Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, December 26, 1993 TAG: 9312260045
SECTION: NATIONAL/INTERNATIONAL PAGE: A-4 EDITION: METRO
SOURCE: JUDY FOREMAN BOSTON GLOBE
DATELINE: LENGTH: Medium
He would wake up and have two fingers of whiskey, "just to get started on the day." At the first coffee break at his state job, he would sit in his car, open his briefcase and have some more. Then more at lunch. More at the next coffee break.
After work, he'd stop at a pub for drinks, though "never more than one or two," he said last week, asking that his last name and hometown not be used. Then he'd move to another pub because "I never wanted anybody to know I was a heavy drinker." Then home for cocktails before dinner, and an evening in his basement shop, "where I always had a little jug hidden in the rafters."
But it was not until five years ago that "retirement pushed me over the edge, to the extent I no longer had these controls on the drinking," he said. "I suddenly found there was no reason not to have more than one in the morning. I had no place to go." Often, he would be "smashed by noontime."
Henry, who has sobered up with the help of a program at St. Elizabeth's Hospital in Boston, is typical, researchers say, of thousands whose lifelong drinking gets worse in later life, exacerbated by retirement, pain, moving or the loss of a spouse.
Though government figures still suggest alcohol abuse and dependence are roughly 16 times more common in people in their teens and 20s than in those over 65, a major new study suggests the problem among older people has been vastly underestimated. Indeed, data show alcohol-related disorders account for more hospitalizations of older people than heart attacks do.
Some specialists also have challenged the wisdom of the trend that saw some nursing homes install pubs and social hours in recent years.
To be sure, not all older drinkers fit Henry's pattern of long-term drinking. About a third of older heavy drinkers have no history of abuse.
For years, researchers thought that, compared to the overall population, those over 65 had little alcohol abuse.
According to 1988 data from the National Institute on Alcohol Abuse and Alcoholism, for instance, only 1.37 percent of people 65 and over abused alcohol, versus nearly 9 percent of the total population and nearly 17 percent of adults 18 to 29.
The big picture, says Dr. Mary Dufour, a deputy director at the institute, is still that the highest rates of alcohol abuse and dependence occur earlier in life.
But as Dufour and others long suspected, geriatric alcohol problems are far more widespread than figures show, partly because there are fewer red flags to alert outsiders.
"If they're not driving, they won't be picked up," Dufour says. "If they're retired, they won't have job problems. If their spouse is dead, they won't have marital problems."
A study published in September in the Journal of the American Medical Association dramatically proved those suspicions right. Researchers led by Dr. Wendy Adams, assistant professor of medicine at the Medical College of Wisconsin in Milwaukee, showed that more people over 65 were hospitalized in 1989 for alcohol-related disorders than for heart attacks.
Drinking is not just a more hidden problem in older people, Adams adds, but a more insidious one, as well. Because of age-related changes in metabolism, the same dose may yield 20 percent higher blood concentrations of alcohol in older than in younger people. Indeed, the same drink a person might barely notice at age 30 packs the wallop of two or three at age 60.
by CNB