Drinking trends in older adults
Drinking patterns among older adults (45 years or above) in New Zealand
Alcohol use among older age remains common, although it decreases with advancing age. In 2018/19, the prevalence of drinking in the past year among older men and women remained high:
Hazardous drinking patterns remain prevalent throughout older New Zealanders
New Zealanders aged 45 years and above comprised almost 40% (309,000) of all hazardous drinkers in 2018/19. Whilst 18 to 24 year olds maintain the highest (35.4%) prevalence of hazardous drinking in the country, hazardous drinking patterns remain prevalent throughout older age groups in New Zealand, particularly among men. In 2018/19, the prevalence of hazardous drinking among men was:
- 28.9% among those aged 45 -54 years;
- 26.1% among those aged 55-64 years;
- 20.2% among those aged 65-74 years, and
- 7.4% for those aged 75 years and above.
Trends over time
Of particular concern, there have been significant increases in hazardous drinking over time among older age groups in New Zealand. Following declines in hazardous drinking between 2006/07 and 2011/12, the prevalence of hazardous drinking increased from 2011/12 to 2015/16. These increases were substantial:
- increased by more than 50% among those aged 45-54 years (11.7% to 18.5%);
- increased by more than 70% among those aged 55-64 years (8.4% to 14.4%); and
- almost doubled for those aged 65-74 years (from 5.5% to 10%).
Therefore, all of the positive reductions in drinking that had been achieved between 2006/07 and 2011/12 were lost by 2015/16. The level of increase was so great that some age groups (35-44yrs, 45-54yrs, 65-74yrs) had significantly higher levels of hazardous drinking in 2015/2016 than in 2006/07. There have been no significant changes in the prevalence of hazardous drinking in the past four years of comparable surveys (i.e. 2015/16, 2016/17, 2017/18, and 2018/19).
Other survey measures
The annual New Zealand Health Surveys utilise the Alcohol Use Disorders Identification Test (AUDIT) to assess the prevalence of hazardous drinking in New Zealand. However, this test is not age-specific. Other measures have been developed to quantify alcohol use in older people. This includes the CARET (Comorbidity Alcohol Risk Evaluation) that takes into account other factors that relate to alcohol use and harm among older adults, not just an older person’s drinking frequency and quantity.
New Zealand drinkers have some of the highest levels of drinking
New Zealand drinkers were found to have some of the highest levels of drinking across the countries studied. The proportion of frequent heavy drinkers was higher in New Zealand compared with most countries, including England and the United States.
High levels of alcohol use in older adults will have significant implications
Should these trends continue, older people will represent a much greater proportion of hazardous drinkers in New Zealand. This is due to the population of older adults being predicted to double by the year 2036 (based on the projection from 2013). At this point, approximately 24% of the population will be aged 65 years and over. High levels of alcohol use in older populations will have significant implications on our strained healthcare system and will compromise well-being in older adults.
The differential effects of alcohol use on older adults
There is considered no safe level of alcohol use among older adults.
Older adults are more susceptible to the harmful effects of alcohol at any level of consumption. The same amount of alcohol produces a higher blood alcohol concentration in older than younger adults due to changes in body composition, leading to a longer time for the acute effects of alcohol to diminish. The ability to absorb, metabolise, and excrete alcohol remains largely unchanged with increasing age.
Thinking skills and memory, co-ordination and mobility may also be more affected by alcohol among older adults. Alcohol also affects emotions and mood.
Conditions such as chronic health problems, medication interaction, and other risky behaviors including drinking driving, further contribute to more harmful effects of alcohol on older adults.
Although there has been debate over the potential “health benefits” from low-risk drinking (particularly for older drinkers), recent research suggests that the findings of benefit were more likely the result of methodological differences in studies and under-adjustment for confounding factors (e.g. personal characteristics, socioeconomic status) that relate to different drinking patterns within the population. It is advised that there is no overall positive health benefit for older adults from drinking.
New Zealand research supports the findings that there are differences in the characteristics of older drinkers who have moderate versus high-risk intakes. It is important to take account these differences when examining health outcomes from drinking. The former were more likely to be wealthier, whilst the latter were more likely to have lower levels of economic standards than other drinking profiles.
For more information, check this button RESEARCH ON OLDER NEW ZEALANDERS' ALCOHOL USE
| FACTSHEET: DRINKING IN THE PAST YEAR | FACTSHEET: HAZARDOUS DRINKING |
Get Prepared
Alcohol causes more harm to the fetus than other drugs
It does not matter what type of alcohol is consumed, it immediately crosses into the baby’s bloodstream via the placenta and adversely impacts normal development.
Alcohol is recognised as the ‘heavy hitter’ causing more damage to the fetus than other recreational substances such as tobacco, methamphetamine, heroin, cocaine or marijuana.
There is no 'safe' level of alcohol use in pregnancy
Drinking to intoxication places a developing embryo and fetus at the greatest risk of harm. However, medical research has not been able to establish a safe amount that all pregnant women can drink and there are studies showing harm at very low level. Therefore, ther advice of many health authorities across the world is - Do not drink alcohol if you are pregnant, could be pregnant or when breastfeeding.
For more information, check out HPA's alcohol.org.nz website -
- Drinking advice for women who could be pregnant, are pregnant or are trying to get pregnant - https://www.alcohol.org.nz/alcohol-its-effects/alcohol-and-pregnancy/what-you-need-to-know
- Alcohol & pregnancy - https://www.alcohol.org.nz/alcohol-its-effects/alcohol-pregnancy
New Zealand has an FASD Action Plan
In 2016, the Government took steps to develop New Zealand’s first FASD Action Plan ‘Taking Action on Fetal Alcohol Spectrum Disorder 2016-2019 – An Action Plan’. (FASD Working Group 2016).
The Plan is a multiagency approach across health, justice, and social sectors to guide policy and service delivery within communities to prevent FASD and improve outcomes for those affected by it.
The plan targets early intervention with those thought to be at high-risk of drinking during pregnancy.
Changes to the drinking environment to reduce alcohol availability were not included in the plan. It is well-known that the wider drinking culture is a strong determinant of the prevalence of drinking during pregnancy. Therefore, we need to take a multi-pronged approach to reduce the harm from FASD.
Although improvements have been occurring regarding FASD diagnosis, children with significant learning and behaviour problems linked to prenatal alcohol exposure remain undiagnosed within our health services and ineligible for extra support. Families living with FASD remain ineligible for respite care.
Ministry of Education FASD Guide for teachers
The Ministry of Education have produced an Inclusive Education FASD Guide for teachers http://inclusive.tki.org.nz/guides/fasd/.
Case for Change
There are two important components in preventing the harm from Fetal Alcohol Spectrum Disorder:
- Preventing FASD by supporting alcohol-free pregnancies
- Enabling effective and appropriate care for persons affected by FASD
There is strong evidence that both components are essential in reducing harm from this preventable disability. Click below to learn more or click the button for the Health Promotion Agency infosheet.
ALCOHOL-FREE PREGNANCY KEY MESSAGES
Take Action
On the spot - take action immediately
Stopping someone from getting behind the wheel after they’ve been drinking could save their life and the lives of innocent others.
If it is an emergency - call 111 and provide the details to emergency services.
If it is safe to do so, take their keys off them and offer to find them a safe ride home.
If the risk of drink driving is associated with a licensed premise - advise the licensee or duty manager of the risk and remind them of their duties to support safe transport options.
If the person has been drinking on a licensed premise and appears intoxicated then report the incident to the local licensing team and/or Police. See the Licensing section for more information.
Be a positive role model
Always drive sober and encourage members of your family/whanau to do likewise.
If you are hosting a family/whanau gathering or event, be a responsible host – e.g. make it alcohol-free, or have a range of alcohol-free options available, arrange a place for people to stay or a safe ride home if they’ve been drinking. See Places and Events for more information on planning events.
Spread the word
Take opportunities as they arise to discuss drink-driving, its risks and consequences with your family/whanau.
Develop some safety protocols/kawa with your family/whanau. These can focus on how to avoid the risks of drinking and driving, and having a plan to get home safely should that be necessary.
Start a group or if you are already part of a group or network you can plan initiatives to reduce drinking and driving in your community.
For more information on doing this see Mobilising Others
Assist people to get the help they need
If you have any concerns about someone you know who is drinking and driving assist them or their family to get professional help.
Help can be reached at your GP/local medical centre, school counsellor or local Community Alcohol and Drug Service.
The Alcohol and Drug Helpline is a useful starting point for anyone who has concerns about their own or others drinking. They will be able to support you towards the best course of action and local services including youth services - 0800 787 797.
Change the wider environment to change our drinking culture
Take action on environmental factors which support low-risk drinking. For example, foster and mobilise others to:
- Reduce the availability of alcohol
- Increase the price of alcohol
- Restrict alcohol adverting and sponsorship
- Promote the uptake of early and brief intervention
Case for Change
Drink driving doesn't just harm the driver - passengers and other road users are often involved in alcohol-related road deaths and injuries.
For every 100 alcohol or drug-impaired drivers or riders who die in road crashes, 47 of their passengers and 16 sober road users die with them.
The risk of crashing increases with the amount of alcohol in the blood at the time of driving. Road traffic crashes involving alcohol are more likely to result in death or severe injuries.
The number of convicted drink-drive offences has declined in recent years. Despite the downward trend, the number of repeat or multiple offenders remains high.
Take Action
On the spot - Address any immediate health and safety issues
If you are concerned about your safety, or that of others, call emergency services on 111.
When any urgent matters are under control and if you feel it is safe to do so, look to minimise any further consumption and risks. Get assistance with this if possible.
If you see an intoxicated person in a licensed premises (e.g pub, night club) alert the duty manager, and/or the Police on 111. If you know that an intoxicated person has been drinking at a particular licensed premises, then follow the above.
Spread the word - Promote informed choice
As opportunities arise guide people in your life to relevant information on alcohol and to the low-risk drinking guidelines.
Develop some safety protocols/kawa with your family/whanau. These can focus on how to avoid drinking excessively, and what to do if they are in trouble.
If you have a group or network that you belong to, work together to raise awareness in your community about alcohol and share relevant information and links to low-risk drinking guidelines or other tools.
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See the section on Mobilising Others for more information and support |
Assist people to get the help they need
If you have any concerns about the alcohol use of people in your life, assist them or their family to get professional help.
- Help can be reached at your GP/local medical centre, school counsellor or local Alcohol and Drug Service.
- The Alcohol and Drug Helpline is a useful starting point for anyone who has concerns about their own or others drinking. They will be able to support you towards the best course of action and local services including youth services - 0800 787 797.
Change the wider environment to change our drinking culture
Take action on environmental factors which support low-risk drinking. For example, foster and mobilise others to:
- Reduce the availability of alcohol
- Increase the price of alcohol
- Restrict alcohol advertising and sponsorship
- Promote the uptake of early and brief intervention
Get Prepared
Alcohol is a toxin the body wants to get rid of
When alcohol is consumed, the human body is alerted and will start to eliminate it. The liver does much of this process.
It takes around one hour for a healthy liver to process a single standard drink. This is only an average, a person's other health issues may impact this.
Drinking more than one standard drink in an hour will mean that the liver cannot keep up, and the alcohol will build up and start to be absorbed into the blood stream.
This leads to a range of impairments;
- Initially, the drinker will experience light-headedness and feelings of euphoria – generally these are pleasant. They are the early signs of impairment.
- Balance and movement will be affected – increasing the risk of falls and other injuries.
- Slowed reaction times – slowing essential skills needed for driving, cooking, looking after children etc.
- Impaired judgement – increasing the risk of aggression, and making poor choices such as driving, or getting into a car with someone intoxicated, or continuing to drink, or having sex you later regret.
- Changed mood and emotional state – this can lead to missing or misinterpreting social cues increasing the risk of aggression and violence, depression.
- “Hangover” – the after effects of heavy drinking can carry over into the next day. This might affect the ability to attend work, school or university, look after children or other responsibilities.
Continued consumption can lead to black-outs and alcohol poisoning.
As well as injuries and violence, heavy consumption of alcohol can have significant and long-term effects on the body including brain damage, liver damage and failure.
The law on intoxication
New Zealand does not have any laws against being intoxicated or drunk. Rather, the Police can apprehend persons if they are creating disorder.
There are a number of offences related to intoxication. Most of these relate to licensed premises. You can read them here.
For example, a licensed premises MUST NOT:
- Sell or supply alcohol to an intoxicated person
- Allow a person to become intoxicated on their premises
- Allow a person who is intoxicated to remain in the licensed premises
In addition, it is illegal for anyone under 18 to be drinking in a public place (without their parent/guardian).
Factors which facilitate heavy drinking in New Zealand
There are a number of factors in our environment which facilitate heavy drinking:
- licensed premises open late at night and early morning,
- a high number of licensed premises in an area
- high exposure to alcohol marketing and promotion,
- cheap alcohol products
- certain types of products such as Ready-to-drinks (RTDs)
- availablity of higher strength beverages.
Screening for hazardous drinking
The earlier we intervene on hazardous drinking, the less harm will result.
Ideally, everyone who is seen by a health practitioner should be screened for alcohol use, and if found to drink hazardously, provided with brief intervention and referral to treatment.
Case for Change
Intoxication increases the risk of a range of alcohol-related harms
Intoxication often leads to acute effects including violence, unintentional injuries and self-harm [5], but also longer terms harms such as long-term health conditions and social problems [5].
Skills and inhibitions decrease with more amount of alcohol is consumed on a single occasion. This often leads to a greater risk of injury during, or immediately, after the drinking occasion [6].
In 2016/17, among those who drank in the past year in New Zealand [7]:
- 15% consumed 6 or more drinks on one occasion at least weekly
- 27% consumed 6 or more drinks on one occasion at least monthly
- 25% were classified as hazardous drinkers.
Drinking four standard drinks on a single occasion more than doubles the relative risk of an injury in the six hours afterwards, and the relative risk rises even more rapidly when more than four standard drinks are consumed on a single occasion [6].
