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Choosing to Change: A Client-Centred Approach to Alcohol and Medication Use by Older Adults

Section 2: The Client - Identifying the Problem

Some people experience negative consequences from drinking because they are simply unaware of low-risk drinking levels. Others have not adjusted their drinking to account for the body’s decreased ability to handle alcohol as they age. Older adults are more vulnerable than other adults to the effects of even small amounts of alcohol, the combination of alcohol and medication, or multiple medications. Women of all ages are more vulnerable than men to the effects of alcohol and medication. (For more information on women and substance use, see The Hidden Majority: A Guidebook on Alcohol and Other Drug Issues for Counsellors Who Work with Women.)

The guidelines below should be shared with clients since they provide some goals to work toward in reducing harmful drinking levels. However, it is important to note that these guidelines may be too high for many older adults and people who have had problems with alcohol.

Guidelines for low-risk drinking for healthy adults endorsed by the Addiction Research Foundation and the Ontario Public Health Association in 1997 include the following:

• Drink no more than two standard drinks on any day.
• Limit weekly intake to 14 or fewer standard drinks for men and nine or fewer standard drinks for women.
• Drink slowly to avoid intoxication, waiting at least one hour between drinks and taking alcohol with food and non-alcoholic beverages.
• If you abstain, don't start drinking alcohol for its protective effect against heart disease; less risky alternatives include exercise, better nutrition and quitting smoking.
• If you choose to drink, the protective effects of alcohol can be achieved with as little as one drink every other day.
• If you are seeking help for a drinking problem, follow the advice of your counsellor or health professional.

A standard drink is defined as 341 mL (12 oz.) of beer (5 per cent alcohol); 142 mL (5 oz.) of table wine (12 per cent alcohol);

43 mL (1.5 oz.) of liquor (40 per cent alcohol); or 85 mL (3 oz.) of fortified wine, such as sherry or port (18 per cent alcohol).