Management of Alcohol Use Disorders in Older Adults: What Doctors Need to Know

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What Doctors Need to Know


Screening and Identification

Alcohol Consumption History

  • Ask all elderly patients at baseline, annual physical
  • Elicit a specific weekly consumption
  • Convert patient’s response into standard drinks: 12 oz. of beer, 5 oz. of wine, or 1.5 oz. of spirits.
  • Ask about patients’ maximum consumption on one day in the past one to three months
  • Physical examination and screen for infections and any concurrent medical disorders ( eg anemia, UTI, chest )


Low-risk drinking guidelines for the elderly

No more than:

  • 9 standard drinks per week for men
  • 7 per week for women
  • 2 drinks in one day (men and women)

Standard drink = 12-ounce (341ml) bottle of regular (5%) beer, five ounces (142 ml) of (12%) table wine or 1.5 ounces (43 ml) of 80-proof liquor.

Ask about size and alcohol content of beverage

Avoid alcohol or drink only under supervision if:

  • Frail elderly
  • At risk for falls (ataxia, cognitive or visual impairment)
  • On sedating medications (e.g. benzodiazepines, opioids)
  • Medical illnesses made worse by alcohol, e.g. gastritis or ulcer, pancreatitis, liver disease
  • Mood disorder
You should not rely on this pocket tool for financial or legal advice. It provides general information only. NICE is not responsible for any use of the information other than for general educational/informational purposes and no claim can be made against NICE or any of its personnel for any such use.
National Initiative for the Care of the Elderly (NICE)
246 Bloor Street West, Room 234
Toronto, Ontario M5S 1V4, Canada