A phone call woke Doug Nordman at 3 a.m. The call was from a surgeon at a hospital in Grand Junction, Colorado, where Mr. Nordman’s father had arrived within the emergency room, unconscious and in pain, after which passed out.
Initially, staff thought he was suffering a heart attack, but a CT scan showed that a part of his small intestine had been perforated. The surgical team repaired the outlet, saving his life, however the surgeon had some questions.
“Was your father an alcoholic?” he asked. Doctors found that Dean Nordman was malnourished and his peritoneal cavity was “flooded with alcohol.”
The younger Mr. Nordman, a military personal finance writer who lives in Oahu, Hawaii, explained that his 77-year-old dad had long been a classic social drinker: he had a scotch and water together with his wife before dinner, a pour at dinner, then one other after dinner and be perhaps a drink.
Drinking three to 4 drinks a day exceeds that current dietary guidelines, which defines moderate drinking as two drinks a day for men and one for ladies or less. But “that was the normal drinking culture back then,” said Doug Nordman, now 63.
However, on the time of his hospitalization, Dean Nordman, a retired electrical engineer, was a widow, living alone and affected by symptoms of dementia. He got lost while driving, had trouble with household chores and complained of a “fading memory.”
He rejected offers of help from his two sons, insisting he was effective. However, during this hospitalization, Doug Nordman found almost no food in his father’s apartment. Worse still, as he looked through his father’s bank card statements: “I saw the recurring charges from Liquor Barn and realized he was drinking a pint of scotch a day,” he said.
Public health officials are increasingly concerned by older Americans drinking. According to recently published data, the annual variety of alcohol-related deaths in 2020-2021 exceeded 178,000 data from the Centers for Disease Control and Prevention: more deaths than from all drug overdoses combined.
An evaluation by the National Institute on Alcohol Abuse and Alcoholism shows that individuals over 65 made up 38 percent of that number. Between 1999 and 2020, the 237% increase in alcohol-related deaths amongst people over 55 was higher than in any age group except those aged 25-34.
Americans are largely unaware of the hazards of alcohol, said George Koob, director of the institute. “Alcohol is a social lubricant when used according to guidelines, but I don’t think people realize that as the dose increases, it becomes a toxin,” he said. “And the older population is even less likely to recognize this.”
Dr Koob said the rising variety of older people was accountable for much of the rise in deaths. An aging population portends a continued increase in alcohol consumption, which worries health care professionals and advocates for older adults, even when older adults’ drinking behavior doesn’t change.
But it was changing. The percentage of individuals over 65 years of age declaring alcohol consumption within the last 12 months (roughly 56%) and the last month (roughly 43%) is lower than in all other adult groups. However, older drinkers are rather more prone to do so incessantly, 20 or more days a month, than younger drinkers.
Moreover, a 2018 meta-analysis found that binge drinking (defined as 4 or more drinks on one occasion for ladies, five or more drinks on one occasion) amongst older Americans has increased by almost 40 percent over the past 10 to fifteen years.
What is occurring here?
The pandemic clearly played a job. The – the CDC reported that the variety of deaths directly related to alcohol use, alcohol-related emergency room visits and alcohol sales per capita increased between 2019 and 2020 with the emergence of Covid and the introduction of restrictions.
“We were impacted by many stressors: isolation, fear of getting sick,” said Dr. Koob. “They indicate that people drink more to cope with stress.”
Scientists also confer with the cohort effect. Compared to those before and after them, “baby boomers are the substance-using generation,” said Keith Humphreys, a psychologist and addiction researcher at Stanford University. And they do not abandon their youthful behavior, he said.
Research shows decreasing gender gap, too. “Women are driving change in this age group,” said Dr. Humphreys.
Between 1997 and 2014, alcohol consumption increased by a median of 0.7 percent per 12 months for men over the age of 60, while binge drinking remained stable. Among older women, alcohol consumption increased by 1.6% annually and binge drinking increased by 3.7%.
“Contrary to stereotypes, educated, upper-middle-class people are more likely to drink,” Dr. Humphreys explained. In recent a long time, as women became more educated, they entered workplaces where drinking was the norm; in addition they had more disposable income. “Women currently retiring are more likely to drink than their mothers and grandmothers,” he said.
However, alcohol consumption is more of an issue for older people, especially women, who get drunk faster than men because they’re smaller and have fewer intestinal enzymes that metabolize alcohol.
Seniors may argue that they’re simply drinking as they at all times have, but “equivalent amounts of alcohol have much more disastrous effects on older adults” whose bodies cannot digest alcohol as quickly, said Dr. David Oslin, a psychiatrist on the University of St. Pennsylvania and the Veterans Affairs Medical Center in Philadelphia.
“It causes slower thinking, slower reaction times and lower cognitive abilities when you are older,” he said, noting the risks.
Alcohol, long related to liver disease, “exacerbates cardiovascular and kidney diseases, and if you drink for many years, your risk of certain types of cancer increases,” he said. Drinking contributes to falls, a number one explanation for injury in older people, and disrupts sleep.
Older adults also take quite a lot of prescription medications, and alcohol interacts with a protracted list of them. These interactions could also be particularly common with pain relievers and hypnotics akin to benzodiazepines, sometimes causing excessive sedation. In other cases, alcohol may reduce the effectiveness of the medication.
Dr. Oslin warns that although many prescription bottles have labels warning against combining these medications with alcohol, patients may ignore this by explaining that they take the pills within the morning and do not drink until the evening.
“These drugs work in the body throughout the day, so when you drink there is still an interaction,” he says.
One proposal to combat alcohol abuse amongst older adults is to boost the federal tax on alcohol for the primary time in a long time. “Alcohol consumption is price driven and is currently quite cheap relative to incomes,” Dr Humphreys said.
Resisting industry lobbying and increasing alcohol prices – just as higher taxes have made cigarettes dearer – could reduce its use.
Similarly, barriers to treatment could be eliminated. Treatment for excessive alcohol consumption, including psychotherapy and medicine will not be less effective in older patients, Dr. Oslin said. In fact, “age is the best predictor of a positive response,” he said, adding that “treatment does not necessarily mean abstinence. We work with people to reduce their drinking.”
However, a 2008 federal law requiring health insurers to offer parity – which suggests providing the identical coverage for mental health, including substance use disorders, as for other conditions – doesn’t apply to Medicare. Several political and advocacy groups are working to eliminate such disproportions.
Dean Nordman never sought treatment for his drinking, but after emergency surgery, his sons moved him to a nursing home, where antidepressants and no access to alcohol improved his mood and sociability. He died in the middle’s memorial ward in 2017.
Doug, who was introduced to beer by his father at age 13, drank heavily, he said, “to the point of blackout” as a school student after which drank socially.
But as he watched his father fall, “I realized it was ridiculous,” he recalled. Alcohol can exacerbate the progression of cognitive decline, and he had a family history of it.
He has remained sober since that dawn phone call 13 years ago.