Aging, Drinking, Alcohol Abuse and Alcoholism

By Emily Carton, LISW

Drinking and aging do not mix well. Anyone at any age can develop or resume a drinking problem. Great Uncle George may have always been a heavy drinker -- his family may find that as he gets older, the problem gets worse. Grandma Betty may have been a teetotaler all her life, just taking a drink "to help her get to sleep" after her husband died -- now she needs a couple of drinks to get through the day. These are common stories. Drinking problems in older people are often neglected by families, doctors, and the public.

Physical Effects of Aging and Drinking

• Alcohol slows down brain activity.
• Because alcohol affects alertness, judgment, coordination, and reaction time, drinking increases the risk of falls and accidents
• Some research has shown that it takes less alcohol to affect older than younger people
• Over time, heavy drinking permanently damages the brain and central nervous system, as well as the liver, heart, kidneys, and stomach
• Alcohol's effects can make some medical problems hard to diagnose. For example, alcohol causes changes in the heart and blood vessels that can dull pain that might be a warning sign of a heart attack
• It also can cause forgetfulness and confusion, which can seem like Alzheimer's disease

Mixing Drugs

Alcohol, itself a drug, is often harmful when mixed with prescription or over-the-counter medicines. This is a special problem for people over 65, because they are often heavy users of prescription and over-the-counter medications.

Mixing alcohol with other drugs such as tranquilizers, sleeping pills, painkillers, and antihistamines can be very dangerous, even fatal. For example, aspirin can cause bleeding in the stomach and intestines; when aspirin is combined with alcohol, the risk of bleeding is much higher. When alcohol is mixed with sleeping pills or barbiturates such as ativan, valium or librium, the combination can slow down the body's vital systems to the point of the person seemingly slips out of consciousness, but in reality, they have gone into cardiac or pulmonary arrest, and die.

As people age, the body's ability to absorb and dispose of alcohol and other drugs changes. Anyone who drinks should check with a doctor or pharmacist about possible problems with drug and alcohol interactions.

Who Becomes a Problem Drinker?

There are two types of problem drinkers -- chronic and situational. Chronic abusers have been heavy drinkers for many years. Although many chronic abusers die by middle age, some live well into old age. Most older problem drinkers are in this group.

Other people may develop a drinking problem late in life, often because of "situational" factors such as retirement, lowered income, failing health, loneliness, or the death of friends or loved ones. At first, having a drink brings relief, but later it can turn into a chronic companion or escape.

How to Recognize a Problem

Not everyone who drinks regularly has a drinking problem. Binge drinking, even just a few times a year, can be a signal that a problem exists. You might want to get help if you:

• Drink to calm your nerves, forget your worries, or reduce depression
• Lose interest in food
• Gulp your drinks down fast
• Lie or try to hide your drinking habits
• Drink alone more often
• Hurt yourself, or someone else, while drinking
• Are drunk more than three or four times last year
• Need more alcohol to get "high"
• Feel irritable, resentful, or unreasonable when you are not drinking
• Have medical, social, or financial problems caused by drinking

What is Binge Drinking?

Binge drinking is also referred to as 'heavy episodic drinking", has been defined in different ways at different times. Most people who binge drink are not alcohol dependent [1], or chronically alcoholic. It currently most often refers to heavy drinking over a short period of time, such as an evening. It often occurs with the intention of getting intoxicated, and is sometimes associated with social or physical harm.

The National Institute of Alcohol Abuse and Alcoholism [2] defines binge drinking as a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 grams percent or higher. This typically happens when the average size American male consumes 5 or more drinks, and when an American female consumes 4 or more drinks, in about 2 hours. In older people, binge drinking can be associated with these health problems:

• Accidental injuries (e.g. vehicle crash, falling, burning, drowning)
• Intentional injuries (e.g. firearm injuries, sexual assault, domestic violence)
• Alcohol poisoning
• High blood pressure, stroke, and other cardiovascular diseases
• Neurological damage
• Sexual dysfunction or sexually transmitted disease
• Poor control of diabetes
• Liver disease

Getting Help

Older problem drinkers have a very good chance for recovery because once they decide to seek help, they usually stay with treatment programs. You can begin getting help by calling your family doctor or clergy member. Your local health department or social services agencies also can help.

Resources:

Alcoholics Anonymous (AA) is a voluntary fellowship of alcoholics who help themselves and each other get and stay sober. Check the phone book for a local chapter or write the national office at: 475 Riverside Drive, 11th Floor
New York, NY 10115; or call
(212) 870-3400.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides information on alcohol abuse and alcoholism. Contact:

NIAAA
6000 Executive Boulevard
Bethesda, MD 20892-7003
(301) 443-3860.

The National Council on Alcoholism and Drug Dependence, Inc., can refer you to treatment services in your area. Contact:

National Headquarters
NCADD
12 West 21st Street
8th Floor
New York, NY 10010
(800) NCA-CALL (800-622-2255).

The National Institute on Aging offers a variety of resources on health and aging. Contact:

NIA Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
(800) 222-2225, TTY (800) 222-4225.

References:

Alcohol Concern Factsheet 20: Binge drinking [3]

Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion [4]

Eliminating high-risk drinking: report [5]

Global Status Report on Alcohol 2004 [6] by the WHO [7].

National Institute on Aging, U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health.

"Quick Stats: Binge Drinking." The Centers for Disease Control and Prevention. April 2008. http://www.cdc.gov/alcohol/quickstats/binge_drinking.htm [8].

About the Author:

Emily Carton, LISW [9] is a licensed social worker who works with eldery people and their families.