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Alcohol and medication: Safeguarding older adults’ health

Alcoholism and alcohol abuse in older adults are common but overlooked concerns. The 2021 National Poll on Healthy Aging conducted by the University of Michigan found that while most surveyed older adults consumed alcohol at low to moderate levels in a given year, a distinct subset of older individuals surpassed recommended guidelines for alcohol consumption, as measured by the frequency and quantity of drinks per week or per day. In the study, older adults cited a variety of motivations for drinking, including for taste, to be social, to relax, as routine, and to help with stress, mood, boredom, or pain.

In addition to alcohol consumption, adults over the age of 65 often have a regimen of medications, with 30 percent of this population taking eight or more prescription medications daily. This overlap of alcohol consumption and medication use represents a crucial area of concern.

Combined use: Alcohol and medication

For individuals of every age, drinking alcohol while on medication can have many harmful effects; though, older adults are more susceptible to negative side effects from combined use. As we age, our body undergoes changes that affect the way these medications are metabolized, which increases the brain’s sensitivity to side effects. Older adults are also more likely to take multiple medications, which increases the chance of potential negative interactions with alcohol. As we know, chronic conditions increase with age, and these too can be worsened by associated alcohol use.

The potential adverse reactions of combining alcohol and medication use include elevated blood alcohol levels, disrupted drug metabolism, diminished medication efficacy, and worsened side effects. These reactions may lead to a myriad of symptoms, from fluctuations in blood pressure and insomnia to dizziness, impaired coordination that can lead to falls or accidents, and the development of diseases, such as liver disease, gastrointestinal toxicity and cancer.

Combined use may also exacerbate preexisting conditions, like depression, seizure disorders or diabetes. Sustained intoxication caused by consistent drinking can slow down reaction time, cause confusion, drowsiness, and loss of balance and coordination. This can lead to an increased risk of falls, car accidents and other injuries for older adults.

Even seemingly innocuous medications like NSAIDs, including aspirin, Motrin, Advil, ibuprofen, and Aleve, can increase the risks for gastrointestinal bleeding when combined with alcohol. For older adults who experience arthritis and musculoskeletal problems, they may be frequently taking these medications. Some vasodilating drugs, such as antidepressants and drugs for Parkinson’s disease, can cause dangerously low blood pressure with alcohol consumption, leading to dizziness and fall-related injuries, whereas other antidepressant drugs can do the opposite, causing a severe increase in blood pressure that can lead to organ damage when mixed with alcohol.

Women and older adults have unique physiological characteristics, marked by higher body fat and lower body water content compared to other demographics. This creates a smaller fluid volume for alcohol to be distributed in the body, which can amplify blood alcohol levels. The ingestion of medication, such as benzodiazepines, in combination with elevated blood alcohol levels can extend the half-lives of these medications, resulting in prolonged sedation and potential coordination issues.

These risks highlight the importance of being transparent with health providers about alcohol consumption as an older adult. This will allow for risk assessments and advice on how to safely use alcohol and medication. Family members and care partners for older adults can help too by familiarizing themselves with the adverse effects of combining alcohol with medication. One drink may seem harmless, but for people at higher risk, it can lead to life-threatening complications.

Alcohol in assisted living facilities

Some assisted living communities will allow residents to drink as long as there is no warning from a medical professional that says it is harmful to their health. It is also important to allow older adults the right to choose if they want to consume alcohol. In some cases, alcohol use can create an issue for facilities and family members if a resident misuses alcohol.

To combat alcoholism or alcohol abuse in these communities, staff can offer special programs to reduce the triggers associated with drinking. They can also be trained to help seniors with alcohol abuse or substance abuse problems, and the facilities can create a supportive environment for seniors that includes activities and interactions to stay connected to their present lives without feeling the need for alcohol. Senior wellness programs can also be implemented to increase physical activity and help seniors manage the side effects of alcohol use. Finally, assisted living facilities can limit access to alcohol, which is an advantage of controlled menus at meal time.

Learn more

There are also a multitude of resources available online that can be accessible for older adults who are struggling with alcohol use. These resources can provide support, assistance, or help users find a rehab facility.

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Brooke Zarecki is a senior at CSU studying biomedical sciences with a minor in Spanish. She is currently a student ambassador for Columbine Health Systems Center for Healthy Aging.