Dan I Lubman
The proportion of Australians aged over 65 years is
increasing. Although screening and treatment for alcohol
and drug issues has traditionally focused on those aged
less than 65 years, there is growing evidence of alcohol and
drug related harm among older people.
This article broadly discusses our current understanding
of alcohol and drug problems among people aged over 65
years, as well as recommended approaches to this issue
within primary care.
Current prevalence estimates are likely to underestimate
the number of older people with alcohol and drug
misuse. Further, only a small number of older people seek
specialist treatment for alcohol or drug problems, despite
documented harms. Enhanced screening and assessment
practices in primary healthcare settings are critical for
improving health outcomes for older people with substance
Population surveys, both nationally and internationally, indicate that alcohol and prescription medications are more likely to be misused by older people than illicit drugs.1–3 Recently the authors analysed data from the 2007 Australian National Drug Strategy Household Survey1 to determine rates of alcohol and other drug use in older Victorians (aged >65 years). Similar to other age groups within the community, tobacco and alcohol were the main drugs associated with serious harm in people aged over 65 years (consumed daily by 8% and 15% of older people, respectively) (Table 1). Prescription drug misuse was also a concern, with 3% reporting that they took opioid or nonopioid analgesics for nonmedical purposes. Furthermore, 5% of people aged over 65 years were estimated to be at risk of short term alcohol related harm (ie. at risk of injury or accidents occurring immediately after drinking).4
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