How Alcohol Addiction Can Sneak Up On You

Alcohol affects us differently as we get older. It takes longer for alcohol to metabolize, so it remains in the body longer. Older adults tend to have higher blood alcohol levels than younger people do because the amount of water in our bodies decreases as we get older. Therefore, it takes fewer drinks to become intoxicated. People who maintain the same drinking patterns as they age can develop alcohol addiction realizing it.

Older adults may consider their drinking to be at a moderate level when it’s actually above that recommended by experts. Alcohol misuse can slowly develop until it’s difficult for people to know what’s normal and what’s not.

When is drinking a problem?

National dietary guidelines say women should consume no more than one alcoholic drink a day, and men should consume no more than two to avoid health problems. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends that adults over 65 consume no more than three drinks on any given day and no more than seven drinks a week. According to the NIAAA, one standard drink is 12 ounces of beer; 8 to 9 ounces of malt liquor; 5 ounces of wine; or 1.5 ounces (a shot) of 80-proof spirits, such as vodka, whiskey, rum and gin.

Not everyone who drinks daily has a drinking problem, and not all problem drinkers imbibe every day. Light to moderate drinking—such as a glass of wine with dinner—can even be beneficial to your health. However, those benefits are negated if you exceed the recommended limits.

Besides the immediate consequences of excessive drinking—falls, injuries, accidents, dangerous interactions with meds—misusing alcohol can have long-term effects. Over time, alcohol addiction can cause health problems, such as cancer, liver damage, brain damage, confusion and forgetfulness; worsen existing health problems, such as diabetes, high blood pressure and osteoporosis; and mask symptoms of serious health issues, such as dulling the pain of heart-attack warning signs.

Mixing alcohol—even one drink—with drugs can create a dangerous, even deadly, cocktail. Common drugs that don’t mix with alcohol include aspirin, cold and allergy medicine, sleeping pills, painkillers and anxiety or depression drugs. Alcohol can also reduce or exacerbate therapeutic effects of certain drugs, such as warfarin. Ask your doctor or pharmacist whether it’s safe to drink while taking your meds.

When to seek help

Doctors often use a set of four questions called the CAGE test to determine alcohol addiction. Answering yes to two or more of the following questions can indicate that you have an alcohol problem for which you should see a healthcare professional:

• Cut down. Have you ever felt you should cut down on your drinking?

• Annoyed. Have people annoyed you by criticizing your drinking?

• Guilty. Have you ever felt bad or guilty about your drinking?

• Eye-opener. Have you ever taken a drink first thing in the morning to steady your nerves or get rid of a hangover?

You may also want to consider seeking help if you feel compelled to hide your drinking or lie about it, are irritable or tense when you don’t drink, drink to forget your troubles or have lost interest in food.

Don’t be afraid to bring up your drinking concerns with your doctor. In fact, your doctor may broach the subject before you do.

The United States Preventive Services Task Force—a federal advisory panel of medical experts that evaluates the scientific evidence for preventive medical protocol—advises primary care doctors to screen all adult patients for unhealthy alcohol use and offer counseling if needed. Your doctor can help you find local resources, such as counselors trained in treating alcohol addiction, support groups for older adults, or programs like Alcoholics Anonymous, to help you stop or cut back on drinking.

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HealthAfter50 was published by the University of California, Berkeley, School of Public Health, providing up-to-date, evidence-based research and expert advice on the prevention, diagnosis, and treatment of a wide range of health conditions affecting adults in middle age and beyond. It was previously part of Remedy Health Media's network of digital and print publications, which also include HealthCentral; HIV/AIDS resources The Body and The Body Pro; the UC Berkeley Wellness Letter; and the Berkeley Wellness website. All content from HA50 merged into in 2018.