SUBSTANCE ABUSE

SUBSTANCE ABUSE

The abuse and misuse of alcohol or drugs was once considered a problem only among the young. Unfortunately, substance abuse has become a growing problem among older adults as well. Community surveys suggest that misuse of alcohol or other drugs is a common cause of physical and mental health problems in older Americans, especially older men. Older adults are particularly vulnerable to the mental and physical effects of these substances, because of the changes that happen in our minds and bodies as we age. In fact, negative health consequences are sometimes seen in older adults at a level of alcohol or drug use that would be considered light to moderate in younger people.

Substance abuse has clear and profound effects on the health and well-being of older adults in all aspects of life. Many different organ systems can be damaged by substance abuse. The social and economic impact is also tremendous. Substance abuse has negative effects on self-esteem, coping skills, and interpersonal relationships, which can add to other losses that are common in the later stages of life.

Many terms are used to define different levels of substance misuse, including dependence, abuse, problem use, and at-risk use. The medical definitions for these terms vary, but they all refer to the use of chemical substances in ways that lead to problems or disability, or to an increased risk of problems or disability. The first step is realizing that substance abuse is occurring, which can be difficult in older adults.

The warning flags of abuse are less obvious in older adults than in younger ones. For example, many older adults are retired and drink at home by themselves, so they are less likely than younger drinkers to be arrested, to get into arguments, or to miss work because of drinking. Also, many of the diseases caused by substance misuse (eg, high blood pressure, stroke, dementia, or ulcers) are common disorders in later life, so healthcare providers and family members may not be thinking of substance abuse as an underlying cause. In addition, the guidelines and screening tests that healthcare professionals use to diagnose substance misuse are often designed for younger people, and may not be easily applied to older adults.