Seniors’ drug abuse often overlooked

Most of the efforts to treat and prevent substance abuse, in Maine and the rest of the nation, have tended to focus on the young.

Yet there is a large and growing group of people in Maine, those 65 and older, who are equally vulnerable to the damaging effects of alcohol and drug abuse but whose problems have so far been overlooked.

“Older adults who are potential abusers of alcohol are an underserved and understudied segment of the population,” said Lenard Kaye, the director of the University of Maine’s Center on Aging. “Our few surveys, both locally and nationally, confirm the fact that older adults are at particular risk when it comes to alcohol consumption, but it’s an issue that’s been swept under the rug.”

Kaye said a two-year study begun at the center last month could go a long way in changing those widespread patterns of neglect and help provide a clearer understanding of how best to assist binge and chronic abusers of alcohol among the state’s elderly.

With a $30,000 grant from the Maine Department of Health and Human Services’ Office of Substance Abuse, the center will try to gauge the prevalence of problem drinking among those 65 and older, learn more about the lifestyles or cultural factors that might contribute to it and recommend what can be done to help seniors change their risky behavior.

“Alcohol abuse among the elderly is not a highly visible problem,” Kaye said in explaining why the issue has been so little examined in the past. “Younger drinkers have gotten most of the public’s attention because they tend to drink in bars and more raucously, they’re more likely to be involved in automobile accidents after drinking and to lose time at work as a result of alcohol abuse.”

Most older heavy drinkers, on the other hand, are “relatively invisible” when they abuse alcohol, Kaye said. They typically drink at home, are usually well-behaved about it, don’t display symptoms of abuse at the workplace and are less likely than the younger generation to be involved in alcohol-related accidents.

Yet living in a state of quiet intoxication, at home and alone, can nevertheless create a complicated and unique set of problems that endanger the welfare of the elderly abuser.

“Among elderly folks,” Kaye said, “the body frequently reacts more severely to alcohol consumption. It can also interact negatively with the different prescription drugs they take, which amount to eight or more a day, on average, and can have an affect on other chronic diseases such as diabetes and heart conditions.”

Maine, which has the largest percentage of elderly people of any state in the country, is at particular risk from alcohol abuse because of its rural and remote nature.

“The rates of mental health and substance abuse issues are higher in rural states,” he said, “and Maine is also poor compared with other states.”

Kaye said 15 percent of Maine’s population is 65 and over, yet his data reveals that no more than one to two percent of people served in alcohol treatment programs are in that age group.

“We could not find a single alcohol prevention program in the state that was geared toward older adults,” he said.

While the center’s researchers will gather statistics and technical expertise from more than two dozen state and community organizations that work with Maine’s elderly, the study will focus especially on the disproportionately high number of older alcohol abusers in Hancock County.

According to a survey conducted by Eastern Maine Healthcare in 2002, Kaye said, 20 to 25 percent of Hancock County’s elderly men reported having indulged in binge or chronic drinking in the previous month. The county also had the highest incidence of elderly depression, anxiety, hospitalization for senility and other organic mental disorders, as well as a suicide rate nearly double that of its peer groups elsewhere in the state.

“We want to come to some understanding about the statistics that have surfaced statewide, with particular emphasis on those in Hancock County,” Kaye said. “We need to determine the factors involved. Is it geographical isolation or a lack of family support? Is it the occupational background of elderly folks or the cultural traditions in mill towns, for instance, that lends itself to binge and chronic drinking?”

Kaye said it’s too early to know exactly where the two-year study will lead, but he hopes the recommendations to come from it will provide the framework for creative prevention programs that the Office of Substance and other agencies can adopt.

“Our challenge will be to think outside the box,” he said, “to develop alcohol prevention and treatment programs that are appealing and accessible enough so that older adults will be able to use them, and with staff that are prepared to serve them. We also need to determine ways in which to get state and local agencies to pay more attention to this problem. It’s been too long neglected.”