Retirement: Leaving work leaves some vulnerable

Here's a number that may shock you: There are 2.5 million American seniors with alcohol and drug problems, and anywhere from 6% to 10% of elderly hospital admissions are the result of alcohol or drug problems.

"Drug misuse and abuse in the elderly is of special concern because it can cause cognitive and physical impairment — putting this population at greater risk for falls, motor vehicle accidents and making them generally less able to care for their daily needs," according to a report by the Center for Applied Research Solutions in Santa Rosa, Calif. "Elderly individuals are particularly vulnerable to prescription drug misuse."

Jamie Huysman, a physician and clinical adviser to Caron Treatment Centers, a drug and alcohol treatment center that recently announced a new center specifically for seniors, says retirement in itself doesn't cause unhealthy habits, but the sense of isolation and depression that some retirees feel can contribute to substance abuse.

"Sometimes the way we leave our job, whether we quit, are phased out or laid off, there is anger and pain. These things lead to events that trigger us. Those things can accelerate alcohol use."

Meanwhile, drug and alcohol abuse are separate issues, he says. Seniors are three times more likely to take prescription medications. "Drugs have become prevalent," he says. "Doctors see 30 to 40 patients a day. Pain is legitimate, and pain management is legit. It takes five minutes to say yes, and 45 minutes to say no.

"Sometimes they do have legitimate pain," he says. "Inadvertently, they become addicts or alcoholics."

Janet Taylor, a New York psychiatrist and AARP consultant, says most people think of drug abuse as illegal substances, but prescription medication is a big issue.

"The proportion of seniors on prescription drugs has tripled," she says. "The risk is enhanced. When people get prescriptions from doctors, they can be abused or misused. You feel like it's OK because you get it from a doctor."

"There are reasons why seniors may be more likely to have higher rates for drug abuse," she says. "Many are going through transitions in their lives. They may be bored. They may have physical problems that make them less mobile. Sometimes they have more free time. They may start drinking earlier in the day. But as you get older your metabolism changes. Those are some of the contributing factors to a pattern of abuse and misuse."

Huysman says that up to 50% of seniors in assisted living and skilled nursing facilities have a substance- or alcohol-abuse problem.

"Can you imagine someone who has been in the workforce for many decades and finds him or herself now among the non-working and who essentially feels adrift?" says Lynnette Khalfani-Cox, an author and personal finance expert who runs the site AskTheMoneyCoach.com.

"If someone hasn't planned and doesn't have a strong sense of what they are going to do outside of whatever role they have played in the last decade, it is disorienting," she says. "It is not just a matter of being financially prepared. It's a life purpose question. A lot of our identities are wrapped up in our titles and careers."

A look at the problem of senior drug and alcohol abuse, according to Caron Treatment Centers:

•Health problems related to substance abuse cost Medicare more than $233 million annually.

•Nearly 50% of nursing home residents have alcohol-related problems.

•Older adults are hospitalized as often for alcoholic-related problems as for heart attacks.

Huysman says elderly patients can get addicted "right under our nose."

"When they are isolated, which seniors get, nobody sees this decline in observable behavior," he says. "They are the fastest-growing group of addicts and alcoholics in our nation."

He says sometimes in retirement there is a feeling of depression, purposelessness or a big financial strain. Sometimes there is marital strain. "They all contribute to abuse," he says.

"I went through a downsizing," Khalfani-Cox says. "It was jarring and shocking and unnerving in my 30s. Imagine a person who is 60 and goes through a downsizing and unexpectedly has to leave the workforce because of illness or having to be a caretaker. We know it is common for 40% to 50% of people to retire before they intended to," Khalfani-Cox says.

Bob Stammers, director of investor education at the CFA institute, tells clients that they can have problems if they don't know clearly what their goals are in retirement. "A lot of people don't know what retirement looks like," he says.

"A lot of people think they will sit at home," Stammers says. "Then they get home and want to travel. And they don't have the finances to do it, because they didn't plan. You have to know what your goals are so you can plan."

And they must prepare personally, as well as financially, he says. "A lot of people don't realize how much they identify with work. Sometimes retirement isn't pleasant because they aren't active and aren't engaged."