Home' Australian Pharmacist : Australian Pharmacist April 2013 Contents 34 Australian Pharmacist April 2013 I ©Pharmaceutical Society of Australia Ltd.
James Pitts, Chief Executive Officer of
Odyssey House McGrath Foundation, said
over the past four years there had been
a change in demand for rehabilitation
services from primarily drug-focussed to
alcohol-focussed treatment being sought.
'Alcohol has become much more
prominent over the past three years as
the drug mentioned by most people as
their drug of concern,' he said.
'Along with that are people who are
alcohol dependent. Normally the prime
drug-using population is between 18 and
32 but we are seeing an increase in
the population of people who are over
45 years of age and almost 80% of those
are alcohol dependent.'
What is raising fears is that the issue of
at-risk drinking amongst the ageing
appears to heading towards a critical
juncture with the huge increase in the
The fears of the 'hidden epidemic'
becoming a major health problem for
Australia are underscored by the findings
of the 2010 Intergenerational Report
which predicted the number of people
aged between 64 and 84 will more than
double by 2050.
It also forecast the population of what it
defined as very old people (85 and over)
more than quadrupling from 0.4 million
people in 2010 to 1.8 million in 2050.
Taken with other population forecasts,
the projections mean the proportion of
people aged 65 years or over will increase
from 13% in 2010 to 23% by June 2050.
Alcoholism is more dangerous for older
people because they usually have a lower
tolerance rate, exacerbated by the fact
that alcohol interacts dangerously with
some of the medications older people
are likely to be taking, such as arthritis
relievers or other types of painkillers.
It also has a greater negative impact on
the organs of older people than on those
of younger, healthier drinkers.
The dangers of alcohol misuse among
the elderly are, according to Dr Ben Teoh,
Medical Superintendent of South Pacific
Private, the real issue.
'There is no evidence of increased
prevalence of alcohol abuse in the elderly.
However, there is higher incidence of
harmful effects of alcohol and problems
with diagnosis,' Dr Teoh said.
'Elderly people are more sensitive to the
harmful effects of alcohol, physically and
mentally. Chronic abuse of alcohol can
lead to damaging effects on the brain,
heart, liver and nervous system which can
aggravate the general decline in old age.
'Complications from alcohol withdrawal
are also more severe in the elderly.
Diagnosis of alcohol abuse can be
masked by other health problems
leading to social isolation and the use of
Despite the clear problems associated
with older alcoholism, little research has
been conducted into the issue, leading to
the view that it is the 'invisible epidemic'.
One study backed by the Foundation
for Alcohol Research and Education,
An exploration of how social context and
type of living arrangement are linked
to alcohol consumption amongst older
Australians, reinforced that 'to date, there
has been little exploration of alcohol
use amongst older Australians, and in
particular little if any research that has
explored in depth the connection'.
The Edith Cowan University study
into alcohol consumption habits in
retirement homes concluded that 'alcohol
served an important social function,
irrespective of setting, and was viewed
as an enjoyable part of life. This may
explain why a significant proportion of
the sample was drinking more than the
'The perception was that alcohol
enhanced many social activities,
highlighting the view that alcohol
"in moderation" had more benefits for
older people than problems.'
The authors said their research indicated
older people may possibly drink more
frequently in retirement villages than
in private homes, but not necessarily
consume greater quantities of alcohol.
The National Drug and Alcohol Research
Centre Guidelines for the Treatment of
Alcohol Problems states: 'Under-diagnosis
appears to be the key barrier to treatment
for older patients. For instance, hospital
workers are significantly less likely to
identify alcohol-related problems in an
older patient than in a younger patient.'
While it doesn't enlarge on this, other
research backs it up. The 2004 paper
Substance misuse in the older generation
which coined the term 'invisible epidemic'
found 'Alcoholism in elderly persons has
been considered an "invisible epidemic",
but the magnitude is really not known.'
One study in Medscape found that
among older patients with alcoholism,
from one-third to one-half developed
alcoholism after the age of 60, and this
group was hard to recognise.
A report by All Saints Home Care and
Referral Services in the US found the
early onset of alcoholism was seen in
individuals that had been drinking for a
long time and are now elderly.
'It is important that family and non-family
caregivers understand the risk factors
of late onset of alcohol and drug abuse
in the elderly such as chronic medical
problems and sleep disturbances.
The individual tends to use alcohol to
control pain and to induce sleep. Women,
isolated or individuals who have a lot of
leisure time, or loss of a spouse to death
are more likely to fall victim to late onset
of alcoholism,' the report stated.
'The late onset is often seen in individuals
in the age range of 40--50, well-educated
with good income, and high levels of
stress. This is treatable and the cause can
be resolved, however, it is often not easily
diagnosed by health care professionals.'
was that alcohol
enhanced many social
the view that alcohol
"in moderation" had
more benefits for
older people than
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