People are ordering their own medical tests. Should we worry?
How old are you when everything changes?
Behind the news reports: Binge-drinking and marijuana use rises among middle-aged adults.
A few days ago the New York Times published an article: Middle-Aged Adults Are Binge Drinking and Using Marijuana at Record Levels by Matt Richtel.
This article discusses a study that confounds life stage and cohort effects.
The article says that “nearly 30 percent of adults [aged 35 to 50] reported binge drinking in 2022…In 2012, 23 percent of such adults reported binge drinking.”
First, the age range of 35 to 50 is large.
Thirty-five-year-olds tend to differ in many ways from fifty-year-olds. Ten years ago this group would have ranged from 25 to 40 where the differences across ages would be even greater.
Second, the 35-year-old of 2022 is not the 35-year-old of 2012.
People who were 35-50 in 2022 had survived the Covid19 epidemic during their prime career and family years. Their introduction to drinking (high school or college) would be different from someone who was 35-50 in 2012.
Third, self-reports can be distorted by social desirability effects.
People today may not be drinking more; they may be less inhibited about reporting their binges. After all, they’re far more open about mental health.
Marijuana use? Now that marijuana is legal in many places, people are very comfortable disclosing their use. I know lots of people in their 60s and 70s who find marijuana more effective and more pleasant than drugs from Big PharmaThey get their prescription from a mainstream doctor. Nothing to hide!
Finally, the article says “it matters.”
It matters, apparently, because the rate of alcohol-related deaths among those over 65 has “tripled.”
According to the CDC, over 20 years the alcohol-related death rate increased from 2.4 to 8.8 *per hundred thousand.” That’s a difference of 6.4 per hundred thousand, which is not nearly as scary as “tripled.”
Will these statistics be relevant in 30 or more years?
The “middle-aged” crowd who are 35-50 today will be 65-80 in 30 years. The world will look quite different and we can expect advances in medical science as well as changes in laws and customs.
Not about life stages!
The article quotes Nora Volkow, director of NIDA (National Institute on Drug Abuse), as saying the study “can inform how health officials and individuals address the risks posed at different life stages.”
The study does not inform us about life stages. It informs us about a particular cohort in a particular time frame. People of 35 and 50 are usually in different life stages whether it’s 2012 or 2022; people 35-50 in 2022 aren’t the same as people 35-50 in 2012.
Most important, when you look at those who died after 65, ask what options they’d have if they’d lived.
Many would be in lifelong pain with increasing restrictions on meds for relief; for some pain, there is no relief without severe side effects or no relief at all.
Many would languish in abusive caregiving facilities. Others would have no access to meaningful activities, due to age discrimination and/or diminished capacity.
Rather than express concern about alcohol-related deaths, why not focus on the stressors of older adults?
As I say in my book, I don’t think we will ever have nursing homes without abusive caregivers. We will always have people who face the tough choice between surviving in misery and seeking a final exit. That question seems much more important than the changing numbers of marijuana users and binge drinkers of any age.