Source:Eldercare Committee/Human Resources Work and Family Program

Last changed on PNN: October 22, 1992

AGING AND ALCOHOL ABUSE

Alcohol abuse among older men and women is a more serious problem than people generally realize. Until recently older problem drinkers tended to be ignored by both health professionals and the general public. The neglect occurred for several reasons: our elderly population was small and few were identified as alcoholics, chronic problem drinkers (those who abused alcohol off and on for most of their lives) often died before old age; and, because they are often retired or have fewer social contacts, older people have often been able to hide drinking problems.

Some families may unknowingly "encourage" drinking in older family members if they have the attitude that drinking should be tolerated because older people have only a limited time left and therefore should be allowed to "enjoy" themselves.

As more people learn that alcohol problems can be successfully treated at any age, more are willing to seek help to stop drinking.

Physical Effects of Alcohol

Alcohol slows down brain activity. It impairs mental alertness, judgment, physical coordination, and reaction time -- increasing the risk of falls and accidents.

Over time, heavy drinking can cause permanent damage to the brain and central nervous system, as well as to the liver, heart kidneys, and stomach.

Alcohol can affect the body in unusual ways, making certain medical problems difficult to diagnose. For example, the effects of alcohol on the cardiovascular system (the heart and blood vessels) can mask pain, which may otherwise serve as a warning sign of heart attack.

Alcoholism can also produce symptoms similar to those of dementia -- forgetfulness, reduced attention, confusion. If incorrectly identified, such symptoms may lead to unnecessary institutionalization.

Alcohol, itself a drug, mixes unfavorably with many other drugs, including those sold by prescription and those bought over-the-counter. In addition, use of prescription drugs may intensify the older person's reaction to alcohol, leading to more rapid intoxication. Alcohol can dangerously slow down performance skills (driving, walking, etc.), impair judgment, and reduce alertness when taken with drugs such as:

* "Minor" tranquilizers: Valium (diazepam), Librium (chlordiazepoxide), Miltown (meprobamate), and others.

* "Major" tranquilizers: Thorazine (chlorpromazine), Mellaril (thioridazine), and others.

* Barbiturates: Luminal (phenobarbital) and others.

* Pain killers: Darvon (propoxyphene), Demerol (meperidine), and others.

* Antihistamines: both prescription and over-the-counter forms found in cold remedies.

Use of alcohol can cause other drugs to be metabolized more rapidly, producing exaggerated responses. Such drugs include: anticonvulsants (Dilantin), anticoagulants (Coumadin), and antidiabetes drugs (Orinase).

In some people, aspirin can cause bleeding in the stomach and intestines. Alcohol also irritates the stomach and can aggravate this bleeding. The combination of alcohol and diuretics can reduce blood pressure in some individuals, producing dizziness.

Anyone who drinks -- even moderately -- should check with a doctor or pharmacist about possible drug interactions.

Who Becomes a Problem Drinker?

In old age, problem drinkers seem to be one of two types.

The first are chronic abusers, those who have used alcohol heavily throughout life. Although most chronic abusers die by middle age, some survive into old age. Approximately two-thirds of older alcoholics are in this group.

The second type begins excessive drinking late in life, often in response to "situational" factors -- retirement, lowered income, declining health, and the deaths of friends and loved ones. In these cases, alcohol is first used for temporary relief but later becomes a problem.

Detecting Drinking Problems

Not everyone who drinks regularly or heavily is an alcohol abuser, but the following symptoms frequently indicate a problem:

* Drinking to calm nerves, forget worries, or reduce depression.

* Loss of interest in food.

* Gulping drinks and drinking too fast.

* Lying about drinking habits.

* Drinking alone with increasing frequency.

* Injuring oneself, or someone else, while intoxicated.

* Getting drunk often (more than three or four times in the past year).

* Needing to drink increasing amounts of alcohol to get the desired effect.

* Frequently acting irritable, resentful, or unreasonable during nondrinking periods.

* Experiencing medical, social, or financial problems that are caused by drinking.

Getting Help

Older problem drinkers and alcoholics have an unusually good chance for recovery because they tend to stay with treatment programs for the duration.

Getting help can begin with a family doctor or member of the clergy; through a local health department or social services agency; or with one of the following organizations:

Alcoholics Anonymous (AA) is a voluntary fellowship of alcoholics whose purpose is to help themselves and each other get -- and stay -- sober. For information about their programs call your local chapter or write to the national office at P.O. Box 459, Grand Central Station, New York, NY 10163. They can also send you a free pamphlet on alcoholism and older people entitled "Time to Start Living."

National Clearinghouse for Alcohol Information is a Federal information service that answers public inquiries, distributes written materials, and conducts literature searches. For information, write to P.O. Box 2345, Rockville, MD 20852.

National Council on Alcoholism distributes literature and can refer you to treatment services in your area. Call your local office (if listed in the telephone book) or write to the national headquarters at 12 West 21st Street, New York, NY 10010.

The previous materials are a summary of information published by: the National Institute on Aging. These materials are meant as a general guideline. You should always consult with your own physician prior to taking action.