A quick glance at articles about the emotional problems many seniors face as they age reveals two common threads: an increased likelihood of isolati0n, and the increased prevalence of substance abuse, especially alcohol. Now, researchers are exploring the link between the two. What if loneliness is a major root cause of the over-consumption of alcohol among U.S. seniors?
We recently discovered this disconcerting article on that topic on the NextAvenue website, written by freelance health writer Joan Reid. Reid writes from first-person experience, watching helplessly and intervening without success as her aging father, isolated after his wife’s death, sank deeper into what doctors now call alcohol use disorder. Her article presents a cautionary tale and also provides resources where concerned family members can find the help and resources their loved one needs.
Loneliness Triggers a Cascade of Substance Abuse
“Loneliness,” Reid poignantly begins. “It became my father’s steadfast companion. The loss of his life partner of 48 years (my mother) triggered a cascade of alcohol indulgence exacerbating his diabetes. Alone at 71, the door of solitude opened wide while the outside world was shuttered from prying eyes. Dad numbed his grief with hidden alcohol use.”
Reid’s father’s struggle was—and is—an all-too-common pattern. The U.S. Surgeon General stated in 2023 that loneliness has become a leading health concern. In the midst of ever-changing life circumstances people can fall away from our lives and social circles, leaving us isolated. “Indeed, the decline in satisfying social connections among retirees may lead to overeating, over medicating and alcohol use,” Reid writes.
Loneliness Can Also Lead to Other Unhealthy Habits
Reid points out that loneliness has been linked to bad health behaviors, like a diet low in nutrients (and highly processed), drug and alcohol use, smoking, and inactivity. “Dad was a capable cook and prepared homemade soups, baked vegetables and fish and ate fresh fruits,” Reid writes. “He didn’t overeat or consume sweets, was vigilant with prescribed medications for his diabetes and high blood pressure. His healthy eating still didn’t curtail his alcohol consumption because he was alone.”
The signs did not go unnoticed by her father’s doctor, but a lack of understanding of alcohol use got in the way. “The doctor warned him repeatedly to stop drinking — eventually releasing Dad from care. But no number of warnings could fill the void Dad experienced,” she writes. Instead, Reid’s father continued to “self-medicate” with scotch, beer, or wine.
Keeping Secrets from Close Family and Friends
Over a period of six years, Reid says her father’s alcohol indulgence “took a toll” on his health. He never told anyone that his doctor had released him from care – essentially firing him as a patient – and he continued to live alone. Reid and her siblings lived within driving distance, but she writes, “We believed he was taking care of himself.” They thought things were fine.
Then, everything changed when Reid was contacted by a local hospital. “I peered past the emergency room examining curtain and caught a horrifying sight: Dad’s feet were darkened black. Necrosis had set-in, a life-threatening condition. His hidden alcohol use was no longer a secret, and his life was saved with a leg amputation from the knee down.”
Tragically, her father sustained a massive stroke and died two weeks later.
Today, Doctors Take a More Enlightened Approach
It has been twenty-six years since Reid’s father passed away, and things have changed for the better from a medical perspective for those facing the same challenges.
Anika Alvanzo, M.D., secretary of the American Society of Addiction Medicine (ASAM) explains, “First, I have never released a patient from care who needed help.” Second, she adds, “the terms ‘alcoholism’ or ‘alcoholic’ are stigmatizing. ASAM encourages the use of non-stigmatizing, person-first language. Rather than using the term alcohol abuse, it is recommended to use ‘unhealthy’ or ‘harmful alcohol use.’”
Dr. Alvanzo also explained to Reid that, for over a decade, medical experts have used the term alcohol use disorder (AUD) to describe the inability to control alcohol use despite harmful consequences.
After a Major Loss, Survivors Deal with Guilt, Despair
“Myriad feelings surface after life-changing losses: guilt, anger and despair are just a few,” Reid explains. “Routine tasks may become burdens, and depending on the circumstances, navigating through these feelings can lead to taking the shortest route for relief: alcohol, a relatively inexpensive drug which doesn’t require a visit to a doctor for a prescription.”
Alcohol is also extremely convenient to find and discreet to purchase these days, since your nearest supermarket and corner store are always well stocked.
But the physical costs are often disastrous. “AUD increases health risks such as heart attack, stroke, depression, liver disease and diabetes,” Reid writes. “There is also shame associated for falling into this abyss. The shame of drinking alone, staying away from family and friends, spirals to a tipping point where medical intervention is a necessity.”
Alcohol Abuse Rising Among U.S. Seniors
This is an increasing problem, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and data from the National Survey on Drug Use and Health indicates that “approximately 20 percent of adults ages 60-64 and 12 percent over age 65 report current binge drinking.”
Not only this, but alcoholic beverages combined with prescribed medications and over-the-counter drugs can become a “toxic cocktail” for older adults, especially since their tolerance for alcohol is decreased. This puts seniors at higher risk for accidents like falls, car crashes, and other injuries.
Dr. Alvanzo says, “The strategy for treatment is not that different regardless of age. We educate patients about healthier coping mechanisms. If it is an issue of isolation, we identify resources in the community, such as senior centers, to get them engaged, if they are willing.”
She continues, “We clinicians should be screening patients for alcohol use when we deal with their medical conditions. We ask how they use alcohol, what is it doing for them, what is the impact on their life, physical and mental health and social functioning. We want to educate our patients how continued use of alcohol is unhealthy and how we can help them meet their goals.”
Treatment Options for Affected Loved Ones
These days, there are better and more accessible treatment options available for those who overuse alcohol. There are three medications currently approved by the U.S. Food and Drug Administration to help people quit, reduce, or prevent drinking: naltrexone (oral and long-acting injectable), acamprosate and disulfiram. “All these medications are nonaddictive, and they may be used alone or combined with behavioral treatments or mutual support groups,” Reid writes.
One thing that’s harder to deal with is the stereotypes which persist about alcohol users. Reid notes the old prejudice about them being “unkempt, constantly intoxicated, making public outbursts or physically abusive to family members.”
Thankfully, new education initiatives are helping to fight against these negative images. “Stay-at-home moms, retirees, widowers and widows, the neighbor who lives alone, all may begin overusing alcohol to relieve stress,” Reid writes. “The commonality is increased solitude and unstructured daily routines, and their lifeline of support vanishes.”
Threshold for At-risk Drinking is Lower for Many Seniors
The NIAA defines “at-risking drinking” for adults over 65 years old as more than three drinks per day and seven drinks per week, but note that these thresholds may be lower for seniors taking medications.
Reid concludes, “Are you or someone you know at risk for AUD? The first step is to bring your concerns to your doctor, be truthful with yourself. There is no shame to have AUD or any medical condition. Learn about better coping strategies, medications and agencies that can help. Go to the websites ASAM, NIAAA and AA. Take that first step away from the precipice of loneliness and hidden alcohol use.”
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(originally reported at www.nextavenue.org)