En español | Alcohol use among Americans has risen over the past year, as many have turned to the bottle as a way to cope with stress, loneliness and boredom during the pandemic. Now a new poll suggests that while most older adults drink moderately, if at all, a significant number report heavier and more risky alcohol use, such as combining alcohol with other drugs.
The poll, conducted by the University of Michigan National Poll on Healthy Aging, surveyed a national sample of adults age 50 to 80 about their alcohol use and reasons for drinking. It found that while two-thirds of such older adults reported drinking alcohol at least occasionally in the past year, more than 60 percent limited it to four times a month or less. Surprisingly, over 85 percent reported no change in their alcohol use during this time, or even a decrease.
These results dovetail with other recent research that found that younger people were the most likely to hit the sauce during the pandemic. In fact, about 40 percent of adults under age 40 reported increased alcohol use compared to only 20 percent of those over age 60, according to a study published earlier this year in the medical journal Preventive Medicine.
But both studies found that older adults who experienced emotions like stress, anxiety and depression were more likely to report heavy alcohol use. “Those who reported only drinking socially may have seen their alcohol use drop, because they were staying home more,” explains poll coauthor Anne Fernandez, an assistant professor in the Department of Psychiatry at the University of Michigan Addiction Center. “But we did see an increase among people who reported that they used alcohol to cope with feelings of loneliness, stress or anxiety, all of which were obviously increased during the pandemic."
Older adults combining alcohol with other drugs
The poll revealed other concerning findings among older adults who did drink, including that 1 in 10 admitted drinking while also using other drugs, such as marijuana, sleeping pills or pain pills. Of this group, 20 percent said they had experienced alcohol-related blackouts. “We were surprised at these numbers, and concerned,” says Fernandez. “One of the more popular drugs was marijuana, and while it's not as risky as combining alcohol with an opioid or sedative, using the two together can cause dizziness in older adults, and increase their risk of having a fall.”
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And almost of a quarter of those who do drink report that when they imbibe, they consume at least three drinks in a sitting. “Even if you drink infrequently, consuming that much alcohol at once can have serious health consequences,” stresses Susan Lehmann, director of the Geriatric Psychiatry Day Hospital Program at Johns Hopkins Medicine in Baltimore. “As you age, you have changes in how your liver metabolizes alcohol, as well as your body mass, so while several beers might not have impaired you at all 20 years ago, it can cause you to become intoxicated faster and lead to you feeling confused and disoriented.” In addition, heavy drinking over time can damage your liver, suppress your immune system and even raise your risk of developing dementia, she says.
In general, groups including the National Institute of Alcohol Abuse and Alcoholism recommend that older adults in good health have no more than seven drinks per week and no more than three drinks on any given day. “A lot of older adults think that it's okay to have four drinks at a dinner or cocktail party, because they don't drink at all the rest of the week,” explains Lehmann. “But we know that sort of binge drinking can be particularly damaging for older adults.” If you take certain medications, such as opioids, anti-anxiety medications or sleeping pills, you should avoid alcohol completely.
Taking a look at the new heavy drinker
If you drink more than that on a regular basis and find it hard to cut back, or if you combine alcohol with recreational or prescription drugs, you should get professional help. This can be a sign of alcohol use disorder, a condition where you can't control your alcohol use, even when it interferes with doing your job or taking care of your family. While about two-thirds of older adults with alcohol use disorder developed it earlier in life, about a third develop it after the age of 50, says Lehmann. “This is often triggered by a stressful life event, such as a divorce, job loss or death of a spouse,” she explains. Rates are also increasing among older women, particularly those over age 60.
"The stereotype of the heavy drinker is a young to middle-aged man, but women's roles in society have changed a lot,” explains Fernandez. “They're juggling home and work responsibilities well into their 60s and 70s, and often turn to alcohol as a way to cope with the stress."
The best place to start is with your primary care physician, says Fernandez. “Many patients are afraid to bring up the topic, because they are worried about the stigma, and they may not yet be ready to quit,” she says. “But just having an initial conversation, to get some advice on safe drinking and referrals to online resources, can often help. This way, you can take an objective look at your drinking and try to figure out some goals and monitor your use.”
Prescription medications such as disulfiram (Antabuse), naltrexone and acamprosate (Campral) can also help, since they blunt your body's response to alcohol and reduce cravings, notes Fernandez, although many primary care physicians aren't very familiar with them. “The bottom line is, every doctor should be screening their older patients for alcohol use, and encouraging them to change their habits if they're drinking too much,” says Lehmann. “The more alcohol use is out in the open, the less stigma there is surrounding it — and the more likely older adults are to get help."