CONTACT: BECKY SOGLIN
Iowa City IA 52242
(319) 335-6660; fax (319) 384-4638
Release: Dec. 19, 2002
UI studies point to alcohol abuse treatment needs of older Iowans
Two University of Iowa investigations point to alcohol
abuse problems in two groups of older Iowans: citizens age 65 and older and
prison inmates age 55 and older. The two analyses, which appear in the November-December
issue of the American Journal of Geriatric Psychiatry, suggest that both
groups are not sufficiently diagnosed or treated for their problems.
Up to 15 percent of elder Iowans appear to be at risk for alcoholism and
face special problems because they live in rural state, one analysis showed.
That report was based on Iowa Department of Public Health community surveys.
Stephan Arndt, Ph.D., UI professor of psychiatry, served on that study team
and also co-authored the prison-based study, which revealed that 71 percent
of the older inmates reported a substance abuse problem, usually alcoholism,
but fewer than two in three had ever received treatment or counseling. That
study examined substance abuse histories provided by nearly 11,000 offenders
as part of their entry interviews into prison.
"A substantial number of older people in Iowa, as well as nationally,
have alcohol abuse problems, and these often are not brought to the attention
of professionals so that individuals can receive help," said Arndt,
who also is director of the Iowa Consortium for Substance Abuse Research
and Evaluation. "People also haven't focused on rural states to see
what the special issues are in these areas. Iowa is a good place to study
this issue because of its growing population of older people."
Iowa currently ranks in the top five among states with a high proportion
of citizens age 65 and older. However, the state does not have many programs
that are tailored to assist elderly people with a substance abuse problem,
which usually is alcoholism in that age group. Excessive drinking in older
people can be very stressful on the body and compromise the ability to live
Arndt said that the two articles, while focused on different elder populations,
together show how difficult it is to diagnose older people with substance
abuse problems and get them proper care.
"The prison study indicates that older prisoners have had fewer treatment
opportunities than middle-aged or younger inmates," Arndt said. "The
investigation also revealed that people typically will not get substance
abuse treatment while in prison, so they're coming out with the same problem
they had when they came in."
Carolyn Turvey, Ph.D., UI assistant professor of psychiatry, who also was
on both study teams, underscored this problem and said that one of the most
striking things about the elder prison inmates was their high rate of "pure
alcohol abuse with no other substance abuse problems."
"These older offenders also had low rates of ever having been treated," Turvey
said. "These differences suggest that the most effective treatment of
their alcoholism may differ from that of younger prisoners, who tend to have
alcoholism accompanied by other substance abuse problems. The prison-based
study suggests that stricter sentencing laws and substance abuse together
contribute to the incarceration of older people.
Turvey said that the findings also suggest that it may be important to
consider ways other than imprisonment to help these individuals who currently
are going to prison late in life for alcohol-related offenses.
The tendency of older inmates to abuse only alcohol reflects the trend
in the overall community, the researchers said. In the community, there is
an additional hidden problem when it comes to older women.
"If an older woman goes to her physician and says she's having trouble
sleeping, is losing weight and getting headaches, the physician may assume
it is psychosomatic or some other type of problem and doesn't stop to ask
if the patient is drinking," Arndt said.
Arndt said that drinking in the elderly can directly damage the liver,
heart and stomach, in particular. It also can contribute to deadly or debilitating
accidents and falls that may require the person to give up independent living.
Arndt said the next step is to examine what existing treatments target
populations age 65 and older. Such information would be useful in making
treatments more effective and readily available.
Susan Schultz, M.D. UI associate professor of psychiatry, was lead author
on the general population study. Michael Flaum, M.D., associate professor
of psychiatry, was on the study regarding prisons.
The study on the general population was supported in part by a federal
Department of Health and Human Services grant and the Iowa Department of
Visit the Iowa Consortium for Substance Abuse and Evaluation online at
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the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and
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