Alcohol, drugs and much more in later life

Abstract

Elderly adults are greater consumers of prescription and 'over the counter' medications than any other age group and polypharmacy, including the co-use of alcohol, is common in this group. Age related physiological changes which influence drug concentrations, metabolism, polypharmacy and interaction of other drugs with alcohol can negatively influence functional capacity, psychomotor ability, and cognition, including attention and memory, placing the older person at greater risk of accident, injury, isolation and ultimately institutionalisation. It is argued that DSM-IV criteria used to define "abuse" or "dependence" are of limited value to the majority of elderly 'problem' alcohol or drug users, with ICD-10 criteria that identify those who are experiencing 'a risk' of or where use "is actually" causing "early" harm, more appropriate. Impediments to psychiatrists and other medical practitioners identifying 'problem' alcohol and other drug use, and appropriate assessment and intervention procedures are briefly discussed. The potential for decreasing the incidence and severity of physical and psycho/social events following a reduction or cessation in problem alcohol or other drug use means that assessment and intervention should be one cornerstone of management practice for this often disenfranchised and vulnerable group.

Declínio cognitivo de idosos e sua associação com fatores epidemiológicos em Viçosa, Minas Gerais

“…O consumo de álcool também pode aumentar a predisposição do idoso a certas enfermidades como, por exemplo, desnutrição, enfermidades hepáticas, gástricas e pancreáticas, bem como interferir no efeito de medicamentos e aumentar o risco de quedas. 25 Pelos resultados obtidos neste estudo, destacase que uma parcela significativa de idosos já sofreu algum tipo de queda no último ano. Tais informações podem ser importantes no planejamento de programas de prevenção de quedas para essa população.…”

Uso de substâncias psicoativas em idosos: uma revisão integrativa

“…Despite the sick not considering nicotine a drug of abuse and, as such, they not always reporting it to professionals, or not always being asked by the professionals (Pillon et al, 2010), the "lifelong" use of drugs is related to the consumption of tobacco (Han et al, 2009), whereby 49.5% of drug users that presented a positive drugs test were smokers (Schlaerth et al, 2004). However, this consumption "in the last year" and "lifelong" consumption decreased between 1991-1992and 2001-2002(Sacco et al, 2013. Voluntary admissions in this age group have diminished, whether for illicit drugs or for illicit drugs and alcohol, although admissions by criminal justice services increased between 1992 and 2005 (Lofwall et al, 2008).…”

“…Rosen et al (2011) report that the ways in which the diagnoses of mental illnesses are evaluated vary considerably, which was also shown to be present in these studies. However, Hulse (2002) reports that the DSM-IV identifies this type of consumer less precisely, in comparison to ICD-10. This is because the diagnosis of abuse or dependence in DSM-IV centers on social, legal, interpersonal and professional consequences, which may not be so applicable given the lifestyle changes that occur in this age group.…”

“…It also estimates that consumption of any illicit drug will grow from 2.2% (1.6 million) to 3.1% (3.5 million), between 1999-2001 and 2020 (Colliver, Compton, Gfroerer, & Condon, 2006). In regard to the diagnosis of disorders resulting from the use of psychoactive substances, an increase from 2.8 million to 5.7 million is predicted from 2002to 2020(Han, Gfroerer, Colliver, & Penne, 2009. It is also estimated that the necessity for treatment among the elderly population will increase from 1.7 million in 2000-2001 to 4.4 million in 2020 (Gfroerer, Penne, Pemberton, & Folsom, 2003).…”

Prevalence and costs of hospitalizations for poisoning and accidental intoxication in Brazilian elderly

“…Hepatic metabolism, homeostatic mechanisms, as well as filtration ability and renal excretion can be compromised, hindering the elimination of metabolites, causing the accumulation of toxic substances in the body and ultimately producing adverse reactions (Hulse, 2002;Nobrega et al, 2005;Rocha et al, 2008;Medeiros et al, 2009).…”