Alcohol Over-use in Older Adults
Alcohol in moderation defined as one to two drinks per day for women and two to three drinks per day for men (one drink is defined as 1.5 oz. of distilled spirits such as whisky, gin or vodka, 12 oz. of beer or 5 oz. of wine) has been reported to have positive health benefits in some studies. However for older adults these benefits may be offset by concerns related to medication interactions, risk of falling and the potential for over use of alcohol.
Overall about 6% of older adults are considered to be heavy drinkers, with men having a much higher rate than women.
About one third of alcohol abuse in older adults can occur as a result of the stresses and losses associated with aging such as loss of a spouse, retirement, isolation and chronic illness. In the other two thirds it is a continuation of a lifelong pattern that may have been marked by periods of greater or lesser drinking.
So how do you know if your drinking is a problem or not? Webster’s Medical Dictionary defines alcoholism this way:
Physical dependence on alcohol to the extent that stopping alcohol use will bring on withdrawal symptoms. In popular and therapeutic parlance, the term may also be used to refer to ingrained drinking habits that cause health or social problems.
Doctors often use the CAGE questionnaire to screen for drinking problems. The CAGE instrument consists of four questions:
C: Have you ever tried to Cut down your intake of alcoholic beverages?
A: Have you ever been Annoyed by criticism of your drinking?
G: Have you ever felt Guilty regarding your drinking?
E: Have you felt the need for an Eye opener in the morning?
Answering yes to two or more of the CAGE questions is an indication that a problem may exist and should be further explored.
If you have a loved one that you are concerned about you may want to look for some of the warning signs listed below:
- loss of coordination, falls
- slurred speech
- problems sleeping
- poor personal care, such as not bathing, not eating (or not eating well) or not taking care of health problems
- empty bottles or cans in the garbage
- irritability, depression or confusion
- making excuses or making up stories to cover up the truth about their drinking
- memory trouble after having a drink
- losing touch with friends or family
As we age our bodies may metabolize alcohol more slowly and we can become more sensitive to its effects. In addition, alcohol can make chronic problems like heart disease, stomach problems, diabetes and liver problems worse.
Alcoholism is itself a chronic condition that requires a plan for management. The condition is characterized by denial, which may not be recognized until a severe adverse consequence occurs. Older adults may take longer to seek help for alcoholism because they may not experience the adverse consequences of drinking-like trouble at work or driving difficulties-at the same rate as younger people. Additionally, some of the health problems related to alcohol in older adults can be misconstrued for common conditions related to aging leading to under-diagnosis of the problem.
Help for the older alcoholic or problem drinker
If you are concerned about a loved one or a friend’s alcohol consumption try not to be confrontational with them. You may say things like-I have noticed that you are not yourself, how are you doing? Ask questions and express concern about things you have observed. Say these things when the person is sober and try to get them to talk about it. Seek out professional assistance in the form of a counselor who is familiar with addictions and talk to the family health care professional as well. 12 Step groups for friends and families of addicts like Al Anon are readily available in most communities and may be very helpful.
Treatment requires first ending the physical dependence, then making lifestyle changes that help the individual avoid relapse. In some cases, medication or hospitalization is needed. Studies have shown that older adults who do enter treatment are more successful than younger people at maintaining sobriety. Research also shows that the most helpful programs are those geared to the specific needs of the older adult.
In their book entitled Aging & Addiction-Helping Older Adults Overcome Alcohol or Medication Dependence, authors Carol Colleran and Debra Jay suggest a loving approach to an older person’s difficulties and offer many ideas and resources including treatment options.
Alcoholics Anonymous is a 12 Step support group for people who are recovering from alcohol problems. To locate the nearest meeting in your area go to aa.org or call the World AA office at 212-870-3400.
The CAGE Questionnaire
Answer yes or no to the following questions
C: Have you ever tried to Cut down your intake of alcoholic beverages?
A: Have you ever been Annoyed by criticism of your drinking?
G: Have you ever felt Guilty regarding your drinking?
E: Have you felt the need for an Eye opener in the morning?
If you answered yes to two or more questions, you may have a drinking problem. Talk to your health care professional.
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