The Baby Boomers Are Coming to Treatment: Are We Ready?

The largest population cohort, eighty million strong, has begun to appear at alcohol and drug abuse treatment facilities. This cohort is known as the “Baby Boomer,” who currently ranges in age from fifty-one to sixty-nine years old. This generation has been transformed from the traditional American family of their childhoods to the American family and what it is today—that is a tremendous difference from fifty years ago. The Baby Boomers are identified not only because of their ages, but also by the many characteristics and historical factors that define them. The have been influenced by the Vietnam War, the Civil Rights Movement, assassinations of leaders, the highest divorce rates and second marriages in history, and the promise of the American Dream. Their values include wanting to make a difference, personal growth, optimism, “trust no one over thirty,” extreme loyalty to their children, and the belief that anything is possible. They have demonstrated the ability to handle crises, they are ambitious, they have a strong work ethic, they are competitive, and they have good communication skills. 

At the same time, this generation was the largest group of people to begin using drugs recreationally in the 1960s and 1970s. They experimented with illegal drugs while continuing the use of alcohol as in previous generations (Simoni-Wastila & Yang, 2006). However, unlike previous generations they have not “aged-out” of their alcohol and drug use. For example, in previous generations as people grew older they either completely stopped their alcohol or drug use or greatly reduced their intake. This is especially true for women. Baby Boomers have not aged out in the same manner. In fact, they are the first generation to have multiple of poly-drug-use problems. Also, not only have many continued the drug use from their youth, but also many are now confronted with prescription drug abuse due to aging and illnesses as well as the availability of new and more powerful prescription medicines. Thus we can expect see a greater amount of older adults seeking help for their alcohol and a drug abuse not just because of their sheer numbers, but also because a greater percentage of the group will be affected. 

Since 2000 it has been predicted that the wave of Baby Boomers needing addiction treatment will grow. It was predicted then that by the year 2020 this need would double. This does not mean, however, that treatment programs are ready. They will need to prepare for the wave of older adults seeking treatment and recovery. This will require not only the expansion of services, but also understanding the unique characteristics of the Baby Boomer generation and working with older adults. Some of the new challenges will include the following: 

• Older adults who use illegal drugs are more likely to use marijuana followed by the nonmedical use of prescription drugs. This applies more to younger Baby Boomers while prescription drug abuse applies to older Baby Boomers. 

• Because of their ages, Baby Boomers who abuse drugs are more likely to be long-time users. On the other hand, it might be important to divide older drug abusers between those who started their abuse before age sixty and those who started after age sixty (Liberto & Oslin, 1995).

• It might be more difficult to assess drug abuse in the older adult due to the fact that many common indicators might not apply, such as missing work, legal problems or relationship problems (Offsay, 2007).

• Older adults might have more problems with small amounts of drugs due to increased sensitivity, slower metabolism, and a smaller volume of distribution (Liberto & Oslin, 1995; Offsay, 2007).

• According NIAAA guidelines for the elderly and alcohol consumption, alcohol abuse might need more attention using a preventive model in the primary care setting (Blow, 1998). However, only 13 percent of primary care physicians use a formal screening tool for alcohol problems. Additionally, most of the screening tools for alcohol abuse were validated on young or middle age adults (Di Bari et al., 2002).

• It is difficult to detect problems from prescription drugs since few, if any, screening instruments have been validated.

• Confusion and disorientation are often signs of a drug overdose, however, in the elderly these may be inappropriately seen as signs of dementia and drug abuse can be overlooked.

• Medication interactions are of particular concern for the elderly who abuse prescription drugs as well as considering synergistic affects with alcohol use. 

Given the above as well as typical aging considerations it is important for personnel in alcohol and drug treatment agencies as well as researchers to consider the following needs:

• More research involving clinical trials for treating older adults with alcohol and drug abuse problems is needed.
• Clinicians need training in assessment and counseling of older adult substance abusers.
• Age-specific treatment approaches should be developed.  
• Training in the use, abuse, and synergistic effects of prescription drugs used medically and nonmedically.
• Train more primary care physicians about substance abuse and the older adult.
• Increase the availability of alcohol and drug abuse treatment programs for the older adult as well as consider the physical limitations of the client. 
• Train emergency room personnel to detect drug overdoses.

On a positive note, however, Baby Boomers may be more willing to accept treatment for substance abuse than previous generations. They are more likely to know a recovering person and that treatment works. Also, they are the largest generation to learn that addiction is a disease and thus less stigmatizing.

Blow, F. C. (1998). TIP 26: Substance abuse among older adults. Washington, DC: Substance Abuse and Mental Health Services Administration. 

Di Bari, M., Silvestrini, G., Chiarlone, M., De Alfieri, W., Patussi, V., Timpanelli, M., . . . Marchionni, N. (2002). Features of excessive alcohol drinking in older adults distinctively captured by behavioral and biological screening instruments: an epidemiological study. Journal of Clinical Epidemiology, 55(1), 41–7.

Liberto, J. G., & Oslin, D. W. (1995). Early versus late onset of alcoholism in the elderly. International Journal of the Addictions, 30(13–4), 1799–818.

Offsay, J. (2007). Treatment of alcohol-related problems in the elderly. Annual Long Term Care, 15, 39–44.

Simoni-Wastila, L., & Yang, H. K. (2006). Psychoactive drug abuse in older adults. American Journal of Geriatric Pharmacotherapy, 4(4), 380–94.