Supporting older adults around alcohol and other drugs

When it comes to drinking alcohol, older Australians aged 50 and over are more likely to drink frequently – often daily – compared with younger people.

As we age, it’s also more common to be prescribed medications like opioids and benzodiazepines.^1,2

These types of substances are linked with some of the most significant harms among older adults, including hospitalisations and overdose deaths. This risk is especially high when someone takes larger doses than prescribed or combines their medication with other drugs.^3-6

Here, we explore how health professionals can better support older adults to safely manage their alcohol and other drug (AOD) use.

To read more about older Australians use of AOD and their experience of related harms visit:

• Drinking, medications, illicit drugs and older Australians
• Why older adults have a high risk of alcohol and drug harm and how to support them.

Why is alcohol and other drug use often overlooked in older adults?

Even though alcohol and other drug use can pose serious risks, it’s not talked about much in health care. And when it does come up, the focus is usually on prescribed medications.⁷

Many older people feel uncomfortable talking about their AOD use - some worry about being judged, and others may not be aware of the risks.⁷

Health professionals might also be unsure about how to start these conversations in a respectful way.⁷

But, this is a missed opportunity since many older Australians see their doctor or pharmacist regularly and also trust them most when it comes to AOD information and advice.⁷

If you work in aged care, health, or community support, you can play a vital role in improving someone’s understanding of AOD harms.

How can we better deliver alcohol and other drug information to older adults?

Delivering AOD information in a way that feels safe, respectful, and relevant is key to supporting older adults.

You can start by building your own AOD knowledge and confidence.

By accessing reliable information and AOD training you will be better equipped to spot risks early and be more prepared for sensitive conversations.

1. Start the conversation - you can create a safe space where older people feel comfortable by asking questions like:
   - “How are you feeling about your medications lately?”
   - “Do you ever use anything to help with sleep or stress?”
   These questions invite reflection and honesty, helping people feel heard.
2. Schedule regular check-ins - they provide opportunities to:
   - review medications
   - identify risky use
   - provide timely advice or referrals.⁷

Pharmacists are especially well-placed to lead these discussions, as they often see older adults regularly and can talk through medication use and potential risks.⁷

Peer support can also play a powerful role. Some older adults may prefer learning from others with lived experience.

Consider connecting an older adult with a community space or group like Men’s Sheds, women’s circles, or other cultural and social groups where older adults already feel safe and supported.

What alcohol and other drug information do older adults need?

Boosting health literacy helps older adults make informed choices about their AOD use.

We know many older adults would like longer, more in depth AOD conversations with health professionals and to feel more involved in their medication decisions.⁷

Improving their health literacy can help them feel more confident to:

• ask better questions
• understand medication risks
• take part in shared decision-making.⁷

Older adults often want AOD information that is:

• easy to understand (large fonts, subtitles, translations)
• available in multiple formats (written, visual, audio)
• clear about the evidence behind the advice.⁷

Being able to provide various content types, either in simple or more detailed formats, can help meet people’s different information needs and learning styles.

Alcohol

Alcohol often plays a social role in the lives of older adults, and many consider themselves to be drinking safe amounts.

Rather than telling someone to stop drinking, conversations can be more effective when they:

• gently challenge perceived health benefits of alcohol, using clear, evidence-based information
• emphasise protecting current health and wellbeing, such as improving sleep, enhancing mental clarity, and reducing the risk of falls or dementia
• offer alternative ways to stay socially connected, like volunteering, joining exercise groups, or participating in creative workshops – activities that don’t revolve around alcohol but still foster connection and enjoyment.⁷

Medications

Providing easy-to-understand information about medications can help older Australians make safer choices and reduce their risk of harm.

There are risks associated with opioids and benzodiazepines, such as dependence, falls and overdose. Sharing this information can allow older adults to make safer decisions and feel more confident speaking up about their care.⁷

We also know that when it comes to deprescribing (planned reducing or stopping medication), some older adults are more motivated when they understand the risk of side effects from long term use of these medications.⁷

Overdose awareness and prevention

Increasingly, older Australians are being impacted by overdose.

Those aged 50 and over are experiencing the greatest rise in unintentional drug-induced deaths since 2001.⁸ Most of these overdose deaths occur at home and involve more than one drug.⁶

To reduce the risk of overdose, older adults need better access to practical, simple information about overdose prevention and response, including:

• how to spot the signs of an overdose and what to do in an emergency
• how mixing multiple medications, alcohol or other drugs can increase overdose risk.

Naloxone is a lifesaving medication that can temporarily reverse an opioid overdose. When opioids are prescribed to older adults, they should be routinely offered take-home naloxone.⁷

How can we increase the wellbeing of older adults?

While more research is needed to identify the most effective approaches for reducing alcohol, medication, and other drug-related harms among older adults, some key considerations include:

• Adopting a holistic approach to care – AOD interventions should be tailored to the individual, addressing broader health and wellbeing needs. This may include integrating mental health support, disability services, and social care alongside an AOD intervention.
• Strengthening social connection – regular contact and open conversations with peers, family, or community groups can support healthier choices and improve overall wellbeing.
• Consider Cognitive Behavioural Therapy for insomnia (CBTi) for those reducing benzodiazepine use – a non-medication approach that can help improve sleep and reduce reliance on these medications over time.⁷

More information

To read more about older adults, alcohol and other drugs visit:

• Trends in substance Use and Related Harms Among Australians Aged 50 years and older 2001-2021 – this report analyses the trends of drug-related hospitalisations, drug-induced deaths, treatment episodes and substance use among Australians aged 50 years and over.
• Strategies to reduce AOD-related harms among older adults – this report provides an overview of evaluated interventions aimed at reducing AOD harms among older adults.

Help and support

• 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.

• Health and Support Service Directory
  An online directory you can use to look for AOD information and services tailored to your client’s specific needs/circumstances.
• GP Psychiatry Support Line (1800 161 718)

A free service that supports GPs in managing the mental health needs of their patients. Mon-Fri, 7am-7pm.