Alcoholism and Prescription Drug Abuse in the Elderly: St. Louis University Grand Rounds

Abstract

This Grand Rounds will review the problem of alcoholism and prescription drug abuse in the elderly. Several case vignettes will be presented. The pharmacology of alcohol and potentially addictive prescription medications will be reviewed. The clinical presentation of and psychiatric symptoms associated with these disorders will be discussed. The process of addiction and issues regarding the clinical evaluation of the elderly addict will be discussed. The medical complications of these disorders will be reviewed, followed by a discussion of guidelines for the appropriate use of these drugs in the elderly. The grand rounds will conclude with a discussion of the treatment of patients with these disorders.

Tranquilliser Use in Elderly Psychiatric Patients

“…The prevalence of alcoholism was estimated to vary greatly from less than 5% to over 60% in the elderly. 27 One large study found that 15 .5% of patients were drinking at hazardous or harmful levels, but only a minority were clinically identified by the medical staff as hazardous or harmful drinkers. 28 This finding highlighted that alcohol abuse in the elderly population was under-recognised by medical staff, and it is of interest that this study also found a low number of subjects consuming alcohol.…”

Aging and Alcohol Abuse: Increasing Counselor Awareness

“…Therefore, age-specific group treatment that is supportive and nonconfrontational is usually most effective with older adults (Barry et al, 2001). Evidence pointing to the success of age-specific 12-step groups suggests that older adults are more willing to share their feelings with peers who are experiencing similar symptoms (Solomon, Manepalli, Ireland, & Mahon, 1993). Counseling relationships built on trust, rapport, and acceptance are important in facilitating an environment where self-esteem and feelings of self-worth can be built or restored (Norton, 1998).…”

Alcoholism in the Elderly

“…78 Depending on the degree of physical dependence, withdrawal from alcohol can be a potentially life-threatening medical emergency.79 Detoxifying elderly pa¬ tients is best carried out in a hospital setting in which doses of benzodiazepines and other medication can be carefully monitored. 78 Depending on the degree of physical dependence, withdrawal from alcohol can be a potentially life-threatening medical emergency.79 Detoxifying elderly pa¬ tients is best carried out in a hospital setting in which doses of benzodiazepines and other medication can be carefully monitored.…”