April 2008

Dr. Lawrence Schonfeld is Chair of the FMHI Department of Aging and Mental Health. He is Principal Investigator/Evaluator of the "Florida BRITE Project" (BRief Intervention and Treatment for Elders), under contract with the Florida Department of Children and Families Substance Abuse Program Office funded through a $14 million "SBIRT" grant from SAMHSA's Center for Substance Abuse Treatment. BRITE is offered by 16 provider agencies throughout Florida to identify and serve elders with problems related to alcohol, prescription medications, over-the-counter medications, or illicit drug use. As shown below, the BRITE project was recently profiled in Hernando Today/A publication of the Tampa Tribune.

Seniors: More Likely To Vote, More Prone To Addictions

Life to the Fullest
Published: March 13, 2008
Hernando Today/A publication of the Tampa Tribune

Once again the importance of the senior citizen vote was demonstrated in the recent Super Tuesday II primaries. Despite the appeal of Sen. Barack Obama that brought out historic numbers of young people to cast ballots, it was the vote of older women that assured victory for Hillary Clinton in three out of the four elections. That those in that age group would have such a decisive impact should have been no surprise since in recent national elections, those 50 years of age or older have made up more than half of all voters.

The hope is that those senior voters would be sober when they show up at the polls. While citizens in the advanced age bracket seldom are illegal drug abusers, nearly one out of 10 is at least a heavy drinker, according to a survey for the federal Substance Abuse and Mental Health Services Administration. And nearly that many more abuse the medications they use, whether accidentally or not, often with the same kind of result.

Research at the Florida Mental Health Institute at the University of South Florida has found that older problem drinkers imbibe more often than younger drinkers in response to feelings of depression, loneliness and boredom, wrote institute chairman Lawrence Schonfeld in a recent edition of Aging Today. (link to article BRITE Model for Substance Abuse Intervention).

The bad news is that drinking problems, and even medication abuses, are harder to detect among older folks than younger ones, Schonfeld explained. The reasons are they are not as often in the situations where the problems are noticed — driving, at work or in marital situations.

The good news is that an intervention program, pioneered in Florida, now has been adopted in varying forms by federal agencies throughout the nation. It's a three-step approach to help them recognize those conditions — loneliness, as an example — that prompt the second stage — a destructive response like binge drinking or overdosing with prescription drugs. The final stage is recognizing the momentary nature of the feel-good consequence of the destructive behavior.
Developed in the experiment conducted for three years in Florida under a program called the BRITE (for Brief Intervention and Treatment for Elders) project, that approach now is conducted with federal financing around the country in a program called SBIRT (for Screening, Brief Intervention, Referral and Treatment).

However, according to another article in Aging Today by California psychotherapist Dr. Terence O'Brien, recent studies of the brain have located the addiction process in a cluster of cells that control memories of so-called reward experiences and regulate emotions connected with them. In addition it has been found that when one addiction is overcome there is a danger of it being replaced by another.

In a growing number of cases for older folks, that replacement addiction is gambling, Rani Desai, a psychiatry and public health professor at Yale University, reported in an additional article in Aging Today. Because many are restricted in physical activities and there are more and more opportunities for gambling — sometimes even promoted in extended-care facilities, those people in higher age brackets are more open to addictive gambling behavior, she said.

Addiction to gambling — more prevalent in states such as Florida where there are large elderly populations along with state lotteries and casino gambling — creates a more serious situation for older folks because most are on fixed incomes and without employment income that might help them replace losses that have drained savings and investment accounts.
On top of all that, the cost of a stay in a nursing home or assisted living facility continues to rise. A recent survey by MetLife of rates in those types of facilities found that they now average between $69,000 and $78,000 a year for assisted living places and between $23,000 and $60,000 annually for nursing homes.

If you have questions about any subject dealing with aging, except medical conditions, please write to Life to the Fullest, Hernando Today, 15299 Cortez Blvd., Brooksville, Fla., 34613, or send e-mail to adontaft@yahoo.com. Please include your name and address.

Adon Taft is a resident of Brooksville.

The Louis de la Parte Florida Mental Health Institute (FMHI) has emerged as a national leader in behavioral health research. The Institute houses several state and national research and training centers focused on improving practices in treating mental, addictive, and developmental disorders.