Substance Abuse
Of all drugs, the most widely abused is alcohol. Alcoholism is a lifelong problem for some, but many people start to drink heavily only later in life. Women are more prone to this problem than men. Alcohol offers escape from the stresses caused by crises of old age, including retirement, bereavement, poor health, and loneliness. Prolonged use of alcohol leads to depression.
The brain of the older adult is especially vulnerable to damage from alcohol, and dementia may be the result. Other problems of the aged alcoholic include the following :
- Malnutrition
- Incontinence
- Diarrhea
- Falls and injury
- Self-neglect and general physical deterioration
- Disturbance in sleep patterns with periods of agitation and irritability
- Social isolation
These signs of alcohol abuse are often mistaken for signs of aging or progression of a chronic disease. Even if they are aware of it, families may deny this problem exists, or believe that advancing age means that it is too late to do anything about it. For these reasons an older person may not get treatment.
Other age-related factors make alcohol especially hard on older people. The drug remains in the bloodstream of an older person longer than it does in a younger person and thus prolongs the deleterious affects. When alcohol is mixed with medications, they may interact with serious consequences. For instance, alcohol cause a drop in blood sugar that interferes with the body`s ability to metabolize medication for diabetes.
The next most widely abused group of drugs are those that alter moods or emotions. A list of these drugs, with an example of each, follows :
- Sedatives (Equanil)
- Hypnotics (Seconal)
- Narcotics (Demerol)
- Antianxiety drugs (Valium)
- Antidepressants (Elavil)
- Antihistamines (Dristan)
- Anticholinergic drugs (Tagamet)
An awareness of the detrimental effects of substance abuse and its signs and symptoms in older persons is essential for nursing assessment. Health education for older people and their families must include information on substance abuse and the message that one can be, and deserves to be, treated at any age.
Reference :
Farrell J : Nursing Care of the Older Person, J.B. Lippincott Company, Philadelphia, 1990.
