Risks of combined alcohol/medication use in older adults

Abstract

Older adults who drink alcohol and who take medications are at risk for a variety of adverse consequences depending on the amount of alcohol and the type of medications consumed. It is important for clinicians to know how much alcohol their older patients are drinking to be able to effectively assess their risks and to counsel them about the safe use of alcohol and medications. Similarly, it is important for older adults to understand the potential risks of their combined alcohol and medication use to avoid the myriad of problems possible with unsafe use of these substances..

Drinking Patterns of Older Adults with Chronic Medical Conditions

“…23 The interaction of alcohol and medication puts the elder adult at unnecessary risk of an adverse event and/or non-control of the condition being treated. 9,10,47,48 Within the context of chronic illness management, at-risk alcohol consumption may be responsible for poor medication adherence, intractable hypertension, increased bleeding, and/or poor self-management skills. [35][36][37]49,50 Currently, universal alcohol screening is recommended by the United States Preventive Services Task Force, 51 and recently, the Centers for Medicare and Medicaid Services approved Medicare payment for alcohol screening and four brief counseling sessions.…”

“…[5][6][7] Moreover, any alcohol use in older adults with specific chronic conditions and/or specific prescription regimes could contribute to adverse medical events. [8][9][10][11] The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines at-risk drinking for persons over 65 years of age as more than seven drinks per week or more than three drinks on any single day. 8,9 Recent studies have estimated the percentage of older adults that drink in excess of this guideline.…”

“…[8][9][10][11] The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines at-risk drinking for persons over 65 years of age as more than seven drinks per week or more than three drinks on any single day. 8,9 Recent studies have estimated the percentage of older adults that drink in excess of this guideline. Nine percent of elderly Medicare beneficiaries (2003 data) reported at-risk drinking defined as either exceeding 30 drinks in a typical month in the past year or heavy episodic drinking (drinking four or more drinks on a single day).…”

“…10,23 For example, alcohol consumption can interfere with the effectiveness of medications commonly used to treat conditions such as hypertension and depression. 9 Despite the potential negative impact of alcohol on persons with chronic illness, studies suggest some health benefits to light or moderate drinking. Reviews of studies on persons with diabetes, cardiovascular disease, coronary artery disease or stroke found associations between light to moderate alcohol consumption and reduced risks of cardiovascular events, mortality and recurrent stroke.…”

Alcohol in the second half of life: do usual quantity and frequency of drinking to intoxication increase with increased drinking frequency?

“…Aging is also associated with lower alcohol tolerance due to reduced muscle mass and slower metabolism (1). In addition, older adults are the biggest consumers of medications that may be harmful when consumed in combination with alcohol (2). For these reasons, more knowledge about the nature of changes in alcohol use that take place among older adults is needed.…”