Alcohol and Drug Use in Ageing Populations

NCETA is assisting specialist and generalist health and welfare workers to better prevent, assess and respond to the needs of older people experiencing, or at risk of experiencing, alcohol and other drug (AOD) related harm. Longer life expectancy, changing patterns of AOD use and differing expectations of current and future generations of older people will all impact on future AOD service delivery. To-date comparatively little attention has been directed to the needs of older people and AOD use and, as a result, AOD use patterns and problems among older Australians have been under-researched and are not well understood. However, this is quickly becoming an emerging area of interest requiring greater resources, improved understanding, changes in service provision.

When addressing AOD issues among older people, attention will also need to be directed to the different needs of the various age groups. Those aged 55-65, 65-80 and 80+ may have different life experiences related to the year they were born, the cohort they grew up with and world events during their formative and later years. Similarly, those from different cultural backgrounds may have specific needs as will Aboriginal and Torres Strait Islander People. Hence, the term ‘older people’ should not be interpreted to mean a large single undifferentiated group. Sensitive responses are required to address the needs of the very diverse population groups that fall under the broad umbrella heading of ‘older people’.

The under-recognition of this important area will constitute significant challenges for services into the future.

NCETA Resources

Grey Matters: Preventing and responding to alcohol and other drug problems among older Australians Information Sheets

	Nicholas, R., & Roche, A.M. (2014). Information Sheet 1: Why the growing use of alcohol and other drugs among older Australians needs attention. Adelaide, South Australia: National Centre for Education and Training in Addiction (NCETA), Flinders University. Information Sheet 1: References Commonwealth of Australia. (2010). Australia to 2050: Future challenges. Canberra: Commonwealth of Australia. Dowling, G., Weiss, S., & Condon, T. (2008). Drugs of abuse and the aging brain. Neuropsychopharmacology, 33(2), 209-218. Australian Bureau of Statistics. (2011). Population by age and sex, Australian states and territories. Canberra: Australian Bureau of Statistics. Gossop, M. (2008). Substance use among older adults: A neglected problem. Lisbon, Portugal: European Monitoring Centre for Drugs and Drug Addiction.
	Nicholas, R., & Roche, A.M. (2014). Information Sheet 2: Alcohol and other drug use and healthy ageing: Patterns of use and harm among older Australians. Adelaide, South Australia: National Centre for Education and Training in Addiction (NCETA), Flinders University. Information Sheet 2: References Wilkinson, C., Dare, J., Waters, S., Allsop, S., & McHale, S. (2012). An exploration of how social context and type of living arrangement are linked to alcohol consumption amongst older Australians. Canberra: Foundation for Alcohol Research and Education. National Centre for Education and Training on Addiction (2013). Secondary analysis of 2010 National Drug Strategy Household Survey. Adelaide: NCETA. Australian Bureau of Statistics (2013). Australian 2010 mortality data. Canberra: Australian Bureau of Statistics. National Centre for Education and Training on Addiction (2013). Secondary analysis of 2009-10 Australian hospital separations data. Adelaide: NCETA. Hunter, B., Lubman, D., & Barratt, M. (2011). Alcohol and drug misuse in the elderly. Australian and New Zealand Journal of Psychiatry, 45(4), 343-343. Chikritzhs, T., & Pascal, R. (2005). Trends in alcohol consumption and related harms for Australians aged 65 to 74 Years (the 'young-old'), 1990–2003. Perth: National Drug Research Institute, Curtin University, WA. Australian Institute of Health and Welfare. (2011). 2010 National Drug Strategy Household Survey Report. Canberra: Australian Institute of Health and Welfare. Roxburgh, A., Bruno, R., Larance, B., & Burns, L. (2011). Prescription of opioid analgesics and related harms in Australia. Medical Journal of Australia, 5, 280-284. Hollingworth, S. A., & Siskind, D. J. (2010). Anxiolytic, hypnotic and sedative medication use in Australia. Pharmacoepidemiology and Drug Safety, 19(3), 280-288.
	Nicholas, R., & Roche, A.M. (2014). Information Sheet 3: The silver tsunami: The impact of Australia's ageing population. Adelaide, South Australia: National Centre for Education and Training in Addiction (NCETA), Flinders University. Information Sheet 3: References Royal College of Psychatrists. (2011). Our invisible addicts. London: Royal College of Psychatrists. Gossop, M. (2008). Substance use among older adults: A neglected problem. Lisbon, Portugal: European Monitoring Centre for Drugs and Drug Addiction. Wadd, S., Lapworth, K., Sullivan, M., Forrester, D., & Galvani, S. (2011). Working with older drinkers. Bedford: Tilda Goldberg Centre, University of Bedfordshire. Kelsall, J., Parkes, P., Watson, M., Madden, A., & Byrne, J. (2011). Double Jeopardy: Older injecting opioid users in Australia. Canberra: Australian Injecting and Illicit Drug Users League.
	Nicholas, R., & Roche, A.M. (2014). Information Sheet 4: Prevention and screening programs. Adelaide, South Australia: National Centre for Education and Training in Addiction (NCETA), Flinders University. Information Sheet 4: References Hunter, B. (2011). Older people and alcohol and other drugs. Melbourne: Australian Drug Foundation. Substance Abuse and Mental Health Services Administration. (1998). Substance abuse among older adults: Treatment Improvement Protocol (TIP) Series, No. 26. Rockville, MD: Substance Abuse and Mental Health Services Administration. National Prescribing Service. (2014). Medicinewise. Viewed 21/10/2014, at: http://www.nps.org.au/ Hunter, B., Lubman, D., & Barratt, M. (2011). Alcohol and drug misuse in the elderly. Australian and New Zealand Journal of Psychiatry, 45(4), 343-343. Hunter, B., & Lubman, D. (2010). Substance misuse: Management in the older population. Australian Family Physician, 39(10), 73-741. Caputo, F., Vignoli, T., Leggio, L., Addolorato, G., Zoli, G., & Bernardi, M. (2012). Alcohol use disorders in the elderly: A brief overview from epidemiology to treatment options. Experimental Gerontology, 47(6), 411-416. Bright, S., Fink, A., Beck, J., Gabriel, J., & Singh, D. (2013). Development of an Australian version of the Alcohol Related Problems Survey: A comprehensive computerised screening tool for older adults. Australasian Journal on Ageing. DOI: 10.1111/ajag.12098.
	Nicholas, R., & Roche, A.M. (2014). Information Sheet 5: Barriers and enablers to accessing assistance. Adelaide, South Australia: National Centre for Education and Training in Addiction (NCETA), Flinders University. Information Sheet 5: References Wadd, S., Lapworth, K., Sullivan, M., Forrester, D., & Galvani, S. (2011). Working with older drinkers. Bedford: Tilda Goldberg Centre, University of Bedfordshire. Royal College of Psychiatrists. (2011). Our invisible addicts. London: Royal College of Psychiatrists. Substance Abuse and Mental Health Services Administration. (1998). Substance abuse among older adults: Treatment Improvement Protocol (TIP) Series, No. 26. Rockville, MD: Substance Abuse and Mental Health Services Administration. DrugScope. (2014). It's about time: Tackling substance misuse in older people. London: DrugScope.
	Nicholas, R., & Roche, A.M. (2014). Information Sheet 6: Common substance use co-morbidities. Adelaide, South Australia: National Centre for Education and Training in Addiction (NCETA), Flinders University. Information Sheet 6: References Gossop, M. (2008). Substance use among older adults: A neglected problem. Lisbon, Portugal: European Monitoring Centre for Drugs and Drug Addiction. Royal College of Psychiatrists. (2011). Our invisible addicts. London: Royal College of Psychiatrists. Substance Abuse and Mental Health Services Administration. (1998). Substance abuse among older adults: Treatment Improvement Protocol (TIP) Series, No. 26. Rockville, MD: Substance Abuse and Mental Health Services Administration. Caputo, F., Vignoli, T., Leggio, L., Addolorato, G., Zoli, G., & Bernardi, M. (2012). Alcohol use disorders in the elderly: A brief overview from epidemiology to treatment options. Experimental Gerontology, 47(6), 411-416. Devanand, D. (2002). Comorbid psychiatric disorders in late life depression. Biological Psychiatry, 52(3), 236- 242. Hunter, B., & Lubman, D. (2010). Substance misuse: Management in the older population. Australian Family Physician, 39(10), 738-741. Eliasen, M., Grønkjær, M., Skov-Ettrup, L. S., Mikkelsen, S. S., Becker, U., Tolstrup, J. S., & Flensborg-Madsen, T. (2013). Preoperative alcohol consumption and postoperative complications: A systematic review and meta- analysis. Annals of surgery, 258(6), 930-942. Oppedal, K., Møller, A.M., Pedersen, B., & Tønnesen, H. Preoperative alcohol cessation prior to elective surgery. Cochrane Database of Systematic Reviews 2012, Issue 7. Art. No.: CD008343. DOI: 10.1002/14651858. CD008343.pub2.
	Nicholas, R., & Roche, A.M. (2014). Information Sheet 7: Older Australians, opioids and the treatment of pain. Adelaide, South Australia: National Centre for Education and Training in Addiction (NCETA), Flinders University. Information Sheet 7: References Blyth F., March L., Cousins M. (2003). Chronic pain-related disability and use of analgesia and health services in a Sydney community. Medical Journal of Australia, 179(2), 84. Gadzhanova, S., Bell, J. S., & Roughead, E. E. (2013). What analgesics do older people use prior to initiating oxycodone for non-cancer pain? A Retrospective Database Study. Drugs & Aging, 30(11), 921-926. The MBF Foundation, 2007. The high price of pain: The economic impact of persistent pain in Australia, viewed 14/10/2014, at: http://www.painaustralia.org.au/images/pain_australia/MBF%20Economic%20 Impact.pdf. Royal Australian College of Physicians (2009). Prescription opioid policy: Improving management of chronic non-malignant pain and prevention of problems associated with prescription opioid use. Sydney: The Royal Australasian College of Physicians. Noble, M., Treadwell, J. R., Tregear, S. J., Coates, V. H., Wiffen, P. J., Akafomo, C., et al. (2010). Long-term opioid management for chronic non-cancer pain (Review). Cochrane Database of Systematic Reviews, 2010, Issue 1. Art. No. CD006605. World Health Organization. WHO pain relief ladder. Viewed 16/10/2014 at: http://www.who.int/cancer/palliative/painladder/en/. Roxburgh, A., Bruno, R., Larance, B., & Burns, L. (2011). Prescription of opioid analgesics and related harms in Australia. Medical Journal of Australia, 5, 280-284. Roxburgh, A., Burns, L., Drummer, O., Pilgrim, J., Farrell, M., & Degenhardt, L. (2013). Trends in fentanyl prescriptions and fentanyl-related mortality in Australia. Drug and Alcohol Review, 32(3), 269-275. National Opioid Use Guideline Group (2010). Canadian guidelines for safe and effective use of opioids for chronic non-cancer pain. Ontario (CAN): NOUGG; 2010. Baldini, A., Von Korff, M., & Lin, E. (2012). A review of potential adverse effects of long-term opioid therapy: a practitioner's guide. The Primary Care Companion to CNS Disorders, 14(3).
Grey Matters: Preventing and responding to alcohol and other drug problems among older Australians Reference List Nicholas, R., & Roche, A.M. (2014). Grey Matters Information Sheet Series: Reference list and citation details. Adelaide, South Australia: National Centre for Education and Training in Addiction (NCETA), Flinders University.
	Nicholas, R., Roche, A., Lee, N., Bright, S., & Walsh, K. (2015). Preventing and reducing alcohol- and other drug-related harm among older people: A practical guide for health and welfare professionals. Adelaide, South Australia: National Centre for Education and Training on Addiction (NCETA), Flinders University.

Other Research & Resources

Research

Australian Institute of Health and welfare. (2020). Alcohol, Tobacco & other Drugs in Australia: Older people. Available here.

Chapman, J., Harrison, N., Kostadinov, V., Skinner, N., Roche, A. (2020). Older Australians' perceptions of alcohol‐related harms and low‐risk alcohol guidelines. Drug and Alcohol Review 39, 44–54.

Gossop, M. (2008). Substance use among older adults: A neglected problem. Lisbon, Portugal: European Monitoring Centre for Drugs and Drug Addiction.

Hunter, B. (2011). Older people and alcohol and other drugs. Melbourne: Australian Drug Foundation.

Hunter, B., & Lubman, D. (2010). Substance misuse: Management in the older population. Australian Family Physician, 39(10), 738-741.

Kelsall, J., Parkes, P., Watson, M., Madden, A., & Byrne, J. (2011). Double Jeopardy: Older injecting opioid users in Australia. Canberra: Australian Injecting and Illicit Drug Users League.

NSW Ministry of Health. (2015). Older People's Drug and Alcohol Project - Full Report. North Sydney: NSW Ministry of Health.

Rao, R., Crome, I., Crome, P., Iliffe,S. (2019) Substance misuse in later life: challenges for primary care: A review of policy and evidence. Primary Health Care Research Development. 20: e117.

Rao, R., & Roche, A. (2017). Substance misuse in older people. British Medical Journal. 358. j3885.

Roche, A., Harrison, N., Chapman, J., Kostadinov, V. Woodman, R. (20200). Ageing and Alcohol: Drinking Typologies among Older Adults. Journal of Aging and Health, 32 (10) 1486–1497.

Roche, A., & Kostadinov, V. (2016). Bongs and baby boomers: Trends in cannabis use among older Australians. Australasian Journal on Ageing. doi.org/10.1111/ajag.12357

Roche, A., & Kostadinov, V. (2019). Baby boomers and booze: we should be worried about how older Australians are drinking. The Medical Journal of Australia. 211(8), p.382.

Royal College of Psychiatrists. (2011). Our Invisible Addicts. London: Royal College of Psychiatrists.

Wilkinson, C., & Dare, J. (2014). Shades of grey: The need for a multi-disciplinary approach to research investigating alcohol and ageing. Journal of Public Health Research, 3, 180.

Wilkinson, C., Dare, J., Waters, S., Allsop, S., & McHale, S. (2012). An exploration of how social context and type of living arrangement are linked to alcohol consumption amongst older Australians. Canberra: Foundation for Alcohol Research and Education.

Wilkinson, C. (2018). Older Australians: Trends and Impacts of Alcohol and other Drug Use. Perth. National Drug Research Institute, Curtin University.

Resources

Alcohol and Drug Foundation. (ND). Alcohol, Other Drugs and Older People Toolkit. Available here.

Duggan, M. (2014). Wiser and older: Safer drinking throughout life. Tasmania: Drug Education Network.

Council on The Ageing. (ND). Alcohol and Older Australians. Available here.

European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). (2010). Treatment and care for older drug users. Luxembourg: Publications Office of the European Union.

Haber, P., Lintzeris, N., Proude, E., & Lopatko, O. (2009). Guidelines for the Treatment of Alcohol Problems. Canberra: Australian Government Department of Health and Ageing.

Matua Raki. The art of engagement. Older people and AOD. Wellington: Matua Raki: The National Addiction Workforce Development Centre.

Matua Raki. Assessment and screening issues for older adults. Using the method from the Alcohol Related Problems Survey (ARPS). Wellington: Matua Raki: The National Addiction Workforce Development Centre.

Matua Raki. Working with Older People. Cognitive Impairment and Compulsory Treatment. Wellington: Matua Raki: The National Addiction Workforce Development Centre.

Matua Raki. Alcohol/drug interactions. Wellington: Matua Raki: The National Addiction Workforce Development Centre.

Wadd, S., Lapworth, K., Sullivan, M., Forrester, D., & Galvani, S. (2011). Working with older drinkers. Bedford: Tilda Goldberg Centre, University of Bedfordshire.

Newspaper Articles

Goodyear, P. (2016, April 25). Getting Older? Why less is more. Sydney Morning Herald. Retrieved from http://www.smh.com.au/lifestyle/diet-and-fitness/getting-older-why-less-is-more-when-it-comes-to-alcohol-20160425-goe2hf.html.