Alcoholism and addiction recognize no boundaries. These equal opportunity killers of mind, body, and spirit certainly do not discriminate based on age or gender, and alcoholism in particular cuts a deep, broad swath across the entire demographic landscape. As addiction specialists know only too well, alcoholism can afflict anyone at any time. Nevertheless, it is still a disease that frequently operates unrecognized, in the shadows, as many are not aware of how at risk they or their family members really are of falling victim to its vicious depredations. This is especially true with respect to older women: if there is any group of people that most do not associate with problem drinking, it is women who have entered their golden years. These women are our mothers, our grandmothers, and our friendly and lovable neighbors; they are the ones who are always there to offer sage advice to their grown children, milk and cookies to the grandkids, and smiles with a positive attitude for everyone else. But cultural clich\u00e9s of moral purity aside, the reality is that in the United States there are perhaps as many as two million women aged 60 and older who could be accurately diagnosed as alcoholics or problem drinkers. Unfortunately, we must place the emphasis here on the phrase 'could be accurately diagnosed', because out of all demographic groups there are none that seek help as infrequently as elderly women. Out of the two million women just referenced, only 5 percent will ever see an addiction specialist or check into a drug and alcohol rehabilitation center, which makes it easy to see why many refer to alcoholism among this group as a "hidden epidemic." The Obstacle of Shame Cultural stereotypes probably explain why alcoholism in older women so often goes unnoticed. Unfortunately, it appears that elderly victims are also influenced by these ideas about how older people are supposed to behave, and the guilt and shame many older alcoholics feel about their drinking problem can make it very difficult to admit they have lost control and need outside intervention and assistance. Older women come from a generation where people were expected to be self-reliant and independent, and for those who have been conditioned to think this way, letting a drinking problem get out of control may be seen as an unforgivable sign of personal weakness. This sense of shame could perhaps be more easily overcome if family members were there to offer encouragement and support. But many older people become isolated or separated from family as they age, and alcoholism in the elderly tends to thrive in the lonely bubble that too many seniors are forced to occupy thanks to the vagaries of time and circumstance. And even when family members are around, many find it hard to confront an elderly mother or grandmother about substance abuse issues because it somehow feels disrespectful to speak about such things with an authority figure and beloved family role model. So rather than being acknowledged honestly, the problem is swept under the rug for fear of making the alcoholic feel uncomfortable or insulted. Complicating the situation further is that medical professionals, who would normally be quite sensitive and aware when dealing with health problems that might be related to substance abuse, tend to confuse the signs of alcoholism in the elderly with the natural deterioration of mental and physical faculties that often accompanies the process of aging. Of course, in many instances elderly people turn to alcohol to help soothe their physical pain, calm their fears about the oncoming of dementia, or escape from the depression they are feeling - all of this can make it extremely difficult for even the most caring and attentive physician to figure out what is going on. The Price of Neglect Failure on the part of older women to get treatment for their alcoholism puts their health at risk in numerous ways. They are more likely to suffer from serious falls, for example, and their drinking can exacerbate existing health conditions such as diabetes, arthritis, or heart disease. Heavy alcohol consumption in post-menopausal women is also a risk factor for many different types of cancer, including those that affect the reproductive system, the liver, the pancreas, and the gastro-intestinal system. The link between alcohol and breast cancer has received much publicity, and some experts claim that as many as 50 percent of all women who suffer from breast cancer also have a history of alcohol abuse and misuse. Overall 75 percent of all new breast cancer cases are diagnosed in women over the age of 50, with the risk climbing continuously as women age, so the possibility that an elderly female alcoholic will eventually develop breast cancer is obviously quite significant. An extensive 1998 study estimated that untreated substance abuse in older women cost the health care industry $30 billion annually, and it is likely that this number has increased substantially in the 15 years since these calculations where first made. Ironically, when older women do enter treatment for alcoholism, they actually do very well; with recovery rates that are far better than average, it makes the failure of most to seek help all the more tragic and unfortunate. Whatever the barriers that are preventing older women with alcohol problems from getting the help they need - and those barriers clearly exist - the addiction treatment community must become more proactive on this issue if they hope to overcome them. Rehabilitation from alcoholism offers elderly women the chance for better health and a brighter future, and spreading the good word about the benefits of sobriety at any age is imperative to those who have committed themselves to helping all addicts and alcoholics win their battle against substance abuse.