Alcohol Treatment

While the Opioid Epidemic makes headline news, the number of people who die from alcohol related illnesses is six times the number that dies from prescription opioid overdose. More people die from alcohol-related medical problems than all other addictions combined.

The Good News: FDA Approved Medications for Alcohol Addiction

Alcohol addiction is much more treatable today than ever before because of the availability of FDA approved medications like Vivitrol, Rivia Campral, and Antibuse that can help cut alcohol cravings and alcohol use so problem drinkers become abstinence (stop drinking altogether) or controlled (moderate), drinkers.

Seniors and Alcohol Use, How Much is Safe?

Seniors cannot drink as much alcohol as younger adults. The liver is unable to detoxify alcohol as efficiently as it used to. Because you have less lean muscle, less water content, and more body fat, it is harder for seniors to eliminate alcohol from the body. Simply said, older adults tolerate less alcohol.

• In seniors, having 3 drinks or more in two hours or less, is binge drinking, not social drinking. One drink equals 1 oz. of alcohol.
• Over the age of 65, 1 drink or more per day for a total of 7 drinks or more per week may indicate a drinking problem.

Many seniors mistakenly consider 3 drinks a day, just social drinking. In older adults, having 3 or more drinks a day, the equivalent of a standard glass of wine, a beer or a “shot”, is now considered binge drinking.

An astounding 10% or more retirees meet this definition. This is tragic as alcohol related medical issues prevent many seniors from living the retirement they always dreamt of.

Alcohol and Medications, a Dangerous Mix

Alcohol use in seniors who take medications is a real problem. Many prescription and over-the-counter medications, and even some herbal remedies including marijuana (see below) become unsafe or even deadly when combined with drinking.

Alcohol can make some medications ineffective or increase certain side effects and even increase their toxicity.

There also may be changes in an aging liver which affects how quickly alcohol is metabolized. This is especially true if a patient is taking medications that affect liver function, such as seizure or psychotropic medications.

For patients taking antidepressants, anti-anxiety or sleep medications, drinking alcohol is especially risky. Alcohol can enhance the effects of these drugs, potentially causing excessive drowsiness, confusion and dizziness, which can lead to falls and auto accidents. Drinking alcohol while taking blood thinners, including aspirin, risks increased bleeding especially the stomach.

Alcohol and Marijuana a Fashionable Poly-addiction, but a Really Bad Idea for Seniors

Marijuana is increasingly popular and available with seniors who use it recreationally or medically to manage pain, anxiety, depression, and sleep problems. However, marijuana use in older adults is especially dangerous due to interactions with medications, riskier driving, cannabis related mental health issues and increased risk of falls and memory problems.

Medical Consequences of Alcohol Misuse in Older Drinkers

Alcohol affects every organ in the body especially older drinkers who are most at risk for cardiac arrhythmias, impaired immune system, decreased bone density, peripheral nerve damage, gastrointestinal bleeding, heart failure and strokes.

Controlled Drinking vs. Abstinence: Severity Predicts Relapse

Patients who enter alcohol treatment for the first time often say they would like to find ways to cut back on their drinking rather than abstaining.

Moderate or “controlled” drinking is defined as up to one drink (1oz) per day for seniors and women, and up to two drinks per day for men.

This strategy can be successful for patients who have not yet developed a pattern of alcohol misuse such as binge drinking, or who have experienced few negative consequences from drinking. Whether moderate drinking is OK for you depends on various factors, including your overall health, medication regimen, tolerance to alcohol, and individual preferences.

As severity of dependence increases, the likelihood of patients’ being able to reduce their drinking to moderate levels, and keep it there, goes down dramatically. For the most dependent drinkers, abstinence may be the only option.

Dual Diagnosis is Common with Alcohol Addiction.

Mood and anxiety disorders are the most common psychiatric disorders seen in alcohol addiction followed by Post Traumatic Stress Disorder and Body dysmorphic syndrome.