Ask a Health Care Professional – Alcohol

By Wei-Ann Bay, M.D., Chief Medical Officer, Blue Cross and Blue Shield of New Mexico

There is a greater need to pay more attention to mental health and substance use problems among older adults. Problems with alcohol use are not uncommon for older adults and tend to be underrecognized.

How much alcohol is too much?

Factors such as age, gender, beverage type and alcohol content are considered when determining how much alcohol is too much. In the United States, a standard drink is any drink that contains 14 grams of pure alcohol, which is about 0.6 fluid ounces or 1.2 tablespoons. Generally, this means one 12-ounce beer equals one standard drink, one bottle of wine equals five standard drinks, and a fifth of hard liquor equals 17 standard drinks. Mixed drinks can contain one or more standard drinks depending on the recipe.

For adults age 65 or older, moderate drinking — or relatively low risk for alcohol problems — is no more than two drinks on any single day and no more than seven drinks per week. Anything above this is considered heavy drinking and an increased risk for alcohol problems.

For some, no level of alcohol intake can be regarded as safe. Examples of these situations include having a personal or family history of alcoholism, being pregnant, or having liver disease.

What do studies show on alcohol and increased age?

As the body ages, the movement of drugs within the body changes. Older adults have slower rates of metabolism and lower body mass. This means alcohol levels can accumulate in the body, leading to intoxication with lower amounts of alcohol intake. Older adults are more vulnerable to the side effects of alcohol than younger adults.

 How can alcohol affect my health?

Alcohol can affect overall health. Some studies show reduction in cardiovascular death with low to moderate alcohol intake. If you have a cardiovascular condition, be sure to discuss your alcohol intake with your health care provider. Problem drinking can decrease one’s quality of life, increase disability, and increase mortality risk. Alcohol use has been shown to increase risk for cancers in the digestive system, breast cancer in women, and liver cancer that results from alcoholic liver disease. People with gout are at increased risk for flares with too much alcohol intake. Osteoporosis, which is thinning of the bones, can be related to heavy alcohol use and result in falls and broken hips. Accidents, violence, depression and suicide are also associated with alcohol use. Long-term alcohol abuse can result in heart, nerve and brain damage. Alcohol can lower the immune system’s ability to fight disease. (Please note: Drinking alcohol does not protect you from the COVID-19 virus.) Finally, alcohol can also interact negatively with some of the medications prescribed to treat chronic medical conditions.

What is alcohol use disorder?

This is the medical term for alcoholism or addiction. People who have alcoholism have two or more of the following problems: drink more or for a longer time than planned, wish they could cut down but can’t, spend a lot of time trying to get alcohol or being drunk, crave alcohol, can’t do the things they want to because of their alcohol use, keep drinking when things in life get worse, keep drinking even in dangerous situations or when they know it affects their mental or physical problems, need to drink more to get the same effect, or have withdrawal symptoms when they stop drinking. Withdrawal symptoms include sweating, racing heart, trembling, insomnia, anxiety, seizures, nausea/vomiting, restlessness and generally not feeling well.

What can I do if I think I have a problem with alcohol?

Many older adults do not share information about drinking concerns because of embarrassment or shame. Many are also isolated from family and social networks, especially during the COVID-19 public health emergency; isolation can lead to increased mental stress and increased alcohol intake. Understand the facts and get help by reaching out to a health care provider immediately. Your discussion with the health care provider is always confidential. Telehealth options are also available. There are several treatment options ranging from medications, counseling and support groups. Admission into a recovery program is available for those with a more serious alcohol problem. The Substance Abuse and Mental Health Services Administration also provides a national helpline at 1-800-662-HELP (4357).

If you have a health question that you would like to be considered in Ask a Health Care Professional, please email [email protected]. BCBSNM will select questions that may appear. Questions will not be personally answered. The opinions expressed in this column are solely those of the author and not necessarily those of BCBSNM. This column is not intended to be a substitute for professional medical care.

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