I read in a recent New York Times piece (“More Older Adults are Struggling with Substance Abuse”, October, 3, 2014) that our elder generation is rapidly falling prey to addiction, most through the use of alcohol and pain pills. The writer said 2.8 million older (50 and above-gasp!) adults in the United States meet the criteria for “alcohol abuse” and the number is expected to grow to 5.7 million by 2020, citing “Diagnostic and Statistical Manual of Mental Disorders”, 4th Ed. The article quoted Stephen Arndt, Professor of Psychiatry at the U of Iowa as saying some of these adults deny or rationalize their use by stating “I don’t have a problem, I just like to drink”, or they got their prescriptions from a doctor and “it’s for my pain” No doubt, all of this is true but the same applies to many other alcoholics or younger people addicted to one chemical or another. One major difference is that older people can better afford the drug of their choice and otherwise lead a fairly inconspicuous life style. On the other hand, younger addicts often seek out creative and often dangerous and clandestine paths to obtain these mind altering chemicals. Regardless of the methodology employed to secure the items, denial and excuse remain the front for the addicts of all ages. An important aspect confronting the young addict is the potential for criminality and health concerns. Such issues pervade our youth. Another interesting issue broached in the article deals with the physician’s inability to talk with the addicts, largely because of their lack of training or time to spend with such patients. Most often, doctors, especially in emergency room settings are quick to simply send a young abuser off to detox centers offering little or no advice to the patient (sometimes the patients are not in a mental position to receive advice). The doctors “talk the talk” but they don’t “walk the walk” when it comes to such patients- they don’t take the time to advise them in any meaningful way. They seem to be more worried about getting sued or in trouble with their employer and often give innocuous advice about the dangers inherent in alcohol and drug abuse and seem to ignore the patient’s immediate and urgent concern; in this respect, try getting painkillers or sleeping sedatives from a doctor who is aware from your nationally published (available to many doctors) medical chart. They won’t do it and often the patient leaves without any medication or proper advice. The sought “medications” can frequently be procured elsewhere and hence the aforementioned criminal and judicial intervention. This isn’t necessarily the fault of doctors serving on the front lines of emergency care but it seems to be a problem with secondary doctors (regular office visits) who simply do not have the time or experience with such issues. This should be changed. We need more physicians trained in such addictions who can take the time to help with addiction problems early on. Our country should not be known for its vast number of rehab facilities who portend to know the answer to addiction; the solution lies with competent doctors who will take the time to advise addicts early on and not simply send patients down the rehab route.
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