Alzheimer’s Disease and Addiction

Alzheimer’s disease is a degenerative condition of the brain that profoundly impacts cognition, memory, perception, and emotional management.

Identified primarily as a side effect of aging, Alzheimer’s—and other types of dementia—are sometimes thought of as random conditions that can strike anyone at any time. But the changes in the brain associated with this disorder can be triggered by environmental exposures and genetic factors, many of which are only partially understood.

The relationship between drug and alcohol abuse and dementia is well-known, however, and people who misuse intoxicating substances for prolonged periods may either bring on dementia, or cause the pace of neurological damage associated with dementia or Alzheimer’s to accelerate. In some cases, people with Alzheimer’s disease may increase their drug or alcohol consumption in response to the onset of their conditions, which will only make things worse in the long run.

Because of its profound and disabling effects, Alzheimer’s disease is among the most feared of all medical conditions:

• More than 6 million American adults who have Alzheimer’s disease.
• One in nine men and women over the age of 65 (11.3%) have Alzheimer’s, and rates rise above 30 percent among people age 85 and over.
• Alzheimer’s is by far the most common form of dementia, affecting up to 80 percent of those who carry a diagnosis.
• Ninety-five percent of those who have Alzheimer’s disease are above the age of 65, and two-thirds of them are women.
• Early-onset Alzheimer’s disease, which produces symptoms in people younger than 65, accounts for about 200,000 to 240,000 (five to six percent) of known Alzheimer’s cases.
• Alzheimer’s disease is the sixth leading cause of death in the United States, and one-third of seniors will die from Alzheimer’s or another type of dementia.

While it is not known what percentage of people with Alzheimer’s disease have a substance use disorder, studies show that about 17 percent of elderly Americans abuse alcohol or drugs (usually prescription medications). Since addiction can potentially trigger dementia, or cause its symptoms to worsen, it is likely a hidden factor in the high rates of Alzheimer’s diagnosed among this population group.

An accurate diagnosis of Alzheimer’s disease, or other types of dementia, requires a physician’s input, as medical professionals are trained to recognize authentic symptoms of this degenerative neurological disorder.

The telltale signs of Alzheimer’s disease include:

• Short-term memory problems
• Difficulties in learning and retaining new information
• A decline in problem-solving skills
• Forgetting names, relationships, and/or faces
• Poor concentration and focus
• Struggles with speech and communication
• Apparent decline in listening skills
• Loss of coordination and physical strength
• Getting lost in familiar locations
• Changes in mood and personality, marked by social isolation
• Confusion related to time (a person with dementia may become momentarily confused about the year or their age)
• Paranoid or hostile reactions to family, friends, and caregivers
• Loss of self-care skills, related to hygiene, meal preparation, etc.

Clinicians will diagnose Alzheimer’s disease based on the presence of such symptoms, and based on the results of tests that measure physical health and cognitive performance. Other possible causes for the signs of dementia must be ruled out before Alzheimer’s can be identified as the problem.

If drug or alcohol abuse occur simultaneously with the development of Alzheimer’s disease, loved ones may tend to blame one or the other for the behavioral, emotional, and psychological symptoms they observe. Over time, substance abuse will inevitably exacerbate the signs of dementia, and in many instances dementia is actually brought on by heavy and prolonged drinking or drug use (the latter condition is referred to as substance-induced persisting dementia).

Nevertheless, clinicians with expertise in addiction are trained to identify substance use disorders even when other mental health conditions are present. For a drug or alcohol use disorder to be diagnosed, at least two of the following symptoms must be reported (six symptoms are required for the disorder to be identified as severe):

• Tolerance for drugs and alcohol has grown, leading to a pattern of escalating consumption.
• Drugs and alcohol are frequently used in greater quantities and for longer periods than originally intended.
• Multiple attempts to stop or reduce drug and alcohol use have ended in failure.
• Significant amounts of time are spent acquiring drugs and alcohol, using them, or recovering from their effects.
• Personal and professional responsibilities are neglected because of the influence of drugs and alcohol.
• Social or interpersonal conflicts are caused by or worsened by drug and alcohol abuse.
• Treasured recreational or social activities are abandoned in favor of drugs and alcohol.
• Bouts of drug and alcohol abuse lead to dangerous or impulsive actions.
• Physical or mental health problems have developed because of drug and alcohol abuse, but the abuse continues.
• Strong cravings accompany attempts to restrict drug and alcohol consumption.
• Attempts to stop using drugs and alcohol are undermined by unpleasant withdrawal symptoms.

The Dangers of Overdose

Even people in the early stages of Alzheimer’s will struggle to regulate their drinking and drug use habits, hampered by memory problems and a lack of self-awareness. They can easily consume far more drugs or alcohol than they realized or intended, and their diminished interpersonal functioning may prevent them from asking for the assistance they need.

The signs of a drug or alcohol overdose in a person with Alzheimer’s disease include:

• Extreme drowsiness
• Unresponsiveness
• Sluggish speech and movements
• Severe nausea leading to vomiting
• Inability to stand up or move around without getting dizzy or losing balance
• Statements or actions that demonstrate extreme levels of confusion or cognitive dysfunction

A fatal result can be avoided if emergency assistance is summoned as soon as an overdose is suspected. As people age, their tolerance for drugs and alcohol naturally declines, making older people vulnerable to overdose at apparently modest levels of consumption.

Alzheimer’s disease is a progressive condition that worsens over time, as proteins continuously coalesce to form plaque deposits that interfere with nerve cell function in the brain. Alarming quantities of brain tissue are lost as Alzheimer’s intensifies, causing levels of dementia that will likewise increase in severity until a person completely loses touch with reality.

The neurological changes caused by Alzheimer’s disease are the direct cause of the condition

Some of the risk factors that increase the odds for Alzheimer’s and dementia include:

• Age. After the age of 65, the risk for Alzheimer’s disease doubles every five years.
• Genetics. Research has revealed that inherited gene mutations can cause early-onset or late-onset dementia, while certain inherited gene variations can increase a person’s chances of developing the disorder.
• Diseases of the heart and blood vessels. Having heart disease, diabetes, high blood pressure, high cholesterol, or a history of strokes are all risk factors for Alzheimer’s.
• Traumatic brain injury. Even brain injuries that occur earlier in life can increase the risk for Alzheimer’s symptoms in later years.
• Unhealthy lifestyle. Dozens of studies have confirmed that improvements in diet, regular exercise, stress reduction, quitting smoking, and ending chronic sleep deprivation can protect a person against Alzheimer’s disease.

Withdrawal symptoms associated with drug and alcohol dependency can be highly stressful. They will peak in intensity in the first three-to-five days after the cessation of alcohol or drug use, making a person highly susceptible to relapse during this time.

The common symptoms of drug and alcohol withdrawal include:

• Anxiety or panic attacks
• Muscle aches and pains
• Nausea and vomiting
• Restlessness and agitation
• Heavy sweating
• Shakiness
• Dizziness
• Runny nose
• Chills and other flu-like symptoms

If left unchecked, alcohol withdrawal can cause a life-threatening condition called delirium tremens, or the DTs. Other side effects of withdrawal can exacerbate existing heart and respiratory problems, which could also be fatal if medical attention is not provided.

Because of such risks, management of withdrawal symptoms should be handled by professionals in a medically-supervised detox program. In a clinical setting that offers the best in round-the-clock care, the physical and mental health of men and women in detox will be monitored closely, and they will be offered treatment services for any existing conditions and any other symptoms of distress that arise. Medications that can ease withdrawal symptoms or promote more sustainable tapering of drug dosages may be provided, and if mental health interventions are required they will be made available.

Needless to say, men and women with Alzheimer’s disease in detox will require higher levels of monitoring and more intensive care services. Everything possible will be done to make them feel comfortable and safe throughout their time in detox, which generally lasts one-to-two weeks.

While people with dementia may suffer from any type of co-morbid mental condition, anxiety disorders and depression are the most commonly diagnosed in men and women with Alzheimer’s disease.

Research indicates that approximately half of those who have this form of dementia will experience symptoms of clinical depression, with half of this group meeting the diagnostic criteria for major depression. Meanwhile, anxiety and anxiety disorders are frequently associated with Alzheimer’s disease, which is to be expected since Alzheimer’s is an inherently stressful condition that creates daunting life challenges on a daily basis.

Substance use disorders are often diagnosed in people who have mental health disorders, as many people turn to drugs and alcohol when they have such conditions as a way to cope with troubling symptoms. The development of Alzheimer’s is an unfortunate complication for those who are already battling mental illness and substance abuse, and the co-occurrence of so many disabling conditions clearly calls for extensive and comprehensive treatment.

Inpatient and outpatient programs for drug and alcohol rehabilitation are not normally designed to meet the needs of people with serious impairments in cognition, memory, self-awareness, and perception. But as the problem of substance abuse in the elderly has received more attention, addiction treatment specialists—and the drug addiction rehab centers that employ them—have developed evidence-based recovery regimens appropriate for older clients, including those who are showing signs of Alzheimer’s disease.

The recovery programs for men and women with chemical dependency and Alzheimer’s disease will include a combination of individual, group, and family therapy, with all therapy sessions delivered in a calm and relaxed manner in a safe, peaceful environment designed to promote healing. The pace of therapy will be determined by a patient’s needs and limitations, and they will never be asked to do anything that causes them undue stress or adds to their confusion.

In addition to therapy, medications for depression, anxiety, and the symptoms of dementia may be administered, depending on the recommendations of the addiction and mental health specialists. Holistic treatment services, including meditation, massage therapy, yoga, acupuncture, and fitness training may be offered to patients who are prepared to participate in such activities. Aftercare services can be essential to recovery, since people with Alzheimer’s disease have a reduced capacity to manage their affairs on their own.

Full recovery from Alzheimer’s disease may not be possible for people who develop this disorder, even if their substance abuse problems are brought under control. But improvements in quality of life can be achieved, with the compassionate and able assistance of medical caregivers, addiction specialists, and devoted family members who are ready to contribute to the rehabilitation process in any way they can.