Alcohol Use and Abuse

Anyone at any age can have a drinking problem. Great Uncle George may have always liked his liquor, so his family may not see that his drinking behavior is getting worse as he gets older. Grandma Betty was a teetotaler all her life—she started having a drink each night to help her get to sleep after her husband died. Now no one realizes that she needs a couple of drinks to get through each day.

These are common stories. The fact is that families, friends, and health care professionals often overlook their concerns about older people's drinking. Sometimes trouble with alcohol in older people is mistaken for other conditions that happen with age. But alcohol use deserves special attention. Because the aging process affects how the body handles alcohol, the same amount of alcohol can have a greater effect as a person grows older. Over time, someone whose drinking habits haven't changed may find she or he has a problem.

Facts about alcohol and aging

Some research has shown that as people age they become more sensitive to alcohol's effects. In other words, the same amount of alcohol can have a greater effect on an older person than on someone who is younger.

Some medical conditions, such as high blood pressure, ulcers, and diabetes, can worsen with alcohol use.

Many medicines—prescription, over-the-counter, or herbal remedies—can be dangerous or even deadly when mixed with alcohol. This is a special worry for older people because the average person over age 65 takes at least two medicines a day. If you take any medicines, ask your doctor or pharmacist if you can safely drink alcohol. Here are some examples:

Aspirin can cause bleeding in the stomach and intestines; the risk of bleeding is higher if you take aspirin while drinking alcohol.
Cold and allergy medicines (antihistamines) often make people sleepy; when combined with alcohol this drowsiness can be worse.
Alcohol used with large doses of the pain killer acetaminophen can raise the risk of liver damage.
Some medicine, such as cough syrups and laxatives, have a high alcohol content.

Effects of alcohol

Even drinking a small amount of alcohol can impair judgment, coordination, and reaction time. It can increase the risk of work and household accidents, including falls and hip fractures. It also adds to the risk of car crashes.

Heavy drinking over time also can cause certain cancers, liver cirrhosis, immune system disorders, and brain damage. Alcohol can make some medical concerns hard for doctors to find and treat. For example, alcohol causes changes in the heart and blood vessels. These changes can dull pain that might be a warning sign of a heart attack. Drinking also can make older people forgetful and confused. These symptoms could be mistaken for signs of Alzheimer's disease. For people with diabetes, drinking affects blood sugar levels.

People who abuse alcohol also may be putting themselves at risk for serious conflicts with family, friends, and coworkers. The more heavily they drink, the greater the chance for trouble at home, at work, with friends, and even with strangers.

How to know if someone has a drinking problem

There are two patterns of drinking: early and late onset. Some people have been heavy drinkers for many years. But, as with great Uncle George, over time the same amount of liquor packs a more powerful punch. Other people, like Grandma Betty, develop a drinking problem later in life. Sometimes this is due to major life changes like shifts in employment, failing health, or the death of friends or loved ones. Often these life changes can bring loneliness, boredom, anxiety, and depression. In fact, depression in older adults often goes along with alcohol misuse. At first, a drink seems to bring relief from stressful situations. Later on, drinking can start to cause trouble.

Not everyone who drinks regularly has a drinking problem, and not all problem drinkers drink every day. You might want to get help if you or a loved one:

Drink to calm your nerves, forget your worries, or reduce depression.
Gulp down drinks.
Frequently have more than one drink a day. (A standard drink is one 12-ounce bottle or can of beer or a wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.)
Lie about or try to hide drinking habits.
Hurt yourself, or someone else, while drinking.
Need more alcohol to get high.
Feel irritable, resentful, or unreasonable when not drinking.
Have medical, social, or financial worries caused by drinking.

Getting help

Studies show that older problem drinkers are as able to benefit from treatment as are younger alcohol abusers. To get help, talk to your doctor. He or she can give you advice about your health, drinking, and treatment options. Your local health department or social services agencies can also help.

There are many types of treatments available. Some, such as 12-step help programs, have been around a long time. Others include getting alcohol out of the body (detoxification); taking prescription medicines to help prevent a return to drinking once you have stopped; and individual and/or group counseling. Newer programs teach people with drinking problems to learn which situations or feelings trigger the urge to drink as well as ways to cope without alcohol. Because the support of family members is important, many programs also counsel married couples and family members as part of the treatment process. Programs may also link individuals with important community resources.

Scientists continue to study alcohol's effects on people and to look for new ways to treat alcoholism. This research will increase the chance for recovery and improve the lives of problem drinkers.

The National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, recommends that people over age 65 who choose to drink have no more than one drink a day. Drinking at this level usually is not associated with health risks.

For more information

National Institute on Alcohol Abuse and Alcoholism (NIAAA)
5635 Fishers Lane MSC 9304
Bethesda, MD 20892-9304
301.443.3860
www.niaaa.nih.gov/

Source: National Institute of Health; National Institute on Alcohol Abuse and Alcoholism