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and what information would be helpful to people who are thinking
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Alcohol and Older People
This leaflet is for:
- older people who are worried about their drinking
- anyone who wants to know more about the problems of drinking in
- how to seek help.
As we get older, our bodies change. On the outside we notice
lines, wrinkles, extra weight. Our skin is perhaps not quite as
strong or flexible as it used to be. On the inside we:
- lose muscle
- gain fat
- break down alcohol more slowly.
This means that we become more sensitive to the effects of
alcohol. We also react more slowly and tend to lose our sense of
balance. So, even if we drink the same amount of alcohol, as we get
older it is likely to affect us more than younger people.
How much is it safe to drink?
The more you drink, the more likely it is that alcohol will harm
your health; BUT there are “sensible” levels of
drinking which, for most people, are unlikely to be harmful. These
- 14 units of alcohol a week for women
- 21 units for men
However, the changes mentioned above mean that safe drinking
levels for older people are probably less than this.
Many drinks now show the number of units they contain on the
bottle. But to give you some idea:
- a pint of light beer (4%) or a double
whisky both contain two units
- a 75cl bottle of wine
contains 8 - 10 units and so a glass of wine might
contain anything from 1 ¼ to 3¼ units depending on its size.
Weekly limits can be misleading. If just a quarter of the
recommended weekly amount is drunk over a matter of hours, this is
more likely to be harmful.
Drink Aware has further information on 'what
is an alcohol unit?'
How many people drink too much?
Older people tend to drink less alcohol than younger people, but
even so 1 in 5 older men and 1 in 10 older women are drinking
enough to harm themselves. These figures have increased by 40 per
cent in men and 100 per cent in women over the past 20 years.
Are there any risks to 'sensible' drinking?
Just because we drink within the limits does not mean that it is
safe. Very little research has been done on older people so we may
be mistaken in thinking that these limits apply to everyone. There
are also some particular problems:
- health problems can make us more susceptible to alcohol
- balance gets worse with age - even a small amount of alcohol
can make you more unsteady and more likely to fall.
- add to the effect of some medications, e.g. painkillers or
- reduce the effect of others, e.g. medication to thin the blood
(warfarin) – this can increase the risk of bleeding or
developing a clot or blockage in your bloodstream.
Check with your doctor about whether it is safe for you to
drink with your particular health problems or medication.
What are the risks of drinking too much?
Alcohol can damage nearly every part of the body:
- the stomach lining → ulcers or bleeding
- the liver → cirrhosis and liver failure
- heart muscle → heart failure produces a build-up of fluid in
the lungs which makes you breathless
- cancer → of the mouth, stomach and liver
- malnutrition→ alcohol has lots of calories for energy, but none
of the protein, fats or vitamins you need to keep your body in good
- sense of balance → falls and accidents (even with 'sensible'
- blackouts or fits
- poor sleep → day-time tiredness.
Not everyone who drinks too much will develop health problems
but, the more you drink, the more likely you are to get
Isn't drinking good for the heart?
If you drink about 1 unit a day, you are slightly less likely to
have a heart attack. This finding came from studies in men in their
40s and 50s - so it may not apply to everyone. It will make
more of a difference if you control your weight,
take exercise and make sure that you get proper treatment for any
high blood pressure, high cholesterol or diabetes.
How can alcohol affect mental health?
Too much alcohol can cause:
- Anxiety: This
may be because you start to feel anxious as the alcohol wears off –
like a mild withdrawal symptom. So you have a drink to feel better
– but as the effect of that wears off, you start feeling anxious
- Depression: You
feel less hungry, have difficulty sleeping and get tired more
easily. You start to feel that you have lost interest in things you
used to enjoy, are slower to take things in when reading or
watching television and feel less positive about the future - or
even feel that life is not worth living.
- Hearing voices: This is less common but can
happen if you have been drinking heavily for a long time. It starts
with vague noises, like leaves rustling, and gradually becomes
distinct voices. These can be unpleasant and are usually
- Confusion: If you have been drinking but not
eating, the lack of Thiamine, an important vitamin, can make you
confused and unsteady on your feet. If this is not treated
urgently, you can get permanent damage to your short-term memory –
this is called Korsakoff’s syndrome.
- Dementia: You
can lose your ability to remember new information, which may be put
down to 'old age', instead of the effects from alcohol.
How might an older person develop an alcohol problem?
About a third of older people with drinking problems (mainly
women) develop them for the first time in later life.
Bereavement, physical ill-health, difficulty getting around and
social isolation can lead to boredom and depression. Physical
illness may be painful and it can be tempting to use alcohol
to make these difficulties more bearable. It may then become part
of our daily routine and difficult to give up. There may be less
pressure to give up drinking than for a younger person, fewer
family responsibilities, and no pressure to go to work each
It is possible that health professionals don't spot heavy
drinking in older people as often as they should, because:-
- Older people tend not to talk about their drinking, perhaps
because of embarrassment.
- They mistake the effects of alcohol for a physical or mental
- They forget that older people may have drink problems so they
don’t look so hard for it.
- They don't have time to ask older people about their
What help is available?
It is often easier to treat drink problems in older people than
it is in younger adults.
- Detoxification or ‘detox’. This involves
giving medication to reduce withdrawal symptoms and then tailing
off and stopping it after a few days or weeks. In older people this
is usually best done in hospital.
- Support groups. Many people find that
self-help groups like AA (Alcoholics Anonymous) are the most
helpful way to overcome a serious drink problem. But they don't
suit everyone. They tend to work on stopping drinking completely
and many older people may just want to cut down. If you have
mobility problems, it can be hard to get to meetings.
- Psychological or ‘talking
treatments’. Treatment can be “one to one” or with a
group of other people, where you can share your experiences
with others. Therapists are trained to talk about your problems
without judging you. They can help you to stop drinking completely,
or to control your drinking better. This can take some time and
there may be setbacks. This is normal and one setback should not be
seen as a failure.
- You will also need to find ways to occupy yourself with
activities, so you can get out of the daily routine that revolves
around alcohol. Friends and family may be able to help with
- Acamprosate and naltrexone are medications for alcohol if
you have stopped drinking. They are mainly prescribed for younger
people as it is not known how safe or effective they
are for older people.
- Helping with the problem that made you start drinking in
the first place. This could be anxiety, depression, physical
problems or just not seeing other people very much.
What do I do now?
If you think that you have an alcohol problem, talk to your
doctor. If necessary they can arrange for you to have tests, see a
counsellor, or refer you to an NHS alcohol team in your
There are also a number of organisations offering free advice
for alcohol problems.
The Royal College of Psychiatrists (2011)
Our Invisible Addicts: College Report CR 165. London:
The Royal College of Psychiatrists.
Rao, T. (2011)
Older people and dual diagnosis - out of sight, but not out
mind. Advances in Dual Diagnosis, 4(1), 4:6.
Supports individuals and families with the ultimate aim of
abstinence. Email: firstname.lastname@example.org
Aims to improve later life for everyone through information
and advice, campaigns, products, training and research. Free
national information line on 0800 169 6565.
National helpline: 0845 769 7555.
National agency on alcohol misuse campaigning for effective
alcohol policy and improved services for people whose lives are
affected by alcohol-related problems. Email: email@example.com
Provides consumers with information to make informed decisions
about the effects of alcohol on their lives and lifestyles
Foundation 66 works with individuals, communities and
policy makers to reduce the harm caused by problem alcohol and drug
use. Email: firstname.lastname@example.org
Institute of Alcohol
An independent organisation that has the broad aim of increasing
awareness of alcohol related issues in society.
Social care organisation which provides services for people with
complex needs, including those affected by drug and alcohol misuse,
mental health problems and those with a learning disability. Email:
Produced by the Royal College of Psychiatrists’ Public Education
Editor: Dr Philip Timms
Expert review: Dr Tony Rao
This leaflet reflects the best evidence at the time of
© November 2012. Due for review: November 2014. Royal College of
Psychiatrists: You can link to, download, print, photocopy and
distribute this leaflet free of charge. But you must not change it
or repost it on a website.
a catalogue of public education materials or copies of our leaflets
Department, The Royal College of Psychiatrists, 21
Prescot Street, London E1 8BB. Telephone: 020
7235 2351 x 2552
Charity Registration number (England and Wales) 228636 and in
Please note that we are unable to offer advice on individual cases. Please see our
advice on getting help.
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