This information is for people over 50 years old, who are drinking alcohol above low risk guidelines (14 units most weeks) and are worried about their drinking.
It may also be of use to carers, friends, or health professionals who are worried about an older person’s drinking.
What’s different about alcohol for older people?
Anyone at any age can drink too much. Sometimes health problems can be mistake for conditions related to ageing, rather than our drinking habits. People drink alcohol for many reasons:
- It might be just a habit or routine; they have always drunk.
- Significant changes in life roles - retirement, no longer caring for dependent children, bereavement, separation/divorce - leading to more opportunity/time to drink.
- Boredom, loss of social contacts, loss of hobbies/interests.
- Change in social group, revolving around pubs/clubs.
As we get older, our bodies change; we, lose muscle, gain fat and break down alcohol more slowly.
This means that we can become more sensitive to the effects of alcohol. Other health problems can also make us more susceptible to the effects of alcohol.
We sometimes react more slowly and balance may deteriorate with age - even a small amount of alcohol can make us more unsteady and at risk of falls.
So, even if our alcohol routine hasn’t changed it can affect us more and can impact on our quality of life
Lower risk drinking
The Department of Health Guidelines state that there is no safe level of alcohol use. The more you drink, the more likely it is that alcohol will harm your health. Drinking 14 units a week or less, is considered low risk. However, the changes to our bodies as we age, mean that safe drinking levels for older people are probably less than this.
It is important to know how much alcohol we drink. Drinks containing alcohol show the number of units they contain on the label. There are also unit calculators online e.g. Alcohol Concern UK.
For example:
- A pint of ordinary strength beer (4%) or a double whisky (50mls) both contain two units.
- A 75cl bottle of wine contains 8 - 10 units and so a glass of wine might contain anything from 1 to 3 units depending on its size.
If you drink 10 units daily, you have alcohol in your body for 10 hours. Over time this puts strain on your liver, which is why alcohol free days are so important.
Lower risk drinking advice is:
- Have two or three alcohol free days each week.
- It’s important to spread drinks evenly over a few days.
- Binge drinking (six or more units) over a matter of hours increases risk of accidental injuries and these risks can increase with age.
Risk behaviours
Alcohol can impair your judgement and alter your behaviour. You can misread situations and react in ways that are out of character. Alcohol can increase your vulnerability to financial and sexual exploitation. Arguments can escalate into assault or fights.
Delay making important decisions if you have been drinking; consider getting advice/support from trusted friends/family/healthcare professions.
Driving
Don’t drink and drive. On average it takes a healthy liver an hour to process one unit of alcohol. An evening drink can mean you still have alcohol in your system the next morning. The safest option is to avoid drinking alcohol altogether when driving.
Alcohol and medicine
Alcohol can enhance the effect of some medications, such as painkillers or sleeping tablets, and reduce the effect of others, such as medications to thin the blood (Rivaroxaban) and antidepressants.
Check with your doctor if it is safe for you to drink with your particular health problems and/or medication. Ask your pharmacist and/or read the leaflet that comes with your prescription, over-the-counter or herbal medicines.
What are the risks of drinking too much?
Alcohol can damage nearly every part of the body:
- The stomach lining - ulcers or bleeding.
- The liver - fatty liver, cirrhosis and liver failure.
- Heart muscle - heart failure produces a build-up of fluid in the lungs which results in shortness of breath.
- Cancer - 6% of cancers world wide can be linked to alcohol. Mouth, stomach, liver and breast cancers have strong links with alcohol use.
- Malnutrition - alcohol has lots of calories for energy, but none of the protein, fats, vitamins or minerals you need to keep the body in good repair. People who drink most days are recommended to take Thiamine and Sanatogen.
- Sense of balance - falls and accidents (even when not intoxicated).
- Blackouts, seizures or fits.
- Stroke.
- Poor sleep - broken sleep, early morning waking and daytime tiredness.
- Menopause - increase in symptoms.
Not everyone who drinks too much will develop health problems, but the more you drink, the more likely you are to get such problems.
Alcohol and mental health
Anxiety
Alcohol can be a short term fix to relieve anxiety, but the anxiety will return. It is not a long term solution. So the temptation is to drink again to feel better.
Depression
Alcohol is a depressant. Low mood and depression can lead to a loss of interest in things you used to enjoy. You can feel tired, but have difficulty sleeping. It becomes more difficult to take things in when reading or following a TV programme. Your appetite can be poor, and your body can become depleted of essential nutrition for normal brain function. In extreme cases you may feel life is not worth living.
Hearing voices
This is less common but can happen if you have been drinking heavily for a long time. It starts with vague noises, like leaves rustling, and gradually becomes distinct voices. These can be unpleasant and distracting.
Confusion
Alcohol use plus poor or absent diet can result in low Thiamine and Magnesium. This can cause confusion and poor memory. If not treated this leads to Alcohol Related Brain Injury, including Korsakoff’s dementia.
Cut down your drinking
Keep a drink diary, this is a good starting point for change. Write down the date, what type of drinks you have, how many units, and add up the total number of units each day. Bottles/cans have information about number of units.
Have an alcohol reduction plan
- Think about hobbies, interests, and social opportunities that don’t involve alcohol. This may be a brand new activity or something that you used to enjoy.
- Alcohol can fill a gap when you are bored so don’t leave space. Occupy yourself and get out of the routine/habits that revolve around alcohol.
- Local Council websites/libraries will have information about volunteering opportunities, wellbeing groups and leisure activities in your local area.
- Friends and family can support you to make changes.
- Home measures are usually large ones. Use a measure or a smaller glass, and make sure you keep track. Don’t top-up your glass before it’s empty. Put the bottle away between drinks.
- Make each drink last longer. Drink a soft drink or water with, or after, each alcoholic drink.
- Eat something before you drink, this will help slow down the absorption of alcohol into your body.
- Plan two or three alcohol-free days a week.
- If you have a lapse or don’t manage to cut down as you had hoped, don’t give up! If it was an easy thing to do you would have done it already.
- Have a plan and acknowledge your successes.
What support and treatments are available?
If you are drinking dependently, it could be unpleasant or even dangerous for you to stop drinking abruptly (cold turkey) as your body is accustomed to alcohol.
Talk to your GP or healthcare professional about alcohol. Each person is different, so speaking to a medical professional about your own circumstances is always a good starting point. Ask about a prescription of Thiamine and Sanatogen A-Z Complete. Your GP may be able to offer a medically supported detox (depending on your alcohol intake, your physical/mental health, and your support at home). You will need a robust plan about how to stay abstinent following detox.
Your GP can offer information about local community alcohol service. They can refer you or you can self-refer.
Community alcohol services, support you to make changes either by a safe/slow reduction or by medically supported detox.
If your goal is abstinence, but cravings for alcohol are a problem, there are medications that might be of use to you, to help reduce these cravings. Ask your GP or local alcohol service.
Discuss with your GP access to Wellbeing support/social prescribing/counselling services. If you are drinking to help manage anxiety, low mood or physical problem, a wellbeing service can help provide alternative strategies, not reliant on alcohol.
Support Groups: Mutual aid organisations AA (Alcoholics Anonymous) and SMART Recovery. These offer abstinence based recovery support. Look at their websites for up to date meeting details.
By making healthier choices about alcohol you can start to see the positive effects on your health and wellbeing.
Support organisations
Age UK
Bristol: 0117 929 7537
South Gloucestershire 0145 441 1707
Alcoholics Anonymous
Bristol helpline: 0117 926 5520
Email: help@aamail.org
SMART Recovery
Self-Help Addiction Recovery | UK Smart Recovery
Bristol ROADS/ Bristol DHI
0117 440 0540
BDP 50+ Crowd
0117 440 0540
South Gloucestershire DHI
0800 073 3011
North Somerset We Are With You
01934 427940
Drinkline
0300 123 1110
© North Bristol NHS Trust. This edition published August 2023. Review due August 2026. NBT003101.