Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

CHAPTER 18Alcoholism and Substance Abusein Older AdultsSHELDON ZIMBERGPeople over 65 years of age are the fastest growing population in the UnitedStates. The U.S. Public Health Service’s Healthy People 2000 initiative notedthat 13% of the population is 65 years of age or older. It was noted that alcoholismand substance abuse are substantial problems in the general population,including elderly people (Menninger, 2002).Although there have been substantial increases in services for youngeralcoholics and substance abusers, including detoxification facilities, outpatientclinics, and inpatient rehabilitation over the years, few specialized programs forelderly people have been developed. Clinical experience has shown thatbecause of increased resistance to acknowledge an alcohol or substance useproblem and lack of emphasis in existing treatment programs on the life issuesthey experience, few elderly are willing to go to existing treatment facilities(Barrick & Conners, 2002). A substantial number of senior citizens have alcoholproblems, in the range of 10–15%. Illicit drug use among the elderly is rare,but prescription drug misuse and abuse is substantial (Reid & Anderson, 1997;Zimberg, 1995).In addition to patient resistance, among health care workers, there is a lowindex of suspicion about these conditions in elderly patients and negative attitudes,such as “Why bother to treat an older person? The alcohol is all that heor she has left.” This attitude can be considered a form of ageism. It is particularlyunfortunate, since elderly patients can be diagnosed and effectivelytreated, if the stresses of aging are recognized and dealt with in an “aging- specific”treatment approach utilized by myself and others to treat this population396