Treating alcohol abuse in senior citizens

As we age, our ability to metabolize alcohol decreases

By: Erinn Elizabeth Beagin, M.D.,in collaboration with Gloria N. Beck
   Alcoholism is a relatively common yet often unidentified problem among the elderly. Statistics show that up to 22 percent of our elderly population acknowledges that they are daily drinkers, with up to 9 percent admitting to being heavy drinkers, consuming between 12 and 21 alcoholic drinks per week.
   While alcohol consumption can be a cause for alarm at any age, it presents particular problems for the elderly population. During the month of April, which has been designated National Alcohol Awareness Month by the National Council on Alcoholism and Drug Dependence, family and friends should take the time to evaluate the alcohol consumption of those around them, and seek help if necessary.
   Since older drinkers may live alone or not have daily responsibilities that can be evaluated to identify problem drinking, look for changes in personality, new friendships or severed old friendships, changes in activities and interests, forgetfulness, dizziness and confusion as possible signs of unhealthy alcohol consumption.
   Tell-tale signs such as the smell of alcohol on the breath and liquor or beer bottles in recycling bins will also aid in evaluating alcohol consumption.
   It is important to remember that just because Uncle Joe always had a beer with lunch and an occasional glass of wine with dinner doesn’t mean that at 70 he isn’t facing a serious drinking problem. As we age, our ability to metabolize alcohol decreases. What was a manageable amount of alcohol at one point may now present a serious problem.
   Also, just because an individual doesn’t drive or have direct access to a liquor store doesn’t mean that he or she is not drinking. A "helpful" neighbor could be inviting them in for a nightcap or picking up a few bottles of wine on the way home from work.
   Drinking more than seven drinks in a week is considered a sign of a drinking problem in the elderly population, but an individual can be drinking too much even if they only have a few drinks a week. Anyone who loses their balance or experiences vomiting after a drink or two may be exhibiting signs of a drinking problem.
   Drinking problems among the elderly can result in misdiagnoses, over- or under- medication for a variety of conditions, as well as an increased risk of injury due to alcohol-related falls. Depression, suicidal thoughts, mood disorders and sleep disorders can often be attributed to alcohol consumption, as well.
   Mixing alcohol and medications can create a dangerous situation for anyone. Since many older Americans are taking at least one physician-prescribed medication and often one or more over-the-counter medications, alcohol consumption can have serious health-related repercussions.
   Alcohol, even in small amounts, can alter the effectiveness of many drugs, in particular pain and anxiety medications, antidepressants, blood thinners and antibiotics. Even the use of aspirin can be harmful in combination with problem drinking.
   Since problem drinkers may not disclose the facts about their alcohol consumption to their physicians, they may be prescribed inappropriate doses of medications, may be treated for symptoms being caused by their drinking rather than actual medical conditions, or alcoholism may mask other serious health concerns.
   For example, alcohol causes changes in the heart and blood vessels that can dull the warning signs of a heart attack. Drinking may result in forgetfulness and confused behavior, which can be mistaken for dementia or Alzheimer’s disease, which often takes place when an unidentified drinker is hospitalized and begins experiencing withdrawal symptoms.
   Additionally, over time, heavy alcohol use can cause certain types of cancer, liver cirrhosis, brain damage and immune system disorders.
   Taking the time to talk to older relatives or friends about their alcohol consumption and urging them to confide in their physician is the first step toward a likely recovery.
   Alcohol treatment has been proven to be very successful among the elderly population, once abuse has been identified.
   For more information on alcoholism and the elderly, visit the National Institute on Alcohol Abuse and Alcoholism at www.niaaa.nih.gov or the National Institutes on Aging at www.nia.nih.gov, or call (800) 222-2225.
   To find a Princeton HealthCare System physician specializing in geriatric medicine, call (888) 742-7496.