Risks of combined alcohol/medication use in older adults.
ABSTRACT Many older adults (ie, those aged >65 years) drink alcohol and use medications that may be harmful when consumed together.
This article reviews the literature on alcohol and medication interactions, with a focus on older adults.
Relevant articles were identified through a search of MEDLINE and International Pharmaceutical Abstracts (1966-August 2006) for English-language articles. The following medical subject headings and key words were used: alcohol medication interactions, diseases worsened by alcohol use, and alcohol metabolism, absorption, and distribution. Additional articles were identified by a manual search of the reference lists of the identified articles, review articles, textbooks, and personal reference sources.
Many older adults drink alcohol and take medications that may interact negatively with alcohol. Some of these interactions are due to age-related changes in the absorption, distribution, and metabolism of alcohol an medications. Others are due to disulfiram-like reactions observed with some medications, exacerbation of therapeutic effects and adverse effects of medications when combined with alcohol, and alcohol's interference with the effectiveness of some medications.
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..
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ABSTRACT: Previous studies investigating human values and alcohol consumption have focused on adolescents, so the current study examined associations between human values and alcohol consumption in a cohort of Norwegians in the second half of life (40 years and above). Human values were studied within Schwartz’ theory [Schwartz, S. H. (1992). Universals in the Content and Structure of Values: Theory and Empirical Tests in 20 Countries. In M. Zanna (Ed.), Advances in Experimental Social Psychology (Vol. 25, pp. 1-65). New York: Academic Press.] A survey was conducted in 2002/2003 among Norwegians aged 40 to 79 years (n = 4 149). The respondents completed measures of human values, drinking frequency and typical drinking quantity. Females (9%) were more likely to report abstinence than males (3%). Males also reported a higher consumption level. Individuals with high education had lower levels of abstinence (4%) than those with basic education (7%), and high education was also related to more consumption. People aged 40-60 years were less likely to abstain from alcohol (3%) than individuals aged 61 years and above (10%). Unmarried individuals were more likely to report abstinence, but also reported somewhat higher consumption than married individuals. Multivariate analyses adjusting for demographics as well as somatic and mental health showed that Hedonistic values were related to lower probability of abstaining, while Conformity and Universalism values were associated with a higher probability of abstaining. Achivement and Hedonism values were associated with more alcohol consumption, whereas Universialism, Tradition and Conformity were related to lower alcohol consumption.Substance Use & Misuse 12/2014; In press. DOI:10.3109/10826084.2014.998237 · 1.23 Impact Factor
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ABSTRACT: BACKGROUND: Due to population aging and generational changes in alcohol and drug use, substance use disorders and treatment need are projected to increase among adults over 50. We analyzed data from two national surveys conducted 10 years apart [(NLAES (1991-1992) and NESARC (2001-2002)] to explore changes in help-seeking for alcohol and drug problems among adults over age 50. METHODS: Data were pooled on help seeking for substance related problems, sociodemographic and clinical variables, and services type (i.e., formal and informal). Differences between the surveys were assessed, and help seeking among those under age 50 was compared to younger individuals; changes in the sociodemographic and clinical correlates of help seeking among those over age 50 were examined. RESULTS: Among those 50 and older, rates of lifetime help seeking for any substance problem were higher in NESARC than NLAES, and percentages of those considering but not getting help were also higher in NESARC. Among those 50+, rates of past-year help seeking for drug use were higher in NESARC, but among those with lifetime substance use disorders, help seeking rates for alcohol and any substance were lower in the NESARC. Older help seekers in the NESARC were less likely to be White, more likely to be low income, and more likely to be current or former drug users than NLAES help seekers. CONCLUSIONS: This study documents increased rates of help seeking for substance related problems among those 50 and older and identifies cohort differences in profile of past-year help seekers.Drug and alcohol dependence 11/2012; 131(1-2). DOI:10.1016/j.drugalcdep.2012.10.008 · 3.28 Impact Factor
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ABSTRACT: Alcohol-use-disorders (AUDs) afflict 1-3% of elderly subjects. The CAGE, SMAST-G, and AUDIT are the most common and validated questionnaires used to identify AUDs in the elderly, and some laboratory markers of alcohol abuse (AST, GGT, MCV, and CDT) may also be helpful. In particular, the sensitivity of MCV or GGT in detecting alcohol misuse is higher in older than in younger populations. The incidence of medical and neurological complications during alcohol withdrawal syndrome in elderly alcoholics is higher than in younger alcoholics. Chronic alcohol abuse is associated with tissue damage to several organs. Namely, an increased level of blood pressure is more frequent in the elderly than in younger adults, and a greater vulnerability to the onset of alcoholic liver disease, and an increasing risk of breast cancer in menopausal women have been described. In addition, the prevalence of dementia in elderly alcoholics is almost 5 times higher than in non-alcoholic elderly individuals, approximately 25% of elderly patients with dementia also present AUDs, and almost 20% of individuals aged 65 and over with a diagnosis of depression have a co-occurring AUD. Moreover, prevention of drinking relapse in older alcoholics is, in some cases, better than in younger patients; indeed, more than 20% of treated elderly alcohol-dependent patients remain abstinent after 4 years. Considering that the incidence of AUDs in the elderly is fairly high, and AUDs in the elderly are still underestimated, more studies in the fields of epidemiology, prevention and pharmacological and psychotherapeutic treatment of AUDs in the elderly are warranted.Experimental gerontology 04/2012; 47(6):411-6. DOI:10.1016/j.exger.2012.03.019 · 3.53 Impact Factor