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Why Older Adults With Addictions Fare Better in Age-Tailored Rehab

Experts explain the particular issues older addicts face


The numbers are, pardon the expression, staggering: The National Council on Alcoholism and Drug Dependence reports that 2.5 million older adults have an alcohol or drug problem. The journal Psych Central ups the ante, reporting that around 3 million people over 65 battle alcohol abuse, and this number might jump to more than 6 million in the next few years.

Another stunning statistic: Fewer than 20% of the nation’s 14,000+ treatment centers offer programs tailored for the 50-and-older crowd, according to the latest National Treatment Center Study by University of Georgia’s Institute for Behavioral Research.

Brenda Iliff
Brenda Iliff

Thankfully, the bad news pretty much stops there. The number of rehab programs and facilities geared for older Americans is rising steadily, as rehab outfits recognize that the boomer generation not only is swelling in numbers, but will be much more amenable to seeking help than their taciturn parents.

“Boomers have been seeking purpose their whole life,” says Brenda Iliff, executive director of the Hazelden Betty Ford Foundation’s Naples, Fla., center, the only one of the organization’s 16 locations to have an older-adult treatment program. “There’s a lot more openness to getting outside help. There used to be only a very few seniors who would seek help. Their philosophy was that they had earned retirement and the time to enjoy life. But when you’re talking addiction, you’re not enjoying life.”

“As boomers, we share more in common; our life problems are a lot different than people two or even one generation younger than us.”

Even at all-ages rehab centers and addiction meetings, the sharing nature, combined with older adults’ increasing presence, means that the days of a reticent 60-something amid a predominantly younger set are almost over, Iliff and other experts say.

Paul Heflin
Paul Heflin

Still, older adults tend to be more comfortable in peer-group settings, says Paul Heflin, a retired Cincinnati auto dealer who now lives in Naples and has gone through Hazelden Betty Ford’s eight-week intensive outpatient program.

“As boomers, we share more in common; our life problems are a lot different than people two or even one generation younger than us,” Heflin says. “All of our stories are very similar, with some more serious than others. I can relate to someone my age a lot more than with somebody my son’s age. At an AA [Alcoholics Anonymous] meeting with older people, there’s a lot of wisdom in that room. I talk to younger people, and they like to go to meetings and talk to people their age, too, often because of their experiences with opioids.”

Contributing Factors Abound

Comfort levels aside, the increasing prevalence of addiction among 60-and-older or even 50-and-older people is likely not going away. Alcohol is the primary drug of choice, but the causes of their addiction are a powerful combination of circumstances. Among them:

  • Free time: Retirees find themselves with more work- or activity-free hours every day. Many fill that time with “recreational activities like golf or bridge, where alcohol is part of that experience,” says William Cope Moyers, Hazelden Betty Ford’s vice president of public affairs and community relations. Adds Illif: “They have free time, they have money and alcohol’s almost always there.” Which brings us to the next factor…
  • Easy access: Deirdre Armstrong, director of the 55Plus program at The Retreat recovery center in Wayzata, Minn., has become alarmed at the number of older-adult living centers that now serve alcohol or allow it to be delivered. “They all have bars now. It’s insane,” she says. Armstrong also cites boomer-dominated residential areas in Florida, such as Margaritaville and The Villages outside Orlando, Fla.
  • Suffering: “Grief and loss and dealing with death or divorce,” Armstrong says, “are huge issues that are par for the course for seniors.” Which often leads to the next factor…
  • Aimlessness: Moyers says a lack of purpose is a recurrent problem. And Armstrong cites “a huge epidemic of isolation and loneliness in old age. People end up in a room alone with their best friend and a bottle of schnapps.” Heflin, who is single, says this fit him to a T. “It didn’t bother me to stay at home and drink all day. I was content to just sit around and get drunk all day long,” he says.

A Matter of Metabolism

These factors often prompt older adults, in Armstrong’s words, to “accelerate from being a moderate-to-heavy drinker to being an alcoholic.”

A couple of complications can exacerbate the situation. First and, perhaps, foremost, as we age, our metabolism changes.

“Our gastrointestinal system slows down, our liver slows down and our kidneys slow down,” Iliff says. “For older adults, a lot of times less is more; seventeen percent are prone to chemical misuse or addiction, having never had a problem because their bodies haven’t adapted.”

She adds that binge drinking for younger women is four drinks in four hours, but for older women it’s two drinks in four hours, due to that metabolism change.

In addition, drinking might well be accompanied by the use of benzodiazepines, commonly prescribed for anxiety or sleep issues. Iliff cites the “common trifecta” of alcohol, benzos and opioids.

“The quantity [of any element] might not be much, but you might add anxiety pills to the two or three drinks that they have had all their lives, and maybe opioids,” Iliff says. “We want to feel good and all those things make us feel good. … And the brain doesn’t care where any of it comes from.”

That helps explain why the National Institute of Alcohol Abuse and Alcoholism recommends a maximum of one drink daily and no more than two on any occasion for men and women 65 and older.

When Addiction Strikes Again

These components can wreak havoc for those who haven’t encountered problems until this time of their lives.

But, of course, some older men and women have gone through treatment in the past and have addiction pop up again. (Except for chronic addicts: As Armstrong notes, “If you’ve been drinking that way your whole life, you’re dead by sixty-five.”)

But recidivists tend to bring with them other physical ailments wrought by their bad habits. Heflin is a prime example. “I had some pretty bad health issues due to alcoholism,” he says, “so when you’re sixty, it’s a life-saving situation. You might not have another chance to get sober.”

“Older adults care a lot once they get in the door. They do their homework, they show up on time, they’re engaged.”

Which brings us again to some good news: Older people tend to make better patients in rehab. They are more amenable to outpatient programs, such as The Retreat’s focus on a 12-step immersion curriculum, and inpatient ones that vary in length. And they tend to arrive fully committed, Armstrong says.

Deirdre Armstrong
Deirdre Armstrong

“Older adults care a lot once they get in the door,” she says. “They do their homework, they show up on time, they’re engaged. … And boomers are more into a health-and-wellness type of environment.”

Boomers also seem to be quite willing to talk about their issues, Illif says. “They love to talk. As people are more mature, you don’t have the behavioral issues. They want the programming; they’ll go for the extra program. They’re excited about getting their lives back.”

In other words, motivation generally is not an issue. “I’ve had people come to me at age eighty and say, ‘I don’t want to die a drunk,’” Armstrong says. “We realize that so much of the basis of recovery is instilling hope that there is a future for them.”

Finding Help for a Loved One

Experts on addiction rehab for older adults say family and friends need to move past the “they’re retired, let them have their fun” stage if they start noticing problems. There might be mobility issues or an increase in late-afternoon “naps,” but most often it’s about behavior.

“A daughter might say, ‘Mom, I don’t want you being around the grandkids,’” Iliff says. “But sometimes the best intervention is the hair stylist who says, ‘Sally, you’re not the same,’ or [this is said by] a pastor or a caretaker.”

Regardless of the circumstances, loved ones will have better luck finding facilities that have programs for older adults if they live in Minnesota, where rehab centers abound, or Florida, where older adults abound.

The best course otherwise is to use these resources to find facilities and call them to inquire about treatments for older patients:

By Bill Ward
Bill Ward is a freelance wine, food, travel and lifestyle writer. His “Liquid Assets” column runs in the Minneapolis Star Tribune, and he has a wine website, www.decant-this.com, with a blog and a travel-itinerary service. He won a James Beard Award in 2004 for a series on Italian regional cuisine. He lives in the Minneapolis suburb of Hopkins, Minn., with his wife, Sandy.

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