..in 1999. (Reach of Louisville, SIG, 2009 ) It is reported that study findings have demonstrated that the most benefit from counseling and treatment for substance abuse is that which elderly people "may derive most benefit from..." (Reach of Louisville, SIG, 2009 ) X. Case Study Review

The work of Welte and Mirand (1995) entitled: "Drinking, Problem Drinking And Life Stressors In The Elderly General Population" relates that it is shown in research that while "...heavy drinking in the United States is less prevalent among older persons, some maintain or increase heavy drinking. Late-onset heavy drinking is believed to be related to stressors of aging such as retirement or bereavement, particularly when coping resources or social supports are inadequate. This study investigated that relationship." (Welte and Mirand, 1995)

Heavy drinkers were oversampled in this study. Questions included such as "...demographics, drinking quantity-frequency, alcohol dependence/problems, stressful life events, chronic stresses, coping resources and social supports." (Welte and Mirand, 1995) The analyses conducted in this study examined the relationship "between drinking and stress" and states as results that there were "...no bivariate correlation between average alcohol consumption and acute or chronic stress. Logistic regressions with interaction terms show that stress has no relationship to heavy drinking (average alcohol consumption of 2+ drinks/day) regardless of coping style or social supports. Logistic regressions predicting late-onset heavy drinking also produced negative results. Chronic stress was, however, positively related to alcohol dependence and problems." (Welte and Mirand, 1995)

Welte and Mirand (1995) state conclusions which include an argument that the treatment and prevention programs for the elderly should focus on other than the simple assumption that "life stresses are a direct cause of drinking, although they may exacerbate consequences of drinking.: (Welte and Mirand, 1995)

Welte and Mirand (1995) state the existing need which is great for coordination of education relating to health problems of the elderly and specifically as associated with substance abuse. Specifically, it is noted by Welte and Mirand (1995) that

"...if social workers in the field of addictions provided education about substance abuse issues and interventions to the geriatric service providers who frequently work with elderly people, such as the visiting nurse, staff of hospital emergency wards, and social service outreach workers, then perhaps the appropriate interventions would be used by these service providers. Same for the training of social workers in addictions. Learning about geriatric health and related issues are paramount when developing an intervention." (Welte and Mirand, 1995)

The work of Adams (1996) entitled: "Alcohol Use In Retirement Communities" reports two studies conducted previously that indicate that there is a high prevalence of heavy drinking in retirement communities. The study reports the objective of providing either verification or refutation this findings as well as to identify "characteristics associated with heavy drinking in retirement communities." (Adams, 1996)

The study reported...

Included in the questionnaire were alcohol use questions that were adapted from the "Khavari questionnaire and the CAGE questionnaire to screen for alcohol abuse." (Adams, 1996) The surveys were completed and returned by 370 of 454 independent residents of the retirement communities completed and returned surveys for a response rate of 70%. Findings in the study reported are those as follows:
(1) 47% used some alcohol;

(2) 15% had one to six drinks per week;

(3) 8% had seven or more drinks per week;

(4) only two of the participants screened positive on the CAGE questionnaire for abusive drinking. (Adams, 1996)

Most of the drinkers are stated to have "decreased alcohol use since moving to the community." (Adams, 1996) Stated to be factors that increased the use of alcohol were those of:

(1) being of the male gender;

(2) socialization;

(3) lack of religious affiliation, and (4) smoking. (Adams, 1996)

Conclusions in the study of Adams (1996) states that despite "the advanced age of this population, regular alcohol use was prevalent. In contrast to previous reports from retirement communities, heavy and abusive drinking were uncommon by our measures, perhaps because of the older age and female predominance of the sample. Drinking appears to be associated with more social contacts and, possibly, better health status." (Adams, 1996)

Summary & Conclusion

The focus of this work has been the examination of alcohol and drug use among elderly individuals as well as the information regarding demographics, culture, and current and advocacy issues in addition to public policy. Risk factors identified in this study are those of: (1) being of the male gender; (2) being socially isolated; (3) being single; (4) being separated or divorced; (5) Substance abuse earlier in life; (6) Co-morbid psychiatric disorders (especially mood disorders); (7) Family history alcoholism; and (8) Concomitant substance abuse of nicotine and psychoactive prescription medicines. (Reach of Louisville, SIG, 2009) Additionally the lack of religious affiliation is also cited as a risk factor for alcohol and drug use on the part of elderly individuals. (Adams, 1996) This study has also found that education of elderly individuals along with education and training for health care workers is of primary importance in dealing with substance and alcohol disorders among the elderly population. This study has further found that there is generally a failure to properly estimate drug and alcohol use disorders and that this problem is further complicated by the fact that healthcare workers generally "have a lower degree of suspicion when assessing older people. (Reach of Louisville, SIG, 2009)

Bibliography

Adams, WL (1996) Alcohol Use in Retirement Communities. J Am Geriatr Soc 1996 Sept, 44(8). Online available at: http://www.ncbi.nlm.nih.gov/pubmed/8790236?ordinalpos=1&itool=PPMCLayout.PPMCAppController.PPMCArticlePage.PPMCPubmedRA&linkpos=3

Welte, JW, Mirand, AL (1995)…