Late Onset Alcoholism

Most older adults with drinking problems begin drinking in adolescence or early adulthood and continue to drink throughout their lives. However, an estimated one-third of older alcoholics drink sensibly, in moderation, until later life when divorce, widowhood, depression, boredom, financial problems, loneliness, grief, loss of purpose, chronic pain or ill health compel a change in drinking habits. Alcohol dependency, which begins later in life (after age 50), is referred to as late onset alcoholism.

The progression from moderate drinking to alcoholism occurs quickly in older adults, who have slower metabolism and decreased tolerance than they did in their younger years. Because the body retains less water and the concentration of alcohol in the tissues is greater, older adults are more sensitive to smaller amounts of alcohol and become intoxicated rapidly. These unexpected changes often take older drinkers by surprise.

Late onset alcoholism differs from early onset alcoholism in several ways. For example, late onset alcoholics:

  • are often women.
  • tend to have a higher socioeconomic status than early onset alcoholics.
  • are less likely to have a family history of addiction than early onset problem drinkers.

Like early onset alcoholics, alcoholism that begins in later life can exacerbate chronic illnesses such as diabetes or high blood pressure. However, although there are always exceptions, late onset alcoholics are less likely to experience alcohol-related diseases such as cirrhosis, and they are less likely to be affected by alcohol-related cognitive damage but they experience falls, injuries, loss of daily structure, decreased cognitive functioning, appetite, sleeping problems and many others.

Unfortunately, many late onset alcoholics never receive treatment, often because they drink in private, or because friends and family think they’re “too old to change.” Loved ones don’t want to accept that a respected parent or grandparent has a drinking problem, or they think that falls or forgetfulness are typical signs of aging. Older people are often ashamed and not willing to talk about personal problems, and physicians are less likely to press the issue and keep prescribing medications which only address presenting symptoms, but hardly ever the cause.

Once the subject is approached, late onset alcoholics tend to be more amenable to treatment than early onset problem drinkers, and the outcome is often very positive, especially when they learn that problems associated with late onset alcoholism are often less severe. Hazelden Betty Ford Foundation reports that the recovery rate for late onset alcoholics is higher than any other age group, although recovery make take longer. Without treatment, however, problems can escalate rapidly and late onset alcoholics are not only susceptible to the above mentioned health complications, but lack of independence and legal issues.

According to SAMHSA (Substance Abuse and Mental Health Administration), less intensive forms of treatment are often effective and should be attempted before progressing to intensive treatment.

Effective treatment for late onset alcoholics should be respectful, supportive and non-confrontational and delivered at an appropriate pace. Treatment providers should be sensitive to health problems that can affect older adults, and underlying issues such as loss, depression, grief, anxiety, trauma as well as other presenting health problems, must be addressed. Involvement of friends and family members is key, both during and after treatment.

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