Why did we undertake this research?
The average age of Australia’s population is increasing and more Australians are living longer than ever before. Lifestyles of the current cohort of ‘younger older’ Australians (i.e., the ‘baby boomers’ born between 1946 and 1964) have changed dramatically and they use alcohol and other drugs at higher rates compared to previous generations. Consequently, alcohol- and other drug-(AOD) related harms among older Australians are increasing and more of them may require treatment for substance use problems in the future.
Despite the increasing harms, AOD use and misuse among older Australians are under-researched and cloaked in misconceptions. As such, NCETA initiated a program of research examining patterns of AOD consumption and harm among older Australians.
What did we do?
Secondary analyses were conducted comparing data collected in the National Drug Strategy Household Survey (NDSHS) since 2004. Only data from participants aged 50 years and older at the time of survey completion was included in the analyses. Frequency analyses explored the distribution of demographic characteristics and alcohol and cannabis use in each survey year. Logistic regression explored the predictors of cannabis use and risky drinking.
In addition, a literature review was undertaken to:
- Highlight the epidemiology of AOD-related problems among older adults and issues specific to this population
- Identify potential interventions and strategies appropriate for responding to AOD problems in older populations
- Provide advice to a range of service providers about older Australians’ needs
- Develop recommendations about how to address these issues.
What did we find out?
Older Australians are increasingly using alcohol at risky levels, experiencing problems with the alcohol consumption, and/or consuming cannabis. Older people who consume alcohol at risky levels and/or who use cannabis fall within three categories: maintainers (those whose previously unproblematic use has become harmful); reactors (late onset users); and, survivors (early onset users with a history of problematic use).
Since 2004, there has been an increase in the percentage of people aged 50 and over who used cannabis recently (i.e., at least once in the last year). However, there has also been a decrease in the amount of people aged 50 or above who commenced cannabis use. As such, it is possible that many older cannabis users are ‘maintainers’ or ‘survivors’ rather than ‘reactors’. This highlights the importance of using motivational strategies with this group since changing long established behavioural patterns is one of the barriers to successful treatment in older age groups.
Although most Australians aged 50 years and over drink alcohol at low risk levels, since 2004 there has been a small, but statistically significant, decrease in low risk drinking accompanied by an increase in risky drinking. In 2013, more than one in six older Australians reported drinking at risky levels at least once per month. Due to the anticipated expansion of this population group, the absolute number of older people who drink alcohol at risky levels is likely to increase into the future even if the proportion of older people drinking alcohol at risky levels does not change.
Where to next?
The ageing of Australia’s population has a number of key implications for policy makers, health and aged care providers, and AOD service provision. Although older people use alcohol and other drugs for similar reasons to the rest of the population, they have physiological, psychological and social characteristics that may make them more vulnerable to problematic use. Therefore, current alcohol consumption guidelines and screening tools are often not appropriate for older populations. Recommended “low risk” drinking levels may still place older individuals at risk of harm due to possible interactions with other medications, as well as the long-term presence of physical and mental health comorbidities increasing vulnerability.
There is a clear and urgent need for more research into prevention/intervention strategies specifically targeting older Australians. Such research should be undertaken with a view to upskilling and educating healthcare practitioners regarding the unique needs of their older clientele, and developing more age-appropriate guidelines and tools for use in practice.
Intervention strategies that prevent, treat, and manage problematic alcohol use among older people are imperative in order to improve quality of life and reduce healthcare costs. A range of prevention and treatment programs are required to reflect the diverse experiences, attitudes, and consumption patterns older Australians may have in relation to AOD matters. In addition, older Australians themselves (and their carers) require better education about the risks associated with alcohol consumption as well as treatment options. Improved collaboration between the aged care and alcohol and drug sectors would facilitate these goals.