Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar 30;23(1):143-148.
doi: 10.5770/cgj.23.425. eCollection 2020 Mar.

Canadian Guidelines on Alcohol Use Disorder Among Older Adults

Peter R Butt  1   2 , Marilyn White-Campbell  3 , Sarah Canham  4 , Ann Dowsett Johnston  1   2   3   4   5   6   7   8   9 , Eunice O Indome  5 , Bonnie Purcell  6   7 , Jennifer Tung  8 , Lisa Van Bussel  7   9
Affiliations

Canadian Guidelines on Alcohol Use Disorder Among Older Adults

Peter R Butt et al. Can Geriatr J. .

Abstract

Background: Alcohol use disorder (AUD) is an increasingly common, under-recognized, and under-treated health concern in older adults. Its prevalence is expected to reach unprecedented levels as the Canadian population ages. In response, Health Canada commissioned the Canadian Coalition of Seniors' Mental Health to create guidelines for the prevention, screening, assessment, and treatment of AUD in older adults.

Methods: A systematic review of English language literature from 2008-2018 regarding AUD in adults was conducted. Previously published guidelines were evaluated using AGREE II, and key guidelines updated using ADAPTE method by drawing on current literature. Recommendations were created and assessed using the GRADE method.

Results: Twenty-two recommendations were created. Prevention recommendations: Best advice for older adults who choose to drink is to limit intake to well below the national Low-Risk Alcohol Drinking Guidelines. Screening recommendations: Alcohol consumption should be reviewed and discussed on an annual basis by primary care providers. This type of discussion needs to be normalized and approached in a simple, neutral, straight-forward manner. Assessment recommendations: Positive screens for AUD should be followed by a comprehensive assessment. Once more details are obtained an individualized treatment plan can be recommended, negotiated, and implemented. Treatment recommendations: AUD falls on a spectrum of mild, moderate, and severe. It can also be complicated by concurrent mental health, physical, or social issues, especially in older adults. Naltrexone and Acamprosate pharmacotherapies can be used for the treatment of AUD in older adults, as individually indicated. Psychosocial treatment and support should be offered as part of a comprehensive treatment plan.

Conclusion: These guidelines provide practical and timely clinical recommendations on the prevention, assessment, and treatment of AUD in older adults within the Canadian context.

Keywords: alcohol; alcohol dependence; alcohol use disorder; geriatric; guideline; older adult; substance abuse; substance use disorder; systematic review.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES The project was funded by Health Canada (Substance Use and Addictions Program). The funder had no role in the creation or approval of the recommendations. Authors received an honorarium for their work. A rigorous process was undertaken to ensure that members of the working group did not have any significant conflict of interest.

References

    1. Kuerbis A, Sacco P, Blazer DG, et al. Substance abuse among older adults. Clin Geriatr Med. 2014;30(3):629–54. doi: 10.1016/j.cger.2014.04.008. - DOI - PMC - PubMed
    1. Woodruff S, Clapp JD, Sisneros D, et al. Alcohol use risk levels among older patients screened in emergency departments in Southern California. J Appl Gerontol. 2009;28(5):539–59. doi: 10.1177/0733464809338040. - DOI
    1. Blow FC, Barry KL. Use and misuse of alcohol among older women. Alcohol Res Health. 2002;26(4):308–15. - PMC - PubMed
    1. Johnston JJ, McGovern SJ. Alcohol related falls: an interesting pattern of injuries. Emerg Med J. 2004;21(2):185–88. doi: 10.1136/emj.2003.006130. - DOI - PMC - PubMed
    1. Chen CM, Yoon YH. Usual alcohol consumption and risks for nonfatal fall injuries in the United States: results from the 2004–2013 National Health Interview Survey. Subst Use Misuse. 2017;52(9):1120–32. doi: 10.1080/10826084.2017.1293101. - DOI - PMC - PubMed

LinkOut - more resources