Gladys became a drug addict at the age of 82 when the pain of arthritis got to be too much for her and she became dependent on opiates to get through the day and to sleep at night.

Frank became a dangerous, problem drinker at 66 after he retired from his job as a maintenance man in a local school. Every day he drove to a bar where he hung out with a few buddies and drank a few too many beers before he drove home.

Samuel grew up during the era of drugs, sex and rock and roll. Throughout his adult life, he smoked marijuana after work without problems at work or at home. After he retired at 65 he smoked more often and getting high began to interfere with the life he had hoped for when he retired.

For most of her adult life, Joan had had two or three glasses of wine with dinner. In her mid-60s her physical tolerance for alcohol diminished. She drank no more than usual, but by the second glass she began to slur her words and to find it hard to think clearly. She frequently fell asleep right after dinner.

These are just a few of the faces of substance abuse or misuse among older adults. They are not the images that ordinarily come to mind when we think of substance abuse, and this is a major reason why these problems often go undetected in elders. Of course, there are older adults who are alcoholics and/or addicted to illegal drugs such as heroin, but fewer and fewer as people age, in part because so many people addicted to alcohol or drugs die prematurely and in part because some survivors turn their lives around.

For older adults, drinking too much and misusing medications are the major substance use problems, affecting as many as 20 percent of them (1). They are particularly vulnerable to the mental and physical effects of alcohol and drugs because of physiological and cognitive changes that take place with age. And, even if they are not addicted to alcohol or illegal substances, they are at risk for serious problems including:

• Adverse drug reactions, including fatal overdoses,
• Accidents — including falls and traffic accidents,
• Exacerbation of health problems,
• Social isolation,
• Sleep disturbances,
• Inactivity,
• Loss of cognitive capacity and
• Suicide — which is more likely among older adults than any other age group.

In general, substance abuse and misuse vastly limit the potential to live well in old age.

During the elder boom there will be tremendous growth of the number of older adults with substance use problems, in part because of the growth of the population of older adults, but also because baby boomers use substances — including illegal substances — much more commonly than their parents’ generation.

For example, a study done by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) projects the growth of people 60 or over who need substance abuse treatment from about 700,000 in 2000 to about 2,300,000 in 2020 (2). Recent surveys (3) confirm that this is already happening, with marked growth of the use of marijuana.

In addition, the CDC recently released a report projecting a vast increase in addiction to prescription painkillers and in deaths due to overdoses, which already kill more Americans than heroin and cocaine combined (4).

Will you, a member of your family, or a close friend be among the older adults with serious substance use problems? Here are a few signs that should cause concern (5).

• Getting unusually high without an increase in use
• Use of alcohol or drugs to sleep and then finding it difficult to get going in the morning
• Reliance on opiates to manage pain in doses that exceed a doctor’s prescription
• Going from doctor to doctor to get additional prescriptions
• Using over-the-counter drugs in amounts or in combinations of medicines that are not recommended
• Cognitive or memory impairments, difficulty concentrating, or confusion
• Slurred speech
• Increased isolation
• Difficulty participating in ordinary activities
• Weight loss and/or poor nutrition
• Increased fatigue and/or weakness
• Poor personal hygiene
• Unusual restlessness or agitation
• Persistent irritability or altered mood
• Balance problems and/or frequent falls

These symptoms can, of course, have causes other than substance abuse or misuse, but if a person is using alcohol or other drugs and has these symptoms, substance use may be a major cause.

You may be able to recognize substance use problems in yourself or a friend or family member. You may be able to cut back or help someone to cut back. But many people need professional help. Talk frankly with your physician. If you don’t know where to turn for help, call 1-800-273-TALK. This is the National Suicide Prevention Lifeline, and it can connect you with mental health or substance abuse services near your home.

Michael B. Friedman and Kimberly Williams are the co-founders of the Geriatric Mental Health Alliance. He is now retired except for teaching at Columbia University. She is the Director of The Center for Policy, Advocacy and Education of the Mental Health Association of NYC.

(1) Blow, F. “Baby Boomers, Mental Health, and Aging: New Challenges and Opportunities.” Keynote address to the Geriatric Mental Health Alliance Annual Conference, May 2011. http://www.mha-nyc.org/media/9736/fred%20blow%20keynote%20presentation%20[compatibility%20mode].pdf

(2) Gfroerer, J. et al. “Substance Abuse Treatment Need Among Older Adults in 2020: The Impact of the Baby Boom Generation” in Drug and Alcohol Dependence, 2003. http://johnstrogerhospital.org/cru/images/education/519cd99e959493c0c6ad6bf40b928794.pdf

(3)Substance Abuse and Mental Health and Services Administration. “Illicit Drug Use Among Older Adults.” National Survey on Drug Use and Health, 2011. http://oas.samhsa.gov/2k11/013/WEB_SR_013_HTML.pdf

(4) Center for Disease Control. “Prescription Painkiller Overdoses At Epidemic Levels: Kill More Americans Than Heroin and Cocaine Combined.” Press Release, November 1, 2011. http://www.cdc.gov/mmwr/pdf/wk/mm6043.pdf.

(5) Blow, F. “Substance Abuse Among Older Adults.” SAMHSA TIP 26, 1998 http://www.ncbi.nlm.nih.gov/books/NBK14467/?report=printable

Follow Michael Friedman, L.M.S.W. on Twitter: www.twitter.com/mbfriedman395

As adults are in a rush to usher in the holiday season they often overlook the fact that their homes are stocked with an assortment of alcohol for the holidays.  And as older friends and siblings come from college for Thanksgiving and want to “party” with their friends it is also a dangerous time for our youth.

CCAAD urges parents and adults to help their teens have a safe, alcohol free holiday season.  We encourage parents to talk to young adults and underage teens about the risks involved in providing alcohol to anyone under 21.

Help our teens have a safe, alcohol free holiday season by:

*Offering to host non-alcohol and drug-free gatherings

*Monitoring or locking alcohol in the home.

*Calling ahead when your teen is going to a party and asking who will be supervising and if alcohol will be served.  If you are hosting the party welcome calls from other parents to discuss the event.

*Talking to your child about not using alcohol and how underage use can affect their health, future plans, relationships and safety.

*Making it very clear you do not want your child to drink alcohol and share what the consequences will be if your child does use alcohol.

*Talking and listening to your teen regularly.

*Spending time with your child getting to know your child’s friends and their parents.

Let’s celebrate a responsible and enjoyable Thanksgiving and holiday season!  If you know of an underage drinking party, contact Local Law Enforcement .

Pride Surveys would like to join CADCA in promoting their petition to raise awareness to President Obama and his Administration about effective drug prevention and the DFC program. Please go to the “We the People” website created by President Obama to view and sign the petition to show your support.

This is a great opportunity to show the President how important it is to hear and know how citizens feel about the dangers of legalizing medical marijuana and the overall importance of continuing drug and substance prevention. CADCA is challenging each of its members to get at least 100 people to sign the petition by the November 4th deadline. Their goal is to get a minimum of 25,000 signatures by November 4, 2011. We would ask that you forward this email to your friends, family, local and state coalitions and agencies as well as post it on your Facebook and Twitter accounts.

Pride Surveys wants to thank you for your continued support and taking the time to sign this petition, so we can help CADCA reach its goal of a minimum of 25,000 signatures. The final day of the petition is November 4, 2011 so please act now.

Viewing and signing the petition is easy, and takes less than one minute, all you have to do is:

1. Go to: http://wh.gov/2Yh

2. Create a username and password, if you don’t have one already.

3. After you have created an account, return to the petition link and hit refresh.

4. Click “Sign Petition” button.

To read more information about the petition, please click here to be redirected to the CADCA website

And what’s more frightening, is how clever they’ve become about
hiding the act from parents. Once upon a time, teens stole alcohol from their
parents, so keeping a close watch on your own liquor cabinet was a fine way to
curb the problem. But today, their creativity puts the old trick of refilling
bottles with Sprite to shame. And the latest trend in undercover drinking is
especially savvy – especially around Halloween time.

Teens are using gummy candy (bears and worms to be exact) to get
drunk. They soak the candy in alcohol, Keloland.com reports.

Darcy Jensen from Prairie View Prevention Services in South Dakota
works with school districts to prevent teen drinking as part of the “Parents
Matter” campaign. She sent out a warning to schools last week to warn them
about the trend. It’s important for parents to be aware so that they can spot
if their teen has tried it, she says.

“Maybe someone has offered the candy and they didn’t even
know. So telling the kids ahead of time this could be something to be aware of
is important,” Jensen said.

And though it’s hard to see the positive side of teens becoming
sneakier when it comes to something as dangerous as underage drinking, a trend
like this can be used to open communication on the topic.

“It’s a good conversation starter to talk about the whole
issue of alcohol and underage drinking and the hazards,” Jensen said.

Michael Montgomery

Previously

Feds seek closure of medical marijuana dispensaries

Federal prosecutors are preparing to target newspapers, radio stations and other media outlets that advertise medical marijuana dispensaries in California, another escalation in the Obama administration’s newly invigorated war against the state’s pot industry.

This month, U.S. attorneys representing four districts in California announced that the government would single out landlords and property owners who rent buildings or land where dispensaries sell or cultivators grow marijuana.

U.S. Attorney Laura E. Duffy, whose district includes Imperial and San Diego counties, said marijuana advertising is the next area she’s “going to be moving onto as part of the enforcement efforts in Southern California.” Duffy said she could not speak for the three other U.S. attorneys covering the state, but noted their efforts have been coordinated so far.

“I’m not just seeing print advertising,” Duffy said in an interview with California Watch and KQED. “I’m actually hearing radio and seeing TV advertising. It’s gone mainstream. Not only is it inappropriate – one has to wonder want kind of message we’re sending to our children – it’s against the law.”

Federal law prohibits people from placing ads for illegal drugs, including marijuana, in “any newspaper, magazine, handbill or other publication.” The law could conceivably extend to online ads; the U.S. Department of Justice recently reached a $500 million settlement with Google for selling illegal ads linking to online Canadian pharmacies.

Duffy said her effort against TV, radio or print outlets would first include “going after these folks with … notification that they are in violation of federal law.” She noted that she also has the power to seize property or prosecute in civil and criminal court.

William G. Panzer, an attorney who specializes in marijuana defense cases, said publishers may have a reason to worry. Federal law singles out anyone who “places” an illegal ad in a newspaper or publication. Nevertheless, Panzer said he is not aware of a single appellate case dealing with this section of the law.

“Technically, if I’m running the newspaper and somebody gives me money and says, ‘Here’s the ad,’ I’m the one who is physically putting the ad in my newspaper,” he said. “I think this could be brought against the actual newspaper. Certainly, it’s arguable, but the statute is not entirely clear on that.”

Panzer said the penalty for a first offense is a maximum four years in prison and eight years for someone with a prior felony conviction.

In the federal law, an exception is made for ads that advocate the use of illegal drugs but don’t explicitly offer them for sale or distribution. Newspapers, Panzer said, could argue that they have a right under the First Amendment to run the ads, and any “prior restraint” before publication is itself illegal.

Duffy said she believes the law gives her the right to prosecute newspaper publishers or TV station owners.

“If I own a newspaper … or I own a TV station, and I’m going to take in your money to place these ads, I’m the person who is placing these ads,” Duffy said. “I am willing to read (the law) expansively and if a court wants to more narrowly define it, that would be up to the court.”

Seven states, including California, allow for medical marijuana to be distributed in dispensaries, though more than 200 California cities and nearly two dozen counties have bans or moratoriums in place on storefront pot businesses. The industry has otherwise exploded in recent years, including a marked increase in delivery services.

Ngaio Bealum, publisher of West Coast Cannabis, described as “the Sunset magazine of weed,” said he receives a significant portion of his revenue from dispensary ads, though he has tough competition for ad revenue from alternative newspapers and even The Sacramento Bee, which began running print advertisements for dispensaries this year.

Bealum said it was “misguided for the Department of Justice to come after people who are following state law and doing well for the economy in a recession.” He disputed the notion that marijuana ads target children.

“We’re just in doctor’s offices and cannabis collectives, where you have to be 18 years old or where you have to be a patient,” he said. “We’re not targeting anyone but cannabis patients.”

Duffy said Proposition 215, also known as the Compassionate Use Act, passed by California voters in 1996 has transformed from an effort to supply marijuana to sick people through nonprofit groups into entirely a profit-making industry. She said the advertising is part of that – and “it’s illegal.”

Duffy said she’s seen marijuana stores advertise coupons, bring-a-friend deals, extra samples for buying a certain amount of marijuana, magazines devoted entirely to the industry, T-shirts for sale, marijuana linked to video games – all things, she said, “in large part directed at our youth and children.”

“The good intentions behind that law,” she said, “have almost completely been taken over by people who are trying to use that permission law to get rich, to distribute marijuana and traffic drugs to people who aren’t sick, to our youth and to people who are using drugs on a recreational basis.”

It’s clear that alternative newspapers throughout the state have benefited from the increased business, even as other advertising sources have dwindled.

In April, the Sacramento News & Review published a special supplement devoted exclusively to marijuana dispensaries. “This year’s edition includes more than 100 regional medical-cannabis dispensaries, physicians, and med-delivery and hydroponics shops for the 2011 Green Pages,” the newspaper wrote. The ads, which have in the past cost $2,000 for a full page, allowed the News & Review to hire additional reporters.

“I don’t see how the News & Review running medical-marijuana ads is any different from TV stations running massive amounts of commercials for pharmaceutical companies selling drugs,” Jeff vonKaenel, CEO and majority owner of the News & Review, wrote in a May 2010 column about the advertising.

Panzer said he doesn’t think the federal government can effectively shut down the marijuana industry, even if it makes short-term gains by targeting high-profile dispensaries and newspapers. Given the government’s lack of resources and the huge size of the marijuana industry, Panzer said officials’ efforts are “a losing proposition.”

“The government is trying to put the genie back in the bottle,” Panzer said.

Circumventing the law on advertising the sale of illegal drugs can bring expensive consequences. In August, Google agreed to pay a $500 million settlement for accepting illegal advertisements from online Canadian pharmacies. Employees of the company had been working with pharmacies to bypass Google’s own internal controls, even as Google executives testified before Congress, claiming the company had clamped down on the illegal ads.

The fine was one of the largest ever from a U.S. company. At the time of the settlement, Google said in a statement that “it’s obvious with hindsight that we shouldn’t have allowed these ads on Google in the first place.”