The Baby Boomers are now into their 60s. As the first generation of Americans to experiment widely with illegal drugs, elderly Baby Boomers are thought to experience substance use problems more commonly than previous generations of senior citizens. The most prevalent substance of abuse among the elderly of all generations is alcohol, due to the ease of obtaining it and its relative social acceptance. With more Baby Boomers reaching their golden years, a growing number of seniors are needing recovery programs, and many are entering Alcoholics Anonymous (AA) to address their substance abuse issues.
AA groups do not usually modify their approaches based on participant age, but seniors with alcohol abuse problems may experience AA differently from younger participants and may need to emphasize certain aspects of AA over others. Since little research has focused on elderly persons in recovery, we conducted a study comparing the perceptions and needs of 26 young adults ages 20 to 40 to those of 25 older adults ages 65 and up, all from outpatient AA groups in the Southeastern U.S. All subjects had been in AA for six months or less. The study revealed some surprising differences between younger and older adults in AA—differences with clear implications for best practices in substance abuse treatment.
Learning about AA
Many older adults were referred to AA by their medical doctors, with half entering AA because of medical problems caused or made worse by their alcohol abuse. But almost none of the younger adults reported alcohol-related medical problems. Instead, the younger adults were generally referred to AA by their employers, with 40% reporting they had problems at work because of their drinking. In contrast, almost no seniors had work concerns.
Younger adults also had many more alcohol-related legal issues, with only 4% of the seniors entering AA in response to court mandates or other legal entanglements.
These differences likely reflect stage-of-life variations between younger and older adults, with younger adults more often in the workforce and older adults generally retired. The greater frequency of legal problems among younger adults in AA also reflects their greater use of illicit drugs compared with the elderly. Thus, younger persons were referred to AA by drug courts and more often had both alcohol and drug abuse concerns from which to recover, whereas seniors mainly had problems with alcohol alone.
Relationships in AA
There was no difference between the two groups regarding whether participants had obtained an AA sponsor. However, of those who did not have a sponsor, many of the younger adults reported being nervous about asking someone to sponsor them, but not a single senior reported nervousness as a reason. This suggests that younger adults may need more prompting or coaching to help them find sponsors.
More broadly, problems connecting with all other AA members remained a consistent concern for young adults, with only 10% even believing that forming friendships was an important part of being in AA. In striking contrast, the vast majority of seniors believed that friendships in AA constituted a significant part of being in the program and, unlike the young adults, most seniors were actively seeking friendships in their AA group. Younger persons also reported being far more uncomfortable than the elderly in attending AA meetings.
These relationship issues suggest that the young adults, especially early in recovery, may lack the social skills needed to integrate quickly into an unknown group of persons or within an unfamiliar interaction format. It has long been obvious to us that many younger persons are not comfortable sharing during AA meetings. It is possible that this discomfort arises not only from a lack of social skills, but also from the fact that a larger percentage of young adults are court-ordered into AA. If court-ordered, they may feel as though they do not belong among the people who are attending AA more willingly and enthusiastically.
Because of the critical nature of building a sober social support network for sustained recovery, it appears that younger persons in AA may be at much greater risk of relapse because of their lack of interest, nervousness, and discomfort in connecting with other AA members. Clearly, deliberate attention may be needed to help younger adults in AA to form personal bonds within their AA group and to assist them in connecting with a recovery support network, better promoting their recovery and maintenance of sobriety.
Difficulties encountered with AA
There were several significant differences between the age groups regarding logistical difficulties in attending AA, with all problems disproportionately affecting the seniors. For example, 60% of the seniors said that scheduled meeting times presented a difficulty for them; half believed that meeting locations made it hard for them to attend AA; and half also said they had difficulty finding transportation to make it to AA meetings as a result of personal mobility problems or no longer having a driver’s license. Very few of the younger persons indicated any such difficulties.
These starkly contrasting findings suggest that seniors need meetings closer to where they live and recreate, and in disability accessible locations such as senior centers or retirement communities. In the absence of such meetings, it is likely that some seniors in need of AA are unable to participate in the program.