CONTENTS

Table of Contents
Introduction

1. Overview
2. Recognizing Alcohol Misuse and Abuse in Older Adults
3. Alcohol and Aging
4. Diagnosing Alcohol Problems in Older Adults
5. Recognizing Other Forms of Substance Abuse
6. Prevention and Early Intervention Strategies
7. Treatment
8. Outcomes and Cost Issues in Alcohol Treatment for Older Adults
9. Legal and Ethical Issues

Supplements
Resources

At Any Age, It Does Matter:
Substance Abuse and Older Adults (for Professionals)

Cautions About “Healthy Drinking”

Despite indications that alcohol may promote health, the World Health Organization (WHO) denounced the health benefits of alcohol several years ago. “We are seeking to demystify advertising that says that alcohol is good for your health and to debunk the idea that to have a drink a day will keep the doctor away,” said Dr. Mario Argondona, chief of WHO’s treatment unit of the Programme on Substance Abuse. The program’s director, Hans Emblad, added that there is no minimum safe level of consumption. Emblad says, “The less you drink, the better.”¹⁷

Emblad continues, “There are other ways of reducing the risk of cardiovascular disease: avoid smoking, engage in physical activity, eat less fat.” However, Brian Pentecost, medical director of the British Heart Foundation, pointed to evidence that moderate consumption of alcohol is associated with a reduction in all causes of death. WHO is concerned that the publicity given to this evidence may have influenced some people to start drinking.¹⁷

WHO claims that there is no indication that drinking more than one drink every other day reduces the risk of cardiovascular disease compared with total abstinence. WHO’s stance has raised questions over the recommended safe levels of alcohol intake. Although WHO is not preaching abstinence, Dr. Argondona reminds people that alcohol is a risky, addictive, and toxic substance.

Furthermore, the recommended level of drinking does not take into account body weight and individual vulnerability, the pattern and spacing of drinking, or the drinking context.¹⁷ These issues are particularly relevant for older adults, in whom the toxic effects of alcohol are increased. Finally, a recent review indicated that alcohol dependence nullifies the protective effect of light and moderate drinking.¹⁸