a better path than the one spent addicted to substances, discovering enduring satisfactions and serenity from chaos.

Late-Stage Alcoholism

Understanding Addiction

Symptoms of Late-Stage AlcoholismAlcoholism is a progressive disease. It is currently considered to be the nation’s third highest cause of death, but this might be misleading.

Although end-stage alcoholism kills many (by liver failure, drunk driving, etc.), many more die of alcohol-related secondary causes that may not be reflected in the statistics.

Most alcoholics will ignore the potential future consequences of continued drinking.

“Hitting bottom” is generally an emotional state brought about by the current accumulation of consequences, but it is instructive to list the potential hazards of continued use of alcohol.

Late-stage alcoholism includes:

  • Hand tremors—especially after not drinking for several hours
  • Nervousness, irritability, excitability
  • Discomfort when eating—nausea and vomiting after eating
  • Recurrent Diarrhea
  • Abdominal pain—high likelihood of liver damage and/or pancreatitis
  • Hypoglycemia or hyperglycemia
  • Heart palpitations, anemia
  • Blackouts, seizures, short-term memory loss
  • Delirium tremens, hallucinations, insomnia and nightmares

Finally, there is “wet-brain syndrome,” which refers to either Wernicke Syndrome or Korsakoff Psychosis.

Possible_long-term_effects_of_ethanolWernicke Syndrome involves Injury to the brainstem and areas near the third and fourth ventricle of the brain. Bleeding of these areas leads to symptoms that include double vision, disorientation, hyperactivity, and confusion. Wernicke Syndrome is considered a serious medical problem requiring immediate treatment. If left untreated, it is often followed by Korsakoff psychosis, which can include a deficit of executive function, meaning compromised reasoning, memory, planning, and problem solving. Without intervention, an alcoholic with this level of impairment is unlikely to seek treatment, and death by alcoholism is the certain outcome.