Substance abuse is a major public health concern in Maine and the United States, affecting more than 23 million people nationwide and 80,091 in the state. Discussions about the substance abuse epidemic have paid little attention to its effects on older adults.
As much as 17 percent of older adults nationwide cope with substance abuse, with many expecting the number to rise as the baby boomers age. In Maine, rates of substance abuse among older Mainers increased 25 percent between 2000 and 2010, though they remain a minority of Mainers seeking treatment.
The incidence of substance abuse among older adults is widely accepted as under-reported, often the result of feelings of shame, as well as ageist assumptions that lead people to ignore or disregard older adults and their problems. Casting aside these assumptions is essential to addressing this health crisis and ensuring older Mainers continue to be happy and healthy residents.
One of more insidious ageist assumptions is that older adults are past their prime, so why treat their addictions. But this couldn’t be further from the truth. For the baby boomers, retirement is coming later and later, with many embarking upon “ encore careers” and continuing to seek higher education.
A 2013 Gallup survey found workforce participation rates among people age 65 and older rose 3 percent between 2010 and 2013, with steady rates for people age 50 to 64. The December 2013 Bureau of Labor Statistics workforce projections predict that, through 2022, workforce participation rates among older adults will rise 29 percent over 2012 levels; meanwhil, rates for people age 16 to 24 will decline 13 percent.
Another faulty ageist belief is that drinking and other substance use makes older adults happy. “Let them drink and enjoy life,” it goes. According to Brenda Iliff, executive director of the Hazelden Center in Naples, Florida, “They’re not enjoying life.” Substance use often costs them their independence.
In fact, many older adults use substances as a means of coping with anxiety, loneliness and social isolation, which results from a loss of family and friends, as well as decreased mobility, which in rural regions such as Maine makes substance abuse harder to detect.
Damage to the nervous system and cerebellum, as well as increased muscle weakness resulting from substance abuse, place older adults at risk for falls, said Clifford Singer, chief of Geriatric Mental Health at Acadia Hospital in Bangor. Further, substance abuse also will exacerbate heart and liver disease, and alcohol can create a dementia resembling Alzheimer’s.
Addiction can require older adults to be placed in a nursing home or to require the service of a home health aide. A nursing home can cost as much as $8,231 per month, while a home health aide can cost as much as $4,195 per month.
While substance abuse can cost older adults their independence, Iliff noted that once treatment has begun, older adults usually reclaim their independence.
Healthy and happy older adults are likely to stay at work longer and live productive lives. When substance abuse is ignored, the cost is significant, and in the end, everyone pays.