Archive for Sunday, November 10, 2002

Older drinkers experts at hiding alcoholism

November 10, 2002


Ron Freeman had never had a problem with alcohol " until he turned 59.

"I drank socially throughout my life, but it didn't accelerate until later on," the 63-year-old Jupiter Farms, Fla., resident said.

Growing up, Freeman said he was athletic and didn't take his first drink until he was in his 30s. But during his late 50s, Freeman became general manager of a large company and in charge of about 550 employees. Within two years, cutbacks forced him to close the plant.

"The stress and the pressure really got to me," Freeman said, and he took a year off. At 59, he began looking for work again. But it wasn't easy. He started to lose his self-esteem.

It wasn't long before Freeman was drinking all day, every day. He'd start with white wine at 7 a.m., move to beer in the afternoon, drink liquor during "happy hour," have some wine before dinner and follow it up with drinks after dinner.

"It was totally debilitating," he said.

Freeman said he was a "functional alcoholic." Unlike some family members of elderly alcoholics, Freeman's loved ones knew about his drinking. In fact, during a three-year period they tried several times to get him to stop.

By that time Freeman's body was beginning to have trouble keeping up with the drinking routine. It took a few bouts of pancreatitis and some advice from a close friend to finally force him to get help.

A dangerous trend

Alcohol addiction among the elderly is not uncommon. Many older adults are unaware that they are at increased risk of developing problems with alcohol.

"Alcohol is a way for people to handle grief and separation," says Bill Hanlon, director of marketing and planning for New Horizons in Fort Pierce, Fla. "And part of the aging process is to lose friends and family and to be separated from children and grandchildren.

Local resources can help you or a loved one tackle alcoholism or its signs:¢ Alcoholics Anonymous 842-0110¢ Bert Nash Community Mental Health Center 843-9192¢ DCCCA Inc. 841-4138¢ Headquarters Counseling Center 841-2345.Online resources:¢ Alcoholics Anonymous:¢ Moderation Management:

"Every once in a while it will hit them, and they don't socialize and they stay home," he added. "The TV set and the bottle might become their best friends."

Hanlon has been working in the field of addiction for 10 years, and though he thinks many older adults seek help for their problems with the bottle, the issue isn't something doctors like to address.

But, he said, if a patient seems unusually depressed or complains of other illnesses that might not be associated with an existing condition, the doctor should ask questions pertaining to addiction.

And in the elderly, health officials say, an addiction to alcohol isn't easily distinguishable.

"It's more difficult to recognize in older adults," says Carol Colleran, director of the Older Adult Services at Hanley-Hazelden Center in West Palm Beach, Fla. "There is a lack of awareness."

Family members and doctors find it difficult to associate addiction with older adults, Colleran said. For instance, shaky hands could be mistaken for Parkinson's disease; or physicians might think short-term memory loss could be attributed to Alzheimer's, she said. But both are symptoms of addiction as well.

"It's difficult to look at a little gray-haired grandmother and bring up alcohol and drug addiction to her," Colleran said.

"The Catch 22 is that older adults usually need more time during examinations, and doctors have less and less time nowadays," she added.

The National Institute on Alcohol Abuse and Alcoholism says one drink a day is safe for older adults " it can even help prevent heart disease.

"It depends also on what types of medication they're taking," Robinson said. "There's a great capacity for a problem to develop in the elderly because of the normal aging process."

Mixing medications

Studies have shown that about 3 million older people have a problem with alcohol, and Colleran says four out of five people over 65 take at least one prescription drug. In addition to the handful of other problems addiction can cause, mixing medications with booze opens the door to more life-threatening situations.

Nollie Robinson, director of substance abuse outpatient services and the criminal justice program at New Horizons, said a "multiplier effect" occurs when antidepressants, like Valium and Librium, anti-anxiety drugs or pain medications, are mixed with alcohol. "If they take one pill and one drink, it's not like two pills and two drinks," Robinson said. "It's like five pills and five drinks for an elderly person. That really catches them unaware."

Every drug also has a half-life, the amount of time it stays in the body, Colleran said, and medications like the ones described have the longest half-lives.

"The effect and the build-up is greater. There's an erratic release of the drug," she said.

This "multiplier effect" is a direct effect of a slower metabolism.

"Alcohol is water soluble, so older adults cannot metabolize it as quickly as when they were younger," Colleran said, adding that the effect six or seven drinks had on a person at 19, a person over 60 gets with two drinks.

Any chronic illness in an older adult can be affected by alcohol or the mixture of certain medications with alcohol: stomach problems, gout, liver problems and colitis.

Symptoms hard to see

Unfortunately, some of the tell-tale symptoms of alcoholism like slurred words, poor work performance or a sudden change in personality are not as easily identified in an older adult.

"Someone who works in the field of addiction or a recovering alcoholic can see the signs easily," Hanlon said. "But family members and doctors have got to know what they are first."

Depressed mood, bruises or broken bones, forgetfulness, isolation and an inability to perform routine chores are just some symptoms family members should look for, the health officials say.

"(Older adults) are not out there in the work force for the most part," Colleran said, "so they're not getting poor job performance reviews. And many of them are not driving cars, so we don't see them getting DUIs."

Colleran also said to look for what she called "nesting" " when an older adult sets up a "nest" in the living room with the TV, the remote control and a bottle.

"When you call at 7 in the evening and they're slurring their words or are not answering, you have to be open to the fact that there might be a problem," she said. "A change in eating habits is crucial to look for, too. Oftentimes, if they drink more, then they nap and don't eat as well."

Staying sober

Colleran said educating professionals and increasing awareness that older adults can, and do, have problems with alcohol, are the only sure ways to lower the incidence.

"I really believe we find what we're looking for and we don't find what we're not looking for," she said. "We need to start listening differently to older adults.

"Alcoholism is a disease, not a moral issue," she said. "There is a lot of shame for older adults. We have to let them and their families know that this is a disease because once (older adults) get into treatment, they have the highest recovery rate."

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