At 3 a.m., a phone call woke Doug Nordman. A surgeon called from a hospital in Grand Junction, Colo., where Mr. Nordman’s father had arrived at the emergency room, incoherent, in pain and then unconscious.
At first, staff thought he was having a heart attack, but a CT scan revealed that part of his small intestine had perforated. The surgical team repaired the hole and saved his life, but the surgeons had some questions.
“Is your father an alcoholic?” he asked. Doctors found that Dean Nordman was malnourished and his abdominal cavity was “full of alcohol.”
The younger Mr. Nordman, a military personal finance writer who lives on the Hawaiian island of Oahu, explained that his 77-year-old father had long been the quintessential social drinker: a glass of scotch and water with his wife before dinner. , and drank it at dinner. , and then another after dinner and maybe a nightcap.
Three to four drinks a day is more than enough Current dietary guidelines, which defines moderate drinking as two drinks per day for men and one drink or less per day for women. But “that was the normal drinking culture at the time,” said Doug Nordman, now 63.
However, while in the hospital, Dean Nordman, a retired electrical engineer who was widowed, living alone, developed symptoms of dementia. He got lost while driving, struggled with housework, and complained of “memory lapses.”
He rejected offers of help from his two sons, saying he was fine. During that hospital stay, however, Doug Nordman could barely find any food in his father’s apartment. To make matters worse, after looking at his father’s credit card statement, “I saw charges popping up in the liquor store and realized he was drinking a pint of Scotch a day,” he said.
public health officials are Getting more and more panicked Due to drinking among older Americans.Recently released figures show that more than 178,000 alcohol-related deaths occurred each year in 2020-2021 Data from Centers for Disease Control and Prevention: More deaths than all drug overdoses.
An analysis by the National Institute on Alcohol Abuse and Alcoholism shows that people over 65 make up 38% of the total. From 1999 to 2020, alcohol-related deaths among people over 55 increased by 237%, higher than any age group except those aged 25 to 34.
George Koob, the institute’s president, said Americans are largely unaware of the dangers of alcohol. “Alcohol is a social lubricant when used within guidelines, but I don’t think they realize that as the dose increases, it can become a toxin,” he said. “Older people are even less likely to recognize this.”
Dr Kubu said the main reason for the increase in deaths was an increase in the elderly population. An aging population portends a continued population boom that worries health care providers and senior advocates even if older adults’ drinking behaviors don’t change.
but it keeps changing. People over 65 reported drinking alcohol in the past year (about 56%) and in the past month (about 43%) at lower rates than all other adult groups. But older drinkers drank significantly more frequently than younger drinkers, 20 or more days per month.
In addition, a 2018 Meta-Analysis Studies have found that rates of binge drinking (four or more drinks on one occasion for women and five or more drinks on one occasion for men) among older Americans have increased by nearly 40 percent over the past 10 to 15 years.
What’s going on here?
this Pandemic It obviously worked.this Centers for Disease Control and Prevention reports As the COVID-19 pandemic hit and restrictions were put in place, the number of deaths directly attributable to alcohol use, alcohol-related emergency room visits, and per capita alcohol sales all increased between 2019 and 2020.
“There are a lot of stressors that affect us: isolation, worry about getting sick,” Dr. Kubb said. “They point to people drinking more to cope with stress.”
The researchers also cited group effects. Keith Humphreys, a psychologist and addiction researcher at Stanford University, said that compared to those before and after them, “baby boomers are a drug-addicted generation.” They haven’t abandoned the behavior of their youth, he said.
research shows The gender gap is narrowing, also. “Women have always been the agents of change in this age group,” Dr. Humphreys said.
From 1997 to 2014, alcohol consumption among men over 60 increased by an average of 0.7% per year, while their rates of binge drinking remained stable. Among older women, the drinking rate increased by 1.6% per year, with the alcohol abuse rate increasing by 3.7% per year.
“Contrary to stereotypes, educated and upper-middle class people have higher rates of drinking,” Dr Humphreys explains. In recent decades, as women have become more educated, they have entered workplaces where drinking is the norm. They also have more disposable income. “Women who are now retired are more likely to drink than their mothers and grandmothers,” he said.
However, drinking affects older people more, especially women, who are more likely to get drunk than men because they are smaller and have fewer intestinal enzymes to metabolize alcohol.
Older people may argue that they are just drinking as usual, but “the same amount of alcohol can have disastrous consequences for older people” because their bodies cannot process alcohol as quickly, says Psychiatrist, University College London. Dr. David Oslin said. Pennsylvania and the Philadelphia Veterans Affairs Medical Center.
“As you get older, it can lead to slower thinking, slower reactions and cognitive decline,” he said, listing the risks.
Alcohol has long been linked to liver disease, he said, and it can also “exacerbate cardiovascular disease, kidney disease and, if you’ve been drinking for years, an increased incidence of certain cancers.” Drinking alcohol can cause falls, a leading cause of injuries as we age, and can disrupt sleep.
Older adults also take numerous prescription medications, and alcohol can interact with a long list of prescription medications. These interactions are especially common with pain relievers and sleep aids such as benzodiazepines, and can sometimes lead to excessive sedation. In other cases, alcohol can make medications less effective.
Dr. Osling warns that while many prescription bottles carry labels warning against using these medications with alcohol, patients may shrug this off and explain that they take their medications in the morning and don’t drink alcohol until the evening.
“These drugs are in your system all day long, so when you drink alcohol, interactions can still occur,” he told them.
A proposal to combat binge drinking among seniors would raise federal alcohol taxes for the first time in decades. “Alcohol consumption is price sensitive and is currently quite cheap relative to incomes,” Dr Humphreys said.
Resisting industry lobbying and raising alcohol prices (much like higher taxes make cigarettes more expensive) could reduce use.
The same goes for removing barriers to treatment. Treatment for excessive drinking, including psychotherapy and medication, Also effective for elderly patients, said Dr. Oslin. In fact, “age is actually the best predictor of a positive response,” he said, adding that “treatment doesn’t necessarily mean you have to stop drinking. We work with people to try to control their drinking.”
But a 2008 federal law requires health insurance companies to offer pari passu coverage, meaning mental health, including substance abuse disorders, have the same coverage as other medical conditions, but not under Medicare.Multiple policy and advocacy groups are working to eliminate this difference.
Dean Nordman never sought treatment for alcoholism, but after emergency surgery his sons moved him into a nursing home, where antidepressants and a lack of alcohol improved his mood and social skills . He died in 2017 in the facility’s memory care unit.
Doug, who was taken out for a beer by his father when he was 13, said he drank heavily himself in college “to the point of amnesia” and has since become a social drinker.
But when he saw his father say no, “I realized this was ridiculous,” he recalled. He had a family history of alcohol worsening cognitive decline.
He has remained sober since that predawn phone call 13 years ago.
