Between 5% and 12% of men and 1-2% of women in their 60s are problem drinkers.1 The rates are substantially higher among hospital outpatients and people attending clinics.2 A study of 1070 elderly men and women selected from general practice lists showed that nearly one fifth of both sexes who were regular drinkers exceeded the recommended limits.3

Both the quantity of alcohol drunk and the frequency of drinking by elderly men - and so the frequency of problems related to alcohol - are higher than those in elderly women.4 On average elderly people drink less than younger people, but aging does not always modify drinking behaviour, and excessive alcohol use may simply be carried into old age. The trend for elderly people to reduce alcohol consumption seems to be less noticeable in women. Elderly people are less tolerant of the adverse effects of alcohol owing to a fall in the ratio of body water to fat, a decreased hepatic blood flow, inefficiency of liver enzymes, and reduced renal clearance.5

Misuse of other substances is uncommon among …