Intended for healthcare professionals


Alcohol and drug problems in older people

BMJ 2011; 343 doi: (Published 24 October 2011) Cite this as: BMJ 2011;343:d6761
  1. Chris Holmwood, director
  1. 1Clinical Workforce Development and Standards, Drug and Alcohol Services South Australia, Parkside, SA 5063, Australia
  1. cholmwood{at}

Are increasing and underdiagnosed, resulting in high levels of unmet need

The recent report from the Royal College of Psychiatrists, Our Invisible Addicts, highlights a range of problems around the use of alcohol and other drugs by older people in the United Kingdom.1 The UK is one of a small group of European Union members whose per capita consumption of alcohol is rising.2 In addition, the number of people in the UK over 65 years of age will continue to increase over the next 40 years. The report notes that the proportion of older people drinking alcohol in excess of recommended levels is increasing. Inappropriate prescribing of benzodiazepines and other psychotropic drugs is estimated to occur in a quarter of people aged over 65.3 Accordingly, it is likely that alcohol and drug related problems will become more prevalent in older people over this period as well as in other age groups.

The age of people accessing addiction related services has been increasing since 2005-6. There is also an ageing cohort effect in heroin and cocaine users, with a decrease in the number of younger people presenting for treatment, but an increase in the number of people over 40 years of age presenting. Although rates of alcohol and illicit drug use in older people are less than in other age groups, the report highlights that, for older people, recognition rates by treating clinicians are low, and unmet need is high.

These changes in the demographics of substance use …

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