Self-reporting and close monitoring of alcohol use for older patients

Among those who consume alcohol at hazardous levels, many older Australians take prescribed medications that adversely interact or have reduced efficacy when combined with alcohol.
 
Data from the National Drug Strategy Household Survey 2016 found that despite younger people consuming less alcohol, Australians aged 49–70 are increasingly drinking at risky levels.
 
In combination with taking regular medication, this potentially puts them at risk of serious health complications, especially if they are not informing their GP or pharmacist.
 
Researchers from Edith Cowan University (ECU) published findings in the Australasian Journal on Ageing, based on an audit of 72 patients aged 58–87 who were discharged from an alcohol and other drugs treatment service.
 
Of this cohort, 92% were taking at least one medication – between one and 12 per day – and consuming alcohol at hazardous levels.
 
The efficacy of 97% of patients’ medication was also found to be significantly reduced when consumed with alcohol.
 
Lead researcher Dr Stephen Bright, from ECU’s School of Medical and Health Sciences, said this is a worrying trend, given older Australians are more likely to have a chronic illness that alcohol can aggravate and make more difficult to treat, putting them at increased risk of experiencing health complications.
 
‘[These patients are] likely to be prescribed an average of four medications and be taking several herbal supplements,’ he said.
 
‘What we’ve found is that when people then mix these medications with alcohol, there’s potential for a whole range of serious side-effects. For example, alcohol can reduce the effectiveness of some medications and that could lead to psychiatric symptoms, stomach ulcers or cardiovascular events. And in some cases it can be fatal.’
 
In addition to regular and close monitoring by healthcare professionals as part of general check-ups, Dr Bright cites the importance of self-reporting.
 
‘If you’re prescribed any medications or are taking any supplements or other drugs, talk to your doctor about your alcohol use and how this may affect it,’ Dr Bright said.
 
‘Particularly with older people who are taking more and more medications, we need to be careful to look at how they interact with each other and how they may interact with alcohol.’
 
Current guidelines on harm reduction from alcohol consumption recommend no more than 10 standard drinks per week and four standard drinks on any one day to reduce associated health risks.
 
However, there are no specific guidelines for older people and the researchers are calling for targeted education for both patients and healthcare professionals to mitigate these risks.
 
‘There’s not enough awareness about what a safe level of drinking is, particularly for older people and those also taking medications,’ Dr Bright said.
 
‘We need to encourage more people to have the conversation with their doctor, pharmacist or healthcare professional so that they can look at alternative medications or give advice on what a safe level of drinking is, if any.’
 
Figures from the Australian Bureau of Statistics confirm that, in 2016, the most common drug-induced deaths in Australia were among middle-aged men misusing prescription drugs, such as benzodiazepines or oxycodone, in a polypharmacy setting.
 
The majority of Australia’s 1740 drug-induced deaths in 2018 were from prescription medications, with alcohol a common contributing factor.
 
Log in below to join the conversation.

alcohol and other drugs alcohol use older people polypharmacy prescription medicine