Drinking, medications, illicit drugs and older Australians

As we age, our bodies can become more sensitive to alcohol and other drugs (AOD). This can increase our chances of injury and disease.¹

This article looks at the patterns of alcohol, pharmaceutical and illicit drug use among older Australians (people over 50 years old). 

It also covers the effects of AOD use on older people and suggestions on how you can reduce your risk of harm.

Alcohol and older Australians

Over the past 20 years, older Australians have consistently used alcohol more than any other substance.²

Older adults tend to drink more often than any other age group and the frequency of daily drinking increases with age.³ Australians in their 70s are the most likely to drink every day, followed by those in their 60s and 50s.¹

What are the risks of drinking alcohol for older adults?

There is no safe level of drinking.

The Australian alcohol guidelines recommend no more than 10 standard drinks per week and 4 standard drinks on any one day. 

Drinking more than these amounts increases your risk of alcohol-related injuries and diseases. This is also known as ‘risky’ drinking.

In 2022/23, one in three older Australians reported drinking above the guidelines.^2,4

Older adults (like most Australians) don’t always recognise their drinking is risky.

Risky drinking can lead to alcohol-related diseases in older adults and, in some cases death. In fact, alcohol causes 60% of AOD-related deaths in older Australians.²

Why is drinking more harmful for older people?

Drinking can be more harmful for older Australians because:

• the body is more sensitive to alcohol (for example the liver, which processes alcohol, becomes weaker with age), increasing the chances of overdose, falls and injuries
• alcohol can cause, or worsen, existing health conditions like heart disease, cancer and dementia
• alcohol might not mix well with some medications, making the medication harmful to the body or increasing the medication’s side effects.^4-6

How can older adults reduce alcohol-related harms?

You can reduce your risk of harms from alcohol by:

• sticking to the Australian alcohol guidelines
• choosing alcohol-free or low alcohol options
• checking with your pharmacist/doctor if your medication might mix badly with alcohol
• talking to your doctor if you are worried about your drinking and want help to cut down or stop.

You can read more in our article about the benefits of cutting down alcohol.

Pharmaceutical drug use and older Australians

About four out of five Australians over 65 have a long-term health issue.⁷

Many of these are treated with multiple medicines. In fact, 40% of Australians over the age of 70 take five or more medications each day.⁸

Older Australians are more likely than any other age group to be prescribed opioids and benzodiazepines (sedatives) by a doctor. This increases with age, with those who are 80 and above having the most prescriptions.¹

Many of these medications are necessary to prevent, treat or cure certain health conditions. But there are real dangers if you are using these drugs in ways that haven’t been prescribed.

What is non-prescribed use of medicines?

Non-prescribed use of medicine is when someone takes medication (available from a pharmacy over the counter or by prescription) in a way that wasn’t meant to be used. 

This includes:

• taking the medicine more often or in larger amounts than you should
• taking other people’s medications
• sharing your medication with others
• combining your medication with other drugs against medical advice
• using medication against medical advice.⁹

Non-prescribed use of medications can happen accidentally when:

• you don't follow the instructions provided by your doctor or pharmacist
• you don’t keep track of your medication intake and take extra doses without knowing.

Sometimes people use medications on purpose for non-medical/recreational reasons to:

• feel happy or relaxed
• relieve pain or illness
• improve performance
• increase the effects of alcohol and other drugs
• help with symptoms of withdrawal from alcohol and other drugs.⁹

When pharmaceutical drugs are used for non-medical/recreational use, this is also known as illicit drug use.

Illicit drug use and older Australians

More older Australians are using illicit drugs.¹ But this doesn’t mean that there are more older adults using illicit drugs for the first time. It’s more likely that people who have used illicit drugs in the past are continuing to do so as they age.¹

What is illicit drug use?

Illicit drug use includes:

• non-medical use of pharmaceutical drugs such as opioid-based pain relief medications, benzodiazepines etc. 
• illegal drugs such as cocaine, heroin and amphetamine-type stimulants
• other psychoactive substances, including inhalants such as petrol, paint or glue¹⁰

In 2022/23, one in ten older Australians said they used illegal or non-prescribed drugs.²

The most commonly used illicit drug by older Australians is cannabis.¹

What are the harms of illicit drug use for older adults?

Illicit drugs have similar harms to alcohol. 

Drug use can lead to dependence (addiction), overdose, and death, especially among older Australians.⁶

In 2021, overdose caused 63% of drug-related hospitalisations and 95% of drug-related deaths in older adults.²

Two thirds of drug overdose deaths involved more than one drug type. The top two most common drug types involved in overdose deaths were opioids, followed by benzodiazepines.²

Understanding how to take these types of drugs safely is important to reducing your risk of harm. 

How can older adults reduce drug-related harms?

Illicit drug harms can be reduced by:

• not mixing illicit drugs with other substances such as alcohol and prescription medications
• starting low and going slow – testing with small amounts and taking doses with longer intervals, especially if you haven’t used before or for a while
• understanding how long a drug stays in your system to reduce overdose risk
• ensuring your equipment is sterile if you inject drugs. You can get sterile injecting equipment through needle and syringe programs. Search for the ‘Needle and Syringe Program’ closest to you on the Australian Government’s Health Direct website.
• talking to your doctor if you are worried about your drug use.

Help and further information

• National Alcohol and Other Drug Hotline 
  1800 250 015 Free and confidential, 24/7 information, support and referrals. You’ll be automatically directed to the Alcohol and Drug Information Service (ADIS) in the state/territory you’re calling from.
• Path2Help
  An online portal you can use to look for AOD information and services tailored to your specific needs/circumstances. 
• ADF Drug Facts
  Information about different drugs, including alcohol, prescription medications, cannabis and more.