Alcohol Abuse

What do all of the following have in common?

• increased muscle Spasticity
• fractures
• heart, liver, kidney, & brain damage
• pressure sores
• malnutrition
• urinary tract infections

Answer: All of these problems are associated with mixing spinal cord injury with alcohol. A recent study indicates that just getting older makes us less able to handle alcohol. Many of the same issues that caused stress at the time of SCI show up again with aging. Alcohol, plus aging, plus SCI can be a risky combination …

How Am I at Risk?

The Age Factor:
At least 10% to 15% of Americans 55 and older abuse alcohol­just as much as younger people. As many older people (those over 55) are hospitalized for alcohol-related problems as are hospitalized for heart attacks.
Use and abuse do not decrease with age, and at least one third of older people with drinking problems develop those problems later in life­usually in response to specific situations, crises or events in their lives. As you age, drinking can get out of hand much more quickly, sometimes in a matter of a few months.

• Loss of a loved one or marital stress
  Retirement, underemployment or unemployment
  Lower income or financial problems
  Health problems or decline in function or mobility
  Decrease in or loss of independence
  Isolation or increased leisure time

Researchers say that these dramatic life changes are risk factors:

Sound familiar? Many of these factors describe life with SCI for some of us. Maybe that’s why people with SCI overuse and abuse alcohol at about twice the rate of the general population.

Is It Use or Abuse?
Ask yourself these questions:

• Have you ever felt you should cut down on your drinking?
• Have people annoyed you by criticizing your drinking?
• Have you ever felt bad or guilty about your drinking?
• Have you ever taken a drink first thing in the morning as an eye opener to steady your nerves or get rid of a hangover?

These four questions make up the CAGE Questionnaire, which is used by professionals for diagnosing drinking problems. Answering yes to one of these questions should serve as a warning. Answering yes to two is a Red Alert, as 81-97% of those giving two yeses really are alcohol abusers.

“But I’m Different!”
There are many other questions that can be used as identifiers of drinking problems and many behaviors which indicate that drinking is more than just social. The challenge in making the call is that many, if not most, of the behaviors are often mistakenly blamed on Disability or what you may think of as “just getting older.”
If any of the things listed below sound familiar and have been going on for quite a while, keep in mind that they often serve as red flags for drinking problems:

• drinking to calm nerves, forget worries or reduce Depression
• loss of interest in food, or poor nutritional habits
• drinking alone or in secret
• making a ritual of drinking­such as before, during or after dinner
• medical, social or financial problems due to drinking
• acting irritable, resentful or unreasonable when sober
• isolation or losing interest in hobbies or activities
• falls or accidents, inadequate self-care
• lack of exercise
• housing problems

So Why Is It a Problem?
As people age, their bodies become less able to handle alcohol. As a result, they can become problem drinkers without increasing their consumption. Alcohol can cause serious health and safety problems for all older people. SCI survivors are even more at risk because their systems are already compromised and they tend to take more
medications. In addition, other dangers exist:

• Alcohol in combination with daily prescription drugs can impair judgement and coordination, speed up or slow down the effects of the drugs, and cause drowsiness.
• Alcohol in combination with antibiotics can result in alcohol intolerance. Symptoms include headache, rapid pulse, vomiting, palpitations, and breathing too fast.
• Alcohol use causes water loss, making you urinate more often. A binge can disrupt a
  catheterization program, interrupt the schedule, lead to a bladder or kidney infection, or even cause involuntary urination.
• Safety is also affected. Judgment becomes impaired. Falls and car accidents are more likely. You may forget or be unable to do weight shifts and transfers safely.
• Symptoms attributed to getting older, such as insomnia, decreased sex drive and depression, might instead be caused by alcohol. Abstaining or cutting down may be one of the most effective ways to eliminate many of the so-called symptoms of “old age.”

The Good News:
Older adults have the highest success rate and greatest one- year sobriety rate after treatment. Excessive drinking in the older population is often in response to negative situations such as loss, grief, loneliness, retirement or illness. Strategies for dealing with these losses could include cutting down isolation, addressing depression and reducing the stressors of aging.
The good news is that many of the factors involved with older drinkers­health problems, loss of self-esteem, too much free time, isolation, depression, financial worries, family changes­are issues you’ve successfully dealt with before. Your job is to fall back on those coping skills and remember: You Know How To Do This.

Getting help can begin with a family doctor or member of the clergy, through a local health department or social service agency, or with one of the following agencies:

• Alcoholics Anonymous (AA), a voluntary fellowship of peers whose purpose is to help
  themselves and each other stay sober. Check your phone book for local chapters.
• National Clearinghouse for Alcohol Information, a federal information service. Write: P.O. Box 2345 Rockville, MD 20852.
• National Council on Alcohol distributes literature and can refer you to treatment services in your area. Check your phone book for the nearest office.
• RRTC for Substance Abuse and Disability does research and distributes information on the combination of alcohol and disability. Write to the RRTC c/o Wright State University, School of Medicine, 3640 Colonel Glenn Highway, Dayton, OH 45435

This is one of more than 20 educational brochures developed by Craig Hospital while it was a federally-funded Rehabilitation Research & Training Center on Aging with Spinal Cord Injury. The opinions expressed here are not necessarily those of the funding agency, the National Institute on Disability and Rehabilitation Research of the US Department of Education.

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