An estimated two million older women in the U.S. could benefit from treatment for issues related to alcohol misuse or dependence, though less than one percent receive treatment. An even greater number misuse prescription drugs.
Some turn to alcohol later in life as a mechanism for coping with the death of a spouse or loved one. Painkillers are often prescribed for the physical ailments that come with aging, and can open the doorway to addiction late in life. Alcohol tolerance also lessens with age, since there’s a decrease in body water and in the ability to metabolize alcohol as people grow older. This combined with the phenomenon of “telescoping,” the fact that women may use a substance and become dependent on it more quickly than men, as well as experience the physical and mental consequences of addiction more rapidly and heavily, puts mature women at particular risk. Multiple studies have found evidence that the female brain atrophies more quickly than the male brain under the effects of alcohol use, and liver disease occurs more often in women.
Unfortunately, dependency and substance misuse in older women often goes unrecognized by loved ones, and even by medical personnel. In part, this is because they are often less likely to openly share with family or medical professionals about substance use. Part of the problem also resides in the fact that medical professionals aren’t recognizing the signs when they see them. Addiction is too often misconstrued as being primarily a young person’s issue. Studies have consistently found that diagnoses of alcoholism are much more common among younger adults struggling with chemical dependency as opposed to older ones. Doctors may misdiagnose symptoms of misuse or dependency as those of anxiety or depression, which can lead to prescribing medications that can aggravate existing addictions. Too often prescription medication is offered up as the primary solution to chronic pain, while alternative medicine and techniques that aim to treat the body holistically are overlooked.
Misdiagnosis may also result from unawareness of the differences in indicators for older adults. For example, an elderly woman who drinks only at home may never display the DSM-IV criteria that cites recurrent legal problems related to substance use. Likewise, the criteria of substance use that results in failure to fulfill major role obligations at work, school, or home may not apply to the retiree who lives alone.
Treating Mature Women
Mature and elderly women in treatment tend to have a very different perspective on recovery than younger patients. They may be paying for treatment on their own—some even mortgage their homes to afford it. Oftentimes this means there may be a greater sense of sacrifice and responsibility involved in their recovery process. Realization of one’s mortality, for obvious reasons, also tends to be stronger or more common in older women. Recovery may be more actively recognized as a matter of life and death.
Below are some suggestions for working with mature women in treatment: