Alcohol Abuse a Growing Problem for Older Adults

The Administration on Aging and The Substance Abuse Mental Health Services Administration issued a brief on Alcohol Misuse and Abuse Prevention. Community surveys have estimated the prevalence of problem drinking among older adults from 1 percent to 16 percent, depending on the definitions of older adults, at-risk and problem drinking, and alcohol abuse/dependence.

Estimates of alcohol problems are the highest among people seeking health care because individuals with drinking problems are more likely to seek medical care. Fourteen percent of men and 3 percent of women older than age 65 engage in binge drinking.

Misuse and abuse of alcohol in older adults present unique challenges for recognizing the problem and determining the most appropriate treatment interventions. Alcohol use problems in this age group often go unrecognized and, if they are recognized, are generally undertreated. Standard diagnostic criteria for abuse or dependence are difficult to apply to older adults, leading to under-identification of the problem. Older adults who are experiencing substance misuse and abuse are a growing and vulnerable population.

For adults ages 60 and older the recommended limits of alcohol consumption are:

Men: No more than 7 drinks/week, or 1 standard drink/day;
Women: No more than 7 drinks/week, or 1 standard drink/day;
Binge drinking:

Men: No more than 3 standard drinks on a drinking occasion;
Women: No more than 2 standard drinks on a drinking occasion.

Older individuals should not drink any alcohol if they:
• Are taking certain prescription medications,
• Have medical conditions that can be made worse by alcohol (e.g., diabetes, heart disease),
• Are planning to drive a car or engage in other activities requiring alertness and skill,
• Are recovering from alcohol dependence, should not drink alcoho.

SBIRT is a comprehensive model for addressing at-risk alcohol use, problem use, and dependence in a variety of health care settings.

Screening quickly assesses the severity of substance use and identifies the appropriate level of intervention.
Brief interventions focus on increasing insight into and awareness of substance use and motivation for behavioral change.
Referral to treatment provides access to specialty substance abuse assessment and care, if needed.

According to the brief, the majority of older adults who are at risk for problem alcohol use, psychoactive prescription medication use, or both do not need formal specialized substance abuse treatment. However, many can benefit from prevention messages, screening, and brief interventions.

The first step in helping older adults who are at-risk for problems related to alcohol use is screening. The most useful alcohol screening instruments include questions on quantity/ frequency and binge drinking to determine an estimate of the amounts consumed, and consequences to determine the extent and severity of the problems.

While this brief was certainly written for health professionals and social service professionals, nonetheless, it is important to know that substance abuse among older adults is real and knowing the acceptable limits of consumption can help you identify someone at risk. That is the first step in getting that person help.