Substance abuse is widespread in Australia. Far from the stereotypes of the twentysomething partygoers or ‘down and out’ heroin addicts injecting in shady laneways, substance abuse affects individuals throughout society, irrespective of education, lifestyle or age.
According to Australian researchers, elderly Australians are not always aware of the risks or harmful effects of drugs and alcohol. Therefore, there is a need to strengthen awareness amongst the community about what constitutes healthy alcohol consumption as well as minimising harmful effects of substance abuse.
As we get older, our bodies change. And so does our ability to tolerate alcohol. To complicate the issue further, many elderly people are taking several prescription medications which may interact with alcohol. Too much alcohol may also negatively impact those with chronic disease, another common problem with the elderly.
Many older people are, somewhat surprisingly, likely to be drinking every day. However, they tend to drink less than younger Australians in one sitting. According to the Australian Institute of Health and Welfare, Australians over the age of 70 were more likely to drink alcohol daily than any other age group. They are also likely to drink alone, adding to the concern that they may overlook the quantity of alcohol they are consuming.
Dr Lynette Cusack from the University of Adelaide School of Nursing, along with her fellow researchers, are trialling a screening tool developed by the World Health Organisation and special addiction researchers for potential use among elderly Australians in the community.
Once the trial is complete, the tool, called the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), will be adapted for use amongst the targeted group. This tool, which has been rigorously tested internationally, screens for a wide range of substance abuse, including tobacco, cannabis, alcohol, amphetamines, sedatives and opioids.
The ASSIST Package consists of three different manuals:
- An introductory manual which aids in identifying individuals who use substances
- A brief intervention manual to help healthcare workers conduct interventions with clients whose substance abuse is putting them at risk
- A self-help manual with strategies to help patients look at ways of cutting down their substance abuse and identify ways in which the substances put them at risk
Essentially, the objective is to reduce alcohol and drug-related problems in elderly people that may manifest either:
- due to the normal ageing process – changes in their metabolism, body compositions, predispositions to increased fractures from falls, or
- due to medical conditions (e.g. chronic conditions such as diabetes and heart disease) or medications an elderly person may take.
Dr Cusack says a screening test will score an individual’s risk for harm, while also encouraging a conversation between healthcare workers and the individuals on safe drug and alcohol use. If required, individuals could be referred to appropriate substance abuse or health care professionals.
Many elderly people with depression, anxiety or other mental health problems drink to improve their mood. However, the effect is only temporary and can make situations worse. Also, those afflicted with depression or anxiety may be taking medications that may also not mix well with alcohol.
Mixing alcohol with any illicit drugs, even cannabis, can have lethal consequences.
In 2009, The Australian guidelines to reduce health risks from drinking alcohol has made some significant differences to the previous guidelines. In particular, it advises that both men and women drink no more than two standard drinks per day to reduce the health risk over a lifetime. Previously the guidelines set the limit at four drinks for men and two drinks for women per day, on average. However, these guidelines are just a start. More information needs to be given to the community at large, and in the case of the elderly, more research and education needs to be carried out.
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