Alcohol Use Disorder Among Older Adults
Patient Guideline Summary
Publication Date: January 1, 2020
This patient summary means to discuss key recommendations from the Canadian Coalition for Seniors Mental Health (CCSMH) for alcohol use disorder among older adults. It is limited to adults 18 years of age and older and should not be used as a reference for children.
- Alcohol Use Disorder describes excess intake of alcoholic drinks leading to adverse consequences.
- We will use the abbreviation AUD throughout this summary to refer to Alcohol Use Disorder
- The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) lists 11 criteria relevant to the diagnosis of AUD. The more criteria that are met, the more serious the condition.
- Symptoms include craving alcohol, lifestyle changes, withdrawal symptoms, and adverse events due to diminished mental acuity.
- This patient summary focuses on managing and reducing AUD in the elderly.
- Based on the number of DSM-5 criteria that are met.
- ONE “drink” is 1/2 ounce of pure alcohol, the amount in:
- 12 oz. of beer
- 5 oz. of wine
- 11/2 oz. liquor (rum, whiskey, vodka, gin)
- Women 65 and older should limit intake to one “drink” a day and 5 per week; for men, 2 “drinks” a day and 7 per week.
- Unhealthy or medicated seniors should drink less.
- Any task requiring mental acuity, such as driving or making important decisions, should be done free of alcohol.
- Alcohol-containing products should be adequately labeled.
- Heavy drinkers should take at least 50 mg of thiamine daily.
- Everyone should be screened for AUD annually and at every contact with medical facilities.
- Screening should include consent to share information with relatives, friends, and care givers.
- Patients with positive findings should be referred to trained professionals for comprehensive evaluation and treatment.
- Behavioral, psychosocial, and medical interventions should be offered in proportion to the severity of the AUD.
- Naltrexone, acamprosate, thiamine, and shorter-acting benzodiazepines are options for medical treatment.
- Tapering daily alcohol is an optional replacement for managed withdrawal.
- Hospitalization should be considered for severe AUD.
- Monitoring treatment with blood testing is recommended.
- Concurrent physical and mental health conditions and social transitions should be included in management decisions.
- Planning for surgery should address AUD.
- AUD: Alcohol Use Disorder
- CCSMH: Canadian Coalition For Seniors Mental Health
Butt PR, White-Campbell M, Canham S, Johnston AD, Indome EO, Purcell B, Tung J, Van Bussel L. Canadian Guidelines on Alcohol Use Disorder Among Older Adults. Can Geriatr J. 2020 Mar 30;23(1):143-148. doi: 10.5770/cgj.23.425. PMID: 32226573; PMCID: PMC7067152.
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.