Substance addiction among the elderly

The Developmental Stages of Erikson consist of 8 stages which include: Infancy: Trust vs. Mistrust, Early Childhood: Autonomy vs. Shame, Play Age: Initiative vs. Guilt, School Age: Industry vs. Inferiority, Adolescence: Identity vs. Role Confusion, Young Adulthood: Intimacy and Solidarity vs. Isolation, Middle Adulthood: Generativity vs. Self absorption or Stagnation, and Late Adulthood: Integrity vs. Despair. The stage in which I’m going to discuss involving addiction is the Late Adulthood stage (Harder, 2002).

The Late Adulthood stage consists of 55 or 65 years of age to death. Erikson felt that much of life is preparing for the middle adulthood stage and the last stage is the recovery from it. He suggests that successful resolution of the final state of ego development leads to a sense of personal integrity and meaning in life rather than despair (Harder, 2002). Ego integrity is defined as the ultimate form of identity integration; people who attain this attribute enjoy a sense of peace and pride in their contribution and accomplishments (Van Womer & Davis, 2008). Other adults in this stage feel despair and may fear death to find a purpose for their life. Problems with psychosocial adaptation at this stage would therefore likely be reflected by a sense of despair (depression), an inability to find meaning in one’s life experiences (low self-coherence), and reliance on others to provide satisfaction (codependency) (Sedlak, Doheny, & Estok, 2000).

For those who feel despair in their late adulthood years may turn towards alcohol consumption to help them deal with their feelings. 10-15% of the elderly living in the community and up to 23% of the elderly living in institutional settings are consideredalcoholics (Wood, 2006). 30% of the elderly problem drinkers begin drinking between the ages of 65 and 74. This population consumes 25 to 30% of all prescription medications (Van Wormer & Davis, 2008). Few people realize the extent of substance misuse among the elderly because they are more likely to drink and use drugs at home rather then in public.

The elderly’s misuse of substances usually consist of drinking smaller amounts at one time, unlike the young alcohol abusers, use prescription drugs, experience a hidden alcohol problem, and drink in connection with life stressors. There are two types of elderly alcoholics: early onset and late onset. The early-onset alcoholics are those who began to have a drinking problem early in their life and continue into old age. These are the ones who are more likely to have a family history of alcoholism (Van Wormer & Davis, 2008). Early onset drinkers are most likely to be men and late onset drinkers are more likely to be women. Two thirds of the elderly alcoholics fall under the early onset drinkers. The reason for late-onset drinking is an effort to cope with recent losses and transitions from the death of a spouse, being alone and retirement (Wood, 2006). Late onset alcoholics are more likely to seek and remain in treatment then those who have had a drinking problem most of their life. Studies show that whites are more likely to drink than members of minority groups and unlike adolescences or young adults who seek drugs for recreational purposes; the elderly may seek the drug or alcohol for therapeutic use such as pain relief (Van Wormer & Davis, 2008). The most common prescription addiction is benzodiazepines which consist of Valium and Xanax.

The misuse of substances in the elderly can cause health problems which can be physical or psychological, economic, familial, and legal stressors. Studies have found that as people age or become ill, they either begin to live their lives more authentically or fall into despair. (Wood, 2006). During this stage, the task is for the elderly to look back at their lives with happiness, but when they misuse substances it can cause: depression, self-coherence, codependency, and other health outcomes which affect their quality of health and ability to function (Sedlak, Doheny, & Estok, 2000).

Ones self-coherence is the ability to find meaning in present life experience and it can be affected by the use of alcohol or other substances. The late adult stage is a time of reflection on the past and being ready for what’s to come, but when ones self-coherence is diminished, they are unable to fulfill their tasks in the developmental stage of integrity vs. despair (Sedlak, Doheny, Estok, 2000).

The remembered past is another importance in completing the integrity phase of the late adulthood. Studies have showed differential associations between the remembered past and sense of coherence. The findings show that indication of evaluation of early childhood, adolescence, and remembering psychosocial experiences in early adulthood(Rennemark & Hagberg, 1997).

There is sufficient research that shows the extent of alcohol and drug addiction among the elderly and how it affects their daily living. The misuse of substances in the late adult stage affects their integrity and there is despair. The isolation and withdrawal associated with substance misuse reduce one’s ability to socialize and lead an active life. Erik Erikson states that the late adult stage is integrity vs despair and with the misuse of substances, there is an absence of integrity.


Harder, F. A. (2002). The Developmental Stage of Erik Erikson. Retrieved on February 7, 2008, from

Rennemark, M., & Hagberg, B. (1997). Social network patterns among the elderly in

relation to their perceived life history in an Eriksonian perspective. Aging &

Mental Health, 1. 321-331.

Sedlak, A. C., Doheny, O. M., & Estok, J. P. (2000). Alcohol use in women 65 years of

age and older. Health Care for Women International, 21. 567-581.

Van Wormer, K., & Davis, R. A. (2008). Addiction Treatment a Strengths Perspective.

Thomson Brooks/Cole. Belmont, CA.

Wood, A. S. (2006). Developmental Issues in Older Drinker’s Decisions: To Drink or

Not to Drink. Alcoholism Treatment Quarterly, 24. 99-118.