Onset of initial drinking problems after the age of 50 years is not uncommon. Some elders with alcohol use problems are those who had a drinking problem early in life, had a significant period of abstinence, and then resumed drinking again in later life. Others may have been heavy or reactive consumers of alcohol early in life. However, esti-mates are that 30% to 60% of elders in treatment programs began drinking abusively after age 60.
Risk factors for late-onset substance abuse in elders include chronic illness that causes pain, long-term use of prescription medication (sedative-hypnotics, anxiolytics), life stress, loss, social isolation, grief, depression, and an abundance of discretionary time and money (Watts, 2007). Elders may experience physical problems associated with substance abuse rather quickly, especially if their overall medical health is compromised by other illnesses.