Prevalence Of Alcohol Abuse Among Senior Citizens
As baby boomers have turned 65, the age at which they qualify for Medicare, the rates of alcohol and other substance use disorders (SUDs) among them have climbed steeply. Families, friends, and even healthcare workers often overlook concerns about alcohol abuse in the senior population, but the reality is that anyone can develop an unhealthy relationship with alcohol.
The University of Michigan’s 2021 National Poll on Healthy Aging found that a substantial subset of seniors significantly exceeded the recommended guidelines for alcohol use. In the survey, 20% of respondents reported drinking alcohol four or more times per week; 27% reported having six or more drinks on at least one occasion (binge drinking) in the past year; and 7% reported alcohol-related blackouts.
A 2022 study from the American Journal of Preventative Medicine focused on the prevalence of SUDs among Medicare beneficiaries, looking at the differences between Medicare enrollees under 65 (who qualify due to disabilities) and those 65 and older. Of the 2% of beneficiaries over 65 who reported a SUD in the past year (over 900,000 seniors nationwide) more than 87% abused alcohol.
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In some cases, older adults have decades-long histories of regular alcohol use, while others develop a harmful reliance on alcohol later in life. This is often a result of major life changes, such as social isolation, new living circumstances, failing health, or the death of a spouse, loved one, or friend. These kinds of challenges can cause loneliness, boredom, physical pain, fear, anxiety, sadness, or depression.
These situations can lead to drinking too much, as they seek to ease their mental, emotional, and/or physical discomfort.
How Alcohol Affects Older Adults
Senior alcohol abuse can lead to a variety of negative physical and mental health consequences, including:
- Heart problems
- Liver problems
- Memory issues
- Mood disorders
- Increased risk of cancer
- Weakened immune system
However, the effects of alcohol change as a person ages and age-related changes in the body place older adults at additional risk.
Older adults have increased sensitivity to alcohol because they typically metabolize it more slowly. Moreover, muscle mass declines with age, and with less muscle to absorb alcohol, effects are felt more quickly. As a result, not only does tolerance to alcohol decrease as the body ages, but drinking frequently can worsen existing health problems.
Sometimes the effects of drinking in older adults are mistaken for other conditions related to aging, such as problems with balance or memory. Because older adults feel the effects of alcohol more strongly, they are more likely to have alcohol-related balance challenges that lead to falls and motor vehicle accidents.
Contributing to the risk for falls is the fact that older adults also have thinner bones that are more susceptible to bone fractures and breaks. Studies show that the rate of bone fractures in older adults increases with heavy alcohol use, with women at a higher risk compared to men.
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Given that many older adults take multiple prescription medications, another important concern for this age group is the dangerous and sometimes fatal result of mixing medications with alcohol. In 2020, alcohol accounted for 11,616 deaths among older adults, an 18% increase over the previous year.
According to data from the Centers for Disease Control and Prevention (CDC) from 2002 to 2021, the rate of overdose deaths among seniors quadrupled from three to twelve per 100,000.
While most seniors suffering from alcohol use disorders don’t die from overdoses, the health consequences are severe and can contribute to other causes of death such as injuries from falls and accidents, accelerated cognitive decline, heart and liver disease, and kidney failure.
In turn, deteriorating physical health can have significant adverse effects on mental and emotional health, and older Medicare beneficiaries with SUDs were more than three times as likely to report “serious psychological distress” as those without (14% versus 4%). About 7% had suicidal thoughts, compared with 2% who didn’t report such disorders.
Implications For Treatment
Unfortunately, very few seniors undergo treatment for their alcohol misuse (just 6% sought treatment in the past year compared with 17% of younger Medicare beneficiaries who did). Many older adults never explore seeking treatment with nearly half of all respondents over 65 reporting that they lacked the motivation to begin the process of looking into treatment.
Barriers To Treatment
Older adults face more barriers, including higher rates of stigma pertaining to alcohol abuse and concerns about what their family, friends, and neighbors might think. There are also more logistical barriers, such as access to transportation, not knowing where to go for help, being unable to afford treatment, and difficulty navigating the health care insurance and treatment system.
Uneven Medicare coverage also presents obstacles. Intensive treatment can be hard to access, and residential treatment (rehab) is often not covered at all. Medicare Advantage plans, with their limited provider networks and prior authorization requirements, are even more restrictive than traditional Medicare.
Common Questions About Rehab
Treatment Options Are Still Available
Although barriers exist, there are still options.
For those worried about the financial impacts of treatment, most addiction treatment programs have self-pay options where people can pay out-of-pocket. Some have a sliding scale based on individual or family income. Many programs have payment plan options that allow for the cost of treatment to be paid in fixed increments over time.
Some facilities offer scholarships to those in need to cover all or part of the cost. Lastly, although asking for financial assistance can be difficult, family and friends may want to help support your recovery journey via donations or loans.
Alcohol use disorders can impact so many areas of life, no matter a person’s age. For seniors, an alcohol addiction can amplify physical and mental conditions that are already present, therefore, seeking treatment for both the addiction and any comorbidities is essential.
A treatment provider can help explain and provide information on the treatment options available to you. Reach out to a treatment provider today, risk-free.
Ashish Bhatt, MD, MRO
Doctor of Addiction Medicine
Learn about Dr. Ashish Bhatt
Dr. Bhatt has been Addiction Center's Medical Content Director for more than three years, providing his expertise to ensure quality and accuracy.
Doctor of Addiction Medicine
Expert in adult and child psychiatry
Over 20 years of professional experience