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.
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