It may surprise you to know that over seventy percent of older adult hospital admissions are in some way related to alcohol or medication problems. The problem of alcohol and medication dependence among older adults, an often misunderstood, denied and misdiagnosed problem is growing rapidly with the aging population.

There are over eight million seniors who are addicted to alcohol or medication, one third of whom suffer from late onset addiction.

Late onset addiction may be of particular concern among retired professionals. They may experience a sudden lack of purpose after a rewarding, demanding and often prestigious career. These retirees have enjoyed a high level of respect along with a demanding career. According to a recovering older alcoholic whose heavy drinking escalated rapidly when he “retired” involuntarily, “to lose one’s professional life is tantamount to losing one’s identity.”

The heavy social drinker who managed to cope in professional life may now drink more in retirement, causing physical, mental and personal consequences. Late onset addiction can result from a number of life transitions and risk factors, such as loss of a spouse or loved one; loneliness or isolation; health problems and pain; or a move to a new home or geographic location. Retirement communities, for example, are often abundant with social activities that revolve around alcohol and happy hour.

Considering Intervention

It is difficult for most people to begin a conversation with an older loved one, colleague, or friend about a suspected problem with alcohol or medication.

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In his latest book, Boom, Voices of the Sixties, Tom Brokaw focuses his famous reporting lens on the Sixties decade. Future business and political leaders came of age, and youth energetically began to carve out new rules and new civil rights. The Vietnam War was defining and divisive, rocking the nation and Baby Boomers in particular. Millions protested the war and the draft. A counter culture, and rebellion against societal mores and “the establishment” was reflected in “acid” music and psychedelic art. Woodstock featured great names in music but became a drug fest. LSD was drug blatantly promoted by Sixties guru, Timothy Leary, who convinced young followers to “turn on, tune in, drop out.”

Tom Brokaw interviewed Sixties top singer, Judy Collins, now in successful recovery from alcoholism and drug abuse. She recounted that there was a lot of chaos as well as lots of drug addicts and alcoholics in those days. Those who recovered and those who died. Judy herself finally got the treatment she needed in 1978, and has helped many others by telling her story of hope. Brokwaalso profiles a San Francisco doctor, Dr. David Smith, who started and ran the Free Clinic for Haight Ashbury youth who had nowhere to turn for needed medical care. Dr. David Smith took LSD himself.

What happened to Janis Joplin and Jimmy Hendricks was a tragic commentary on the times. Others are in recovery, like singer Grace Slick of the Jefferson Airplanes. Singer-guitarist James Taylor overcame his heroin habit but his marriage to Carly Simon didn’t survive. The drug culture was vividly described by Tom Wolff’s famous The Electric Kool-Aid Acid Test as it follows the trail of Ken Kesey and his “Merry Band of Pranksters, and the Grateful Dead’s early “Acid Test” music.

At the same time, most kids who tried pot and grew their hair long later shed both. Baby Boomers went on to become the wealthiest generation ever. Energetic optimistic, individual, entrepreneurial, Boomers nevertheless experienced divorce at a rate off one out of two marriages. It was a youth culture. They felt they would naturally stay young, and remain healthier longer than the precious generation. Looking young has cost Baby Boomers a bundle in plastic surgery and cosmetics, yet what is the illusive definition of attractiveness as we age? To age seems somehow reversible to many in this generation.

We know the incidence of late onset and long-term addiction among those over age 50 is on the rise. Many Baby Boomers are self-medicating for chronic pain, slipping into addiction to pain pills, which they obtain from “doctor shopping” or the Internet. And many suffer late onset addiction to their earlier drugs of choice. Some never quit heavy drinking and/or drug use.

Baby Boomers understand the value of therapy and self-help. They want choice, and to be engaged in decisions. These factors can help Boomers in successful treatment for those who struggle with alcohol and chemical dependency. Being engaged in one’s treatment is key, and an individualized care plan begins with the assessment of the person physically, mentally, emotionally and spiritually, Therapies within a the holistic program are based on the 12-Step philosophy, and may include Motivational Interviewing, and expressive, experiential therapies such as movement, art therapy, writing and music, as well as wellness, nutrition and spirituality. Menopausal and post-menopausal women find Hormonal shift assessment helpful as well. Both men and women renew connection to self and others.

Baby Boomers in recovery are like so many in their generation who are finding renewed purpose in life. They are asking, “What do I want my relationships to be, my work to be? What can I do to make a difference to others and society? What does vitality mean to me?” Exploring healthy aging, even if we use the dreaded word “aging,” really is a step towards vitality for those who are on a recovery journey or who want to make meaningful choices in the “second half of life.”

Hanley Center’s Center for Older Adult Recovery, http://www.hanleycenter.org addresses the Young Older Adult in a new model of treatment for the disease of addiction, because older Baby Boomers have different profiles in values, worldview and patterns of drug and alcohol use than those mid-sixties and up. The incidence of dual diagnosis is also more prevalent in Young Older Adults, such as anxiety and depression. Traditional older adults who suffer from addictions are primarily dependent on alcohol or medications, and view illegal drug use as immoral.

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By Bill Urell

For successful alcohol addiction recovery, three factors must come together simultaneously.  Addiction recovery is amazingly complex subject that just begs to be broken down into simplicity.  Here are the three factors that should come together to have a reasonable chance of success and lifelong abstinence:

1. Strong motivation - If the drinker is not aware or can’t see that drinking has become problematic, the logic becomes why fix something that isn’t broken?.  This is a huge problem because the denial of a problem is one of the defining characteristics of alcohol addiction.  Now, even if the drinker does believe that they have a problem, there’s a question of whether they’re willing to do something about it, and what are they willing to do? Often they may concede that there’s a problem with their drinking, but are not motivated to “do what ever it takes” to become completely abstinent.  They will spin around in circles in futile efforts to maintain ‘control’ over their drinking.

2. Timing - If the drinker concedes that they have a problem with alcohol addiction or it is causing problems in their life, that’s great, but it’s not enough. Many drinkers are fully aware that they have a problem but not ready to do anything about it. Timing and motivation are frequently brought about by personal crisis that is close to home and personal.  Getting whooped in the head with a figurative 2 x 4, such as narrowly escaping death, or losing a job, or losing somebody close to them. Motivation and  timing generally do not come together as a result of nagging, finger-pointing or educating the alcoholic on the evils of addiction.  I knew I had a problem with drinking for 20 years, and said I could quit any time I wanted to, but the time was never quite right.  If a drinker has admitted that they have a problem with alcohol and states that want to quit the next question to be asked to simply… now? If the timing is right we move onto the next piece of the puzzle.

3. Persistence - If the motivation and timing are in place and a drinker has actually stopped drinking and achieved abstinence, the question now is how they stay stopped drinking for the long run? The only solution is to keep abstinence and growing in sobriety the primary alcohol addiction recovery goal. The way that is done is through persistence.  It’s crucial to keep a high level of daily awareness that no matter what twists of fate life has in store for us, returning to alcohol use is not a solution. The vast majority of people who have relapsed back into alcohol use have stated that sobriety lost its priority.  They did not persistently maintain their awareness of their alcoholism; actively pursue relapse prevention, and life skills.   Many people returned to drink because their life is going so well they forget they have a problem with alcohol and believe they can once again return to its use and control it.

There are many ways to look at alcoholism and recovery.  There is no one definite view or methodology that has been proven to be more successful than another, so there are many theories and opinions out there.  It is simply my experience as a professional working with people and alcohol addiction recovery that the confluence, or coming together, of motivation, correct timing, and persistence, are necessary pieces of the puzzle for long-term sobriety.

Pick up your Free Addiction Recovery Help Guide, Over 100 pages of   alcohol addiction recovery tips, resources and links to enhance your life. Bill Urell MA.CAAP-II, is an addictions therapist at a leading residential treatment center. Visit our growing community at: http://www.AddictionRecoveryBasics.com

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The following is one of a series of excerpts from the book “Men’s Healing: A Toolbox for Life”, with expicit permission from the authors.

Why do men drink? What is it that drives a man to seek out an altered state of mind? For many men there is a correlation between their initial introduction to alcohol and their initiation into manhood. Drinking takes practice! The bitter taste of most beer and liquor is not an immediate favorite for most neophyte drinkers. But it is not the taste that hooks, it is the effect. So what really happens when we drink? There are many physiological changes that occur in the body when you add alcohol, but what of the emotional and social effects? 

Many men describe alcohol as a social lubricant. The initial freedom from the bondage of self-doubt and uncertainty: uncertainty of how to act, how to fit in, how to “be a man.” Time and again we hear men say that they “needed” a drink or two to quell the inner voices that prevented them from socializing sober. The problem for many men is that the line between “socially comfortable” and blackout is frequently, unintentionally, crossed. For many men, the consumption of alcohol is accepted as a rite of passage. Reports of college fraternity pledges dying of alcohol poisoning are all too frequent. Some of our most hallowed institutions of learning are more famous for their parties than for their faculties. For some, these years of alcohol abuse are left behind upon graduation, and a life of moderate social drinking is adopted. For others, the abuse of their teens becomes the addiction that shapes the rest of their lives.   

Some men learn to drink like their fathers. For others, the behavior of their fathers promotes a life of complete abstinence. Marijuana, cocaine, LSD, ecstasy, methamphetamine, heroin, anxiolitics, and a variety of other drugs are frequently part of a man’s journey. Whether upper or downer, each drug has its own unique pathway to “somewhere else.” Somewhere else, anywhere else, is often preferable for a man who may be riddled with pain, shame, fear, and self-doubt. There may not be a definitive moment when a man moves from abuse to addiction.

For some, a genetic predisposition has left them wide open to dependence. For others, years of abuse have left them physically unable to stop using. Either way, the outcome was similar: strained relationships, physical and emotional bankruptcy, missed opportunities.

Knowing why a man became dependent is not as critical as his willingness to recover from that dependency, but it certainly can help to take a good look at some of the significant events over the lifespan of each man and to look for correlation in the types and amounts of substances used and the consequences incurred.

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New Grand Theft Auto Game Allows Players to Drive Drunk

While drunk driving continues to be one of our nation´s deadliest acts, killing nearly 13,500 people each year, the latest version of the popular Grand Theft Auto video game allows players to get behind the wheel and experience drunk driving. Substance abuse prevention advocates and national organizations, including CADCA, are concerned that the game normalizes a behavior that costs thousands of lives and injuries.

Released on April 29, Grand Theft Auto IV is the ninth title in the Grand Theft Auto video game series produced by Rockstar North. While the game has always been controversial, allowing players to earn points by killing police officers, the new version takes it to another level, with the inclusion of a module where players have to drive drunk.

Members of CADCA are already weighing in to say the game glamorizes drunk driving and could have a particularly dangerous impact on younger teens.

“It’s unconscionable that something that has devastated so many lives is being made into entertainment,” said Pamela White, Executive Director of Community Anti-Drug Coalitions Across Tennessee (CADCAT). “Allowing drunk driving in a video game normalizes a behavior that is not only illegal, but threatens lives.”

Cheryl Guthier, Executive Director of Community Prevention Partnership of Berks County, echoed that sentiment, pointing to how children and young teens would interpret drunk driving in a video game. “People may argue that teens can tell the difference between a game and reality, but I think it could really have an impact on younger kids because they are impressionable,” Guthier noted. “I have young grandkids and I know that if they play this game, they’re going to see it as funny and cool, and something that people do.”

While the game is currently rated as mature, Mothers Against Drunk Driving (MADD) is calling on the Entertainment Software Ratings Board to reclassify Grand Theft Auto IV as an Adults Only game. In addition, in a recent advocacy alert, MADD is requesting that the manufacturer consider a stop in distribution, “if not out of responsibility to society then out of respect for the millions of victims/survivors of drunk driving.”

In response to MADD’s request, Rockstar North issued a statement to the Associated Press, saying: “We have a great deal of respect for MADD’s mission, but we believe the mature audience for ‘Grand Theft Auto IV’ is more than sophisticated enough to understand the game’s content.”

CADCA believes a video game with a drunk driving mode is offensive—even to a “sophisticated” mature audience. We agree with MADD’s position and encourage coalitions to contact retailers to express their views about Grand Theft Auto IV’s drunk driving mode.

“A game that in any way promotes or makes light of drunk driving is a cause for deep concern. I would strongly encourage both the makers of the game and those that distribute it to reconsider selling it,” noted Gen. Arthur T. Dean, CADCA’s Chairman and CEO.

This article is reprinted from CADCA’s website, originally posted on May 1, 2008 at www.cadca.org

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DANGEROUS DRUG SERIES

What is it?
Methamphetamine is a powerful addictive stimulant that is similar to adrenaline, and dramatically affects the central nervous system. 

The fact that it is widely manufactured from inexpensive ingredients in simple labs, often home-based, contributes to its widespread use. Toxic ingredients such as battery acid and drain cleaner are also used to produce meth. 

Slang Terms:
Meth, crank, crystal, speed, ice and glass. Use is often referred to as “doing a line.” Binging is “doing a run.” 

How is it used?
Meth is a white or colored powder that can be taken intravenously, smoked, “snorted” through the nose, or it can be made into pill form and swallowed. Smokeable meth is known as glass or ice.  

Signs of usage:
When under the influence of meth, the user may be very talkative with a high level of energy. Dry mouth can be observed, as well as dilated pupils. Users may also scratch at imaginary bugs on the face and other skin, leaving sores.Weight loss can be observed after a period of use. Effects of usage:
At first the user feels energized, focused, positive and alert. Many people take the drug to stay awake and active. However, the first “high” is usually not attained again with the same dose, so more meth is taken the next time. Many teenage girls and young women take meth to lose weight, which seems easy because of loss of appetite. Insomnia, sweating and repeated motor activity are common results as well as some alarming psychological and physical effects. These can include paranoia; increased heart rate; increase in blood pressure; delusional thinking; anger and aggression; tremors, and at higher dosages, palpitations, and hypothermia.How long do the effects last?
The effects of meth can last anywhere from three to 12 hours. Users often “do a run” for several days straight in an effort to increase and prolong meth’s perceived positive effects, going without sleep or food.Effects of withdrawal:
When the feeling of well being and energy wears off, the meth user may experience entirely opposite effects, because the drug suppresses the normal production of adrenaline in the body. Irritability and fatigue may result. This often leads to the desire to use more in order to remain high.Adverse reactions:
Many of the effects of meth use can be negative, such as sleeplessness, anger and paranoia. More dramatic reactions include convulsions and agitation. An overdose can result in a potentially fatal cardiac arrest or stroke. There is also a possibility of lead poisoning. Meth abuse during pregnancy can result in congenital deformities and premature delivery.Effects of prolonged usage:
The pleasure/tension cycle is self-perpetuating. Long-term meth use is devastating. The user is unable to function in daily life and experiences exhaustion when the drug wears off. Dental decay is a well-known result of prolonged use. Long term use and higher doses needed to get high increase the risk of toxicity, overdose and death. Death by overdose rose 125 percent between 1998 and 2002. Meth may permanently cause brain damage after prolonged use.

Usage by youth:
The heartbreak of meth’s high incidence of use by teens and young people is exacerbated by the desire by young women to be thin. Meth use crosses every income and social background, and is common at “rave” clubs. The Internet is rife with sites that provide meth recipes and information on where to obtain ingredients. Over .3 percent of 12 to 17-year olds and 18 to15-year olds currently use meth. Among students, meth use was reported in 2000 to be 1.3 percent of 8 grade students, 1.5 percent of 10 grade students and 1.5 percent of seniors. Higher percentages have actually used meth at some time, including almost 12 percent of seniors. At least 4 percent of the U.S. population have reported using the drug.

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DANGEROUS DRUG SERIES

What is it?

Oxycodone is a prescription narcotic used medically for pain relief in the opiate class of drugs.

Slang Terms:
Hillbilly heroin, oxycotton, oxy, OC, killer

How is it used?
The drug can be ingested, snorted, injected or smoked.

Sign of usage:
The user displays droopy eyelids, constricted pupils and sluggish, delayed speech and mannerisms. The opiate user will appear very drowsy and have difficulty with mental functioning and attention span. If the user administers the drug with an injection, there will be needle marks and possible signs of infection at injection sites.
.
Effects of usage:
Oxycodone produces an initial euphoric effect. It can also produce drowsiness, lowered blood pressure, lowered body temperature, nausea, slowed breathing, decreased pulse rate and constipation.

How long do the effects last?
Length of effects varies depending on dosage. OxyContin (continuous release form) has an eight to twelve hour duration of action.

Effects of withdrawal:
Withdrawal, which in regular abusers may occur as early as a few hours after the last dose, produces drug craving, restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, hot/cold flushing with goose bumps and muscle cramps. Major withdrawal symptoms peak between 48 and 72 hours after the last dose and subside after about a week.

Adverse reactions:
Overdose of oxycodone can result in respiratory arrest and death. For those users with already compromised physical health, respiratory complications can result due to the drug’s depressing effects on respiration.

Effects of prolonged usage:
Long-term use of oxycodone can lead to physical dependence and addiction.

Usage by youth:
Youths were more likely than older adults to have misused oxycodone (1.0 percent among youths aged 12 to 17 vs. 0.7 percent among adults aged 26 or older). 15.4 percent of high school seniors reported non-medical use of at least one prescription medication within the past year.

Recent Developments:
High levels of availability (medicine cabinet, internet & physicians) contribute to a steady increase in abuse.
Combining oxycodone with other drugs, including alcohol as well as crushing the slow release formula of oxycodone and injecting or snorting the powder create high risks for addiction and overdose.

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Some experts, including Dr. Henry Lesieur, St. John’s University, NY, who co-authored the SOGS screening assessment, believe it isn’t really about the money, even though money becomes a looming issue. Seeking action seems to be the major impetus for many. Being in action may be similar to the high of taking cocaine. “Chasing losses” is term use by habitual gamblers to describe attempting to recoup the gambling losses by winning. The action gambler usually likes to gamble on site, at a casino, racetrack, or other “live” venue. Often they are identified by casinos as “high rollers” and received comped rooms and meals. Others, though, don’t gamble for action so much as numb their feelings with compulsive gambling, so it becomes the ultimate, albeit temporary escape.

Age and gender as factors: A study by University of Connecticut Health Center psychiatrists published in 2002 evaluated gamblers seeking treatment and found significant differences by age and gender in pathological gamblers. Middle aged (aged 36-55) and older gamblers tended to include more women, at 45-55 percent, than younger gamblers (aged 18-35) at 23 percent. Middle aged and older women didn’t begin gambling regularly until the age of 55, while older men reported a habit of lifelong gambling. Perhaps surprisingly, the women also wagered greatest amounts in the month prior to treatment. Younger gamblers reported most problems with substance abuse, social and legal problems, while older gamblers found more employment-related problems.

There is hope for recovery :Pathological gamblers, like others who suffer from addiction can and do recover. Hanley

Center has found that Cognitive Behavioral Therapy, with Rational Emotive Behavioral Therapy, can change unhealthy behaviors and thoughts, including false beliefs, rationalizations, and self-destructive feelings. Dialectical Behavioral Therapy also helps individuals to meet life on its own terms rather than escape painful emotions with compulsive addictions.A holistic treatment program addresses the root issues of addiction as well as any co-occurring disorders, in individualized therapies. Continuing care may be essential, especially for impulse control, as well as ongoing participation in support groups such as Gamblers Anonymous. The recovering gambler may also need professional financial advise, and Family Therapy can help to develop a supportive, healthy family structure for sustained recovery.Resource box: How to find premiere age and gender-specific treatment for recovery from addictions and dual diagnosis:

Hanley

Center’s medically-based, holistic program is rooted in the Twelve Step Philosophy for more information vistwww.hanleycenter.org.

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At Hanley Center, we also see patients who suffer from cross-addictive disorders, such as alcoholism or drug dependency with problem gambling. Some estimates state that 35 percent of those with substance abuse or dependence also have met the diagnostic criteria for pathological gambling at some point in their lives.

Assessments have shown that at least 15-20 percent of our patients who have been admitted for substance abuse also have compulsive gambling problems. The SOGS (South Oaks Gambling Screen) is the accepted psychosocial diagnostic tool to identify a gambling problem and its progression. Both substance and gambling addiction are progressive diseases, and may be characterized by inability to control impulses (to use or to gamble) denial, anxiety mood swings and depression and the need for instant gratification. Gambling, like chemical dependency, offers euphoric highs, which are inevitably followed by emotional valleys and usually remorse and shame.

A major difference in gambling versus substance addiction is that the alcoholic or drug addict doesn’t believe the substance is the answer to recovery and to his problems, while the compulsive gambler believes the Big Win will be the answer to all his problems.Gambling addictions can also result in symptoms such as blackouts and sleep disorders and hopelessness. Divorce, relationship and work problems, even arrests are some devastating consequences of compulsive gambling. A person’s general health is often neglected, including medical conditions that have been ignored. Gambling addiction is certainly a family disease, creating a dysfunctional family system that revolves around the individual’s addiction. Children may be emotionally stranded as well as physically neglected. Kids are affected long term too, with studies estimating 35 to 50 percent of children of pathological gamblers eventually experiencing gambling problems of their own.It is important that when chemical and gambling addictions co-occur, they are treated at the same time.

Like chemical dependency, gambling addiction is addressed in holistic treatment based on the Twelve Step Philosophy. Treatment is individualized and takes into account issues of gender and age.

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The casino is a world onto itself. There are no windows, no clock, but there are flashing lights, and the din of clacking coins and whirring slot machines. Beyond the slots, figures are mesmerized at the crap table. Interest in poker hit new heights with televised Texas Hold ‘Em tournaments. For the majority of gamblers, this is excitement, recreation, a fun diversion or escape from the ordinary and a chance to beat the odds.

For others, an estimated three percent of the adult population, Gambling is an addiction, an endless roller coaster of excitement and despair. A pervasive characteristic of addiction of any kind is that the repeated behaviors have led to a range of negative consequences. This may be putting it mildly in the case of pathological gambling, because someone in the grips of compulsive gambling usually suffers severe blows to finances and relationships before seeking help. His or her life may be in shambles. Often the compulsive gambler’s denial leads him to believe that the next round will save the day. Of course, if the numbers come up right, the cash or credit won is then “invested” again. Gambling addiction is hardly a recent development, but the advent of electronic poker and the break-neck speed of today’s slot machines, as well as Internet gambling have actually sped up the time it takes to gamble for fun and when it slips into problematic, then compulsive behavior.

Pathological gambling, like other addictions, is both a biological and a behavioral disease.While we don’t know all the factors leading to gambling addiction, they often include social, family and psychological elements. We do know that the brain neuropathways involving the brain’s mechanisms are affected in an individual’s perception of rewarding experiences. The emotional escape that an individual finds in gambling may become entrenched.
Part 2: Gambling is a Disease?

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