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Risks of Alcohol Abuse for Older People

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The effects of alcohol are renowned. People might feel chatty and relaxed to begin with, but things can quickly turn ugly when a person has drunk more than their tolerance level.

As people age, their bodies change, and this has a significant effect on how alcohol is metabolised and impacts a person’s health and physicality.

It was reported that “the rate of older people over the age of 65 admitted to hospitals in England for alcohol-related conditions rose by 7% from 2016/17 to 2019/20″.

Being aware of alcohol use and late-onset alcoholism is important. It supports preventative measures, helps identify problematic drinking, and means treatment can be accessed more quickly.

How is drinking alcohol different for older people?

Drinking is different for older people because of how bodies change. It’s clear from looking at an older person that skin alters (becoming wrinkled, losing elasticity, and gaining blemishes such as liver spots), but there are other things too that are significant.

The older people get, the less muscle they have, and it’s usually replaced by fat. This is significant in how alcohol metabolises (breaks down). It makes people more sensitive to the effects of alcohol, especially in relation to heavy drinking.

Late-life drinking problems can develop as lifestyles change. This might be linked to increasing leisure time after retirement, distressing life events as significant others become unwell and/or die, and issues related to health. (There are also more likely to be incidents of alcohol interactions with medications).

What Causes Ageing People to Drink?

It’s important to keep in mind what leads people to drink in older age. This creates a space for compassion and understanding as well as highlights ideas on how to improve a person’s habits.

Causes might be linked to:

What’s Safe to Drink for Older People?

The NHS recommends “no more than 14 units of alcohol a week, spread across 3 days or more”. This is a general rule for all.

However, for those who have mental or physical health issues, or alcohol use disorders, intake is best kept to a minimum and in worst case scenarios, avoided at all costs.

In relation to older people, those who are “65+ should consume no more than three drinks on any given day. Those with certain medical conditions such as major depression, or those taking certain medications (e.g., pain medications) should consume less alcohol or abstain completely.”

It’s beneficial to keep in mind that alcohol introduces toxins to the body and the higher the intake, the more health is affected.

Small amounts, but especially excessive drinking patterns in older individuals, are far more likely to lead to medical issues and issues around balance and coordination.

Can Older People Drink Safe Amounts Without Health Issues?

Even when consuming what some might consider a standard drink, there are risks, especially for the older person.

Health conditions make alcohol effects stronger and as physical health tends to deteriorate with age this is a concern. Alongside this is the topic of medications. Alcohol can both increase side effects as well as reduce effectiveness of medication.

What Can Happen If People Drink A Lot In Older Age?

There are many illnesses and diseases that are linked to and a direct cause of alcohol use.

People often associate alcohol-dependent use with a deterioration in brain and cognitive functioning, but it also destroys stomach lining (causing ulcers), the liver (leading to cirrhosis), and causes heart problems and cancer.

Increased Reactivity And Sensitivity

Age-related changes in the body means that the enzyme that breaks down and metabolises alcohol doesn’t function as well. This means there’s a higher level of alcohol in the blood.

As well as this the reduction in muscle mass means alcohol stays in the body longer. People can feel more intoxicated and it lasts longer.


As a person gets older, their thirst reduces, renal functioning decreases and balance of water changes. This combined with alcohol consumption increases the opportunities for dehydration.

Medication Interactions

Prescription medication is more common in older age. Drinking can cause adverse effects in relation to intoxication and can counter medications so they’re less effective. This means chronic conditions aren’t managed as well as they could be.

More Likely To Catch An STI

Between 2017 and 2019, there was a 20% increase in over-65s contracting STIs. This was largely connected to the chemsex scene where both alcohol and drugs are used by gay men at sex parties.

People’s risk-taking behaviours were raised through the use of “hook up” apps. Often, people drink alcohol in hook-up situations and this lowers inhibitions around sex.

Health Problems

As mentioned, alcohol use leads to medical conditions. It impairs heart and liver functioning leading to illnesses and disease, causes high blood pressure, gastrointestinal disease, and osteoporosis. It also negatively affects memory and causes cognitive impairment and alcohol-related dementia.

I Heard Drinking Had Health Benefits?

Research shows that “just over half a unit of alcohol a day was the optimal level of consumption among current drinkers”. This study, though, was connected to deaths linked to alcohol. Health complications associated with alcohol are minimised the less a person drinks.

People often think red wine is good for health. While there are some antioxidants in red wine, it’s not essential to a person’s diet and antioxidants can be gained through other foods and drinks that have many nutritional benefits.

How Does Alcohol Impact Mental Health?

Alcohol addiction and mental health conditions are highly associated with each other. In healthcare settings, this is often termed a dual diagnosis.

While people often use alcohol to try and ease mental health symptoms, drinking (especially heavy alcohol consumption) can lead to depressive symptoms and anxiety.

At its worst, people experience psychosis (including hallucinations) and go on to develop alcohol-related dementia (Wernicke–Korsakoff syndrome).

Safety Issues For Elderly People Who Drink

The intoxicating effects of alcohol, regardless of whether drinking habits are frequent impact how a person moves, feels, and thinks. Sense of balance and coordination reduces as one ages and this coupled with alcohol intake increases the risk of falls.

How to Tell If An Older Person Has Been Drinking

There are common signs of alcohol abuse that reveal whether a person has been drinking both in the immediate moment as well as over a period of time. Being aware of these makes the signs easier to spot.

  • Slurred speech
  • Impaired balance and coordination
  • Personality changes (i.e. very chatty, aggressive etc.)
  • Frequent falls
  • Missing appointments
  • Self-neglect regarding medication, eating and hygiene
  • Cognitive decline
  • An increasing alcohol tolerance
  • Experiencing withdrawal symptoms (i.e. mood swings, a tremor, sickness and diarrhoea)
  • Finding alcohol or products with alcohol in (i.e. cough syrup) around the house or in hidden place

How Do I Encourage An Older Person To Get Help For Alcohol Use?

There are a few things you can do when trying to support someone to seek treatment. It’s imperative you approach the person with compassion and an open mind. Express concern and explain that you’re worried about their health and their consumption of alcohol.

You might mention that while a glass of wine may have been okay in the past, you’ve noticed that it seems to affect their medication or balance etc.

Being inquisitive and asking for their thoughts is helpful too, though they might be in denial of having a problem or confidently declare they’ll do as they please.

Depending on the person’s personal circumstances and the severity of the issue, it might be advisable to get a healthcare professional (i.e. the GP) involved.

While addiction recovery needs to be desired by the person with the condition, there are certain circumstances (i.e. being vulnerable and elderly) where additional support and care is essential.

What Treatment Options Are There For Older Adults?

There are both inpatient and outpatient treatment options for people who have alcohol use disorders. As well as this, there are various group support options that people find helpful.

  • The NHS offers outpatient support in towns throughout the UK. There, a keyworker is assigned, and the individual will be assessed and a care plan put in place. The plan will include some one-to-one support, group sessions, and harm reduction advice. The goal is often to support people to reduce alcohol use as much as possible while living at home.
  • Inpatient clinics are what people tend to mean when they refer to “rehab”. These offer intensive treatment programmes with the aim of supporting a person to detox from alcohol completely and to develop the basis of an abstinent lifestyle. Try something reputable like Rehab Recovery, an alcohol rehab in London, something which may be ideal for your situation.
  • SMART Recovery groups offer people guidelines and practical advice on how to manage problematic drinking. Individuals are supported to develop healthy new habits and coping strategies to manage cravings and find meaning in daily life.
  • Alcoholics Anonymous is a worldwide fellowship with both in-person and online sessions. At these, people work through the 12 Steps with the aim of achieving a sustainable life of sobriety within a community context.


Are older adults at risk for alcohol abuse?

Yes, older adults are at risk of alcohol abuse. Many begin drinking due to feelings of loneliness, boredom, anxiety, or by distressing life changes such as the loss of a loved one.

Can older people with mental health conditions and alcoholism recover without treatment?

It’s very unlikely an older person with both a mental health condition and addiction will recover without support. Doctors, mental health, and addiction specialists are needed to offer support and provide the medical and psychological treatments necessary to heal.

Photo by Kelli Tungay on Unsplash

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