Older people can find plenty of reasons to drink alcohol or use other addictive drugs to excess. Pain relief. Isolation and loneliness. Feelings of boredom and uselessness after retirement. Loss after loss after loss. For some, it’s simply a decades-old habit.
What’s hard to do is to stop using addictive substances when they are ruining your life.
Special Risks for Older People
Fewer than 40% of older adults with a substance use disorder seek treatment, according to Kay King, who coordinates the Older Adults Program for the National Alliance on Mental Illness of Minnesota (NAMI). In a webinar presented to the Minnesota Gerontological Society earlier this year, she pointed out that changes that come with age increase the risk of having this condition. Metabolism slows with aging, for example, and there is less water in body tissues to absorb addictive substances.
Increased use of medication also adds risk to older adults, King said. Changes in vision, coordination, and balance can amplify the dangerous effects of substance use. Alcohol and other drugs can worsen memory loss, high blood pressure, and other chronic conditions. Opioid use for pain can create dependency, with dire consequences.
Hard to Get Help
Older adults may also be nervous about the stigma of addiction or see their drug abuse as a moral flaw.Yet, excessive using behavior may be dismissed or misunderstood by others. Garbled thinking due to a substance use disorder may be misdiagnosed as dementia. When older people fall and injure themselves while on a binge, old age or physical maladies may be blamed. Or their excessive substance use may be dismissed with comments like, “Oh, let her drink. She deserves to enjoy life at her age.”
If the drug use disorder is recognized, access to treatment is quite limited. Medicare and other health plans have requirements that may restrict access. Private pay programs can be prohibitive due to price. Few older adults are eager to enter a program where young street drug users may make up much of the clientele. Older adults may also be nervous about the stigma of addiction or see their drug abuse as a moral flaw.
Beyond the Barriers
Yet, older adults can and do get sober. Life gets better when they do. Much better.
Some go through one of the many available licensed treatment programs for chemical dependency. At age 61, Mark made a decision overnight to end a 48-year habit of alcohol abuse.
“I was sick of living the way I was living,” he recalls, passing out drunk every single night. He contacted Hazelden Betty Ford in Center City and entered treatment on March 12, 2020. Drinking “is not on my mind today,” he says. Instead, he is rebuilding relationships with his family and others.
A small number of older adults find recovery in programs specifically designed for older adults. In the Twin Cities, three programs offer this service: Senior Recovery Center in St. Paul, The Retreat in Wayzata, and Silver Sobriety in Lake Elmo, an innovative, unlicensed day program that offers a six-month-long approach to treatment, plus aftercare.
Greg, a substance abuser since his youth, entered the Silver Sobriety program a year ago at age 63 “begrudgingly,” he says. His wife was going to leave him and “I’d lose everything,” he says. “I decided to straighten up.”
He also left behind a lucrative job that had fed his habit. Now his marriage, which had been rocky, is much better and he spends more time on his late-life career of creating sculptures, exhibiting his work, and teaching classes at local art centers.
Mark thought he was doing pretty well even though he knew his drinking was excessive. He admits he lost jobs, lost houses, lost cars. But he’d just get better ones, he says. He managed to hide his drinking from his significant other, though toward the end, she would go out looking for him.
“I wasn’t a nice person when I was drinking,” he says. “I had no friends, not even my drinking buddies. I had alienated everyone. I sat in isolation. I just wanted to be alone.” He had to get rides home from the bar.
Mark says he spent $1.7 million on alcohol and marijuana over the years of his using.
Mark had checked out Alcoholics Anonymous in 1990. “I went to a meeting at the Rochester fair grounds,” he recalls. “It was smoke-filled with a bunch of older guys, and I didn’t feel I belonged.” He sobered up for a short time in his thirties “to save a marriage and a job.” But, he says, “There was still a lot of the defiant brat in me back then.”
Mark “experimented” with using for the next 26 years until he decided he’d had enough.
“One day I woke up and I was done with it,” he says. “I can’t say why, other than my Higher Power said I had suffered enough.”
That was two years ago. Since spending 28 days in residential treatment, another 28 days in Hazelden’s day program, and many hours at AA meetings, “I’ve seen the promises,” he says. “It’s worth it.”
He adds, “If I wasn’t sober, I’d probably be dead,” referring to all the times he drove home from the bar and didn’t remember doing so.
Now Mark enjoys spending time with his family members, though one daughter no longer will talk to him. He also enjoys giving service in the AA program at the group and district level.
“Working with another alcoholic, helping others in the program, working a spiritual program is where the solution is, so I’m working real hard at it,” Mark says. He emphasizes that “I never helped anybody in 48 years even though I was a coach. I helped the kids, but as soon as I got off the field at end of the day, I headed to the bar because that is all I cared about.” Now he enjoys helping people, including guiding and encouraging his grandsons who are athletes.
“I’m a lot nicer, more tolerant,” he says. “I don’t know how much time I’ve got left, but I go one day at a time. I make sure I do the best I can that day and try to be better when tomorrow comes around than I am today.”
A hard-core drug and alcohol user since his teens, Greg was drummed out of the military on a medical discharge due to his drinking. Soon after, he completed a lengthy treatment program and stayed sober for 36 years. Eventually he became a therapist in the corrections field, with some of his clients being addicts.
Shortly after he retired in 2013, Greg says, “I decided I’ve been a good boy long enough” and began to drink occasionally. He slipped into heavy drinking before long.
Greg took on a new job as a crime scene technician, working to clean up messes after forensics officials finished their investigation at crime scenes. He also cleaned up hoarding and garbage houses.
I don’t know how much time I’ve got left, but I go one day at a time.At these locations, he could take home with him whatever he found. That included “tons of free booze,” he says. “I had a non-stop supply.”
Greg figured he “deserved a drink” while doing this messy work. Soon he was driving drunk, having blackouts, and diagnosed with diabetes. When he was falling down from the blackouts at home and hurting himself, he couldn’t hide his drinking from his wife anymore. She wanted a divorce.
Greg didn’t want to quit drinking, but he took a look at a flyer his wife gave him about Silver Sobriety. He liked the idea of being with people his own age, and he appreciated its focus on the 12 Steps. The price was also quite modest compared to other programs, and he was able to set up a payment plan.
Rather than risking the loss of his marriage and home, Greg quit his job and signed on with Silver Sobriety. A year later, after attending three meetings a week there, he has completed their initial program and is entering aftercare. He and his wife have also worked on their relationship in couples therapy. Now, he says, “There aren’t the resentments. I feel a lot of love.”
Silver Sobriety for Older Adults
The Silver Sobriety program was founded in 2015 by two neighbors who both have long histories in recovery. Peter Oesterreich is a licensed alcohol and drug counselor, who previously directed treatment at the Senior Recovery Center. Win Miller has an extensive business background and is also an executive coach for people in recovery.
These two men lead a group of 10-12 older adults in meetings three times a week that emphasize the 12 Steps but also offers a range of other resources for supporting recovery. Most importantly, Silver Sobriety offers a unique, comprehensive peer group model of treatment for older people. Participants also attend 12 Step meetings in the community.
Silver Sobriety overcomes one common barrier for older adults in treatment by providing transportation for those living nearby. They also shifted during the pandemic to a hybrid model, allowing for online and in-person participation.
Silver Sobriety also overcomes the high-cost barrier for treatment. It is a private pay service. Full cost is $4500, but people with high need can attend for far less.
“We’re a long-term program because all of the studies show that the longer someone stays in the program of recovery their chances for long term sobriety go up exponentially,” says Oesterreich. The program is not licensed by the state and Oesterreich does not work in counseling capacity with clients, but both he and Miller provide recovery coaching. They also make referrals to mental health services, when needed.
Silver Sobriety does very little marketing for their service. “We try to let our program grow organically,” says Oesterreich. It’s a model that could easily be replicated, he says, and he and Miller are willing to offer guidance on how to create a local version in other communities.
Greg describes the group as “a great bunch. They are very accepting. It’s not in-your-face treatment. It’s very gentle. They are very giving. You feel a lot of care.”
Pat Samples is a freelance writer, writing coach, and the author of several Hazelden publications, including Older Adults in Treatment and Older Adults After Treatment.
Last Updated on September 10, 2022