Table 3.
Summary of results; prevalence of alcohol consumption, alcohol interactive medication use and concurrent use among older adults
| Study | Prevalence of alcohol consumption in older adults (gender); Heavy/Problem drinking (gender) |
Prevalence of alcohol interactive medication use: | Concurrent use reported among: Total sample of older adults |
Concurrent use reported among: AI medication users |
Concurrent use reported among: Current drinkers |
|---|---|---|---|---|---|
| Studies reporting on a wide range of alcohol interactive (AI) medicines (n = 13 studies) | |||||
| Adams 1995 [18] | 47% drank alcohol in previous 6 months Heavy (>7 drinks/week): 8% |
80% used one or more of the following in the last 6 months: NSAIDS, aspirin, sedatives, narcotics, antidepressants, anti-hypertensives, antacids, H2 blockers, warfarin & meds for congestive heart failure, gout or diabetes | 38% reported concurrent use of alcohol and AI medications, 6% reported concurrent heavy alcohol consumption and AI medications | Overall drinkers: 80% used an AI medication (50% used anti-hypertensives, 27% used aspirin, 20% used NSAIDs, 18% used chronic heart failure drugs, 11% used sedatives; 5% used narcotics, 5% used warfarin, 4% used diabetic drugs, 3% used antidepressants, 3% used drugs for gout) Heavy drinkers: 80% used an AI medication (48% used anti-hypertensives, 28% used aspirin, 16% used NSAIDs, 16% used chronic heart failure drugs, 4% used sedatives, 4% used narcotics, 4% used warfarin, 8% used diabetic drugs, 12% used antidepressants, 4% used drugs for gout) |
|
| Aira 2005 [19] | 44% drank alcohol in previous 12 months (66% of men & 37% of women) Heavy (>7 units/week): 7% of men & 0% of women |
90% used one or more of the following regularly or as needed: acetaminophen, anticonvulsants, antidepressants, antihistamines, benzodiazepines, histamine H2 receptor agonist, neuroleptics, nitrates, NSAIDs, opiates or warfarin | 39% reported concurrent use of alcohol and AI medications, 1.9% reported concurrent heavy alcohol consumption and AI medications. Concurrent alcohol and specific AI medications: 7.5% acetaminophen, 0.19% anticonvulsants, 5.16% antidepressants, 0.76% antihistamines, 11% benzodiazepines, 1.15% histamine H2 receptor agonist, 2.29% neuroleptics, 23% nitrates, 29% NSAIDs, 3.8% opiates & 3.6% warfarin | Overall AI medication users: 44% drank alcohol (36% acetaminophen users, 17% anticonvulsants users, 40% antidepressants users, 21% antihistamines users, 38% benzodiazepine users, 43% histamine H2 receptor agonist users, 25% neuroleptic users, 43% nitrate users, 46% NSAID users, 38% opiate users & 40% warfarin users) | Overall drinkers: 88% used AI medications |
| Breslow 2015 [20] | 47% drank alcohol in previous 12 months (55% of men & 39.7% of women) | 78.6% used one or more of the following: cardiovascular agents, CNS agents, coagulation modifiers, GI agents, metabolic agents, psychotherapeutic agents, respiratory agents | 35% reported concurrent use of alcohol and AI medications. Concurrent alcohol and specific AI medications: 28% cardiovascular agents, 10% CNS agents (1.8% anticonvulsants, 2% anxiolytic/sedative/hypnotic, 2% narcotics, 2.2% NSAIDs), 3% coagulation modifiers, 2.2% GI agents, 16.9% metabolic agents, 3.9% psychotherapeutic agents (3.8% antidepressants), 2.1% respiratory agents | Overall AI medication users: 45% drank alcohol (44% cardiovascular agents users, 40% CNS agent users (34% anticonvulsants, 40% anxiolytic/sedative/hypnotic, 43% NSAID), 44% coagulation modifier users, 43% GI agent users, 43% metabolic agent users, 41% psychotherapeutic agent users (42% antidepressants), 48% respiratory agent users) | Overall drinkers: 77.8% took AI medications (61.3% used cardiovascular agents, 22% used CNS agent (3.9% used anticonvulsants, 4.6% used anxiolytic/sedative/hypnotic, 4.8% used NSAID), 6% used coagulation modifier, 4.7% used G I agent users, 36.5% used metabolic agent, 9.6% used psychotherapeutic agent (9.2% used antidepressants), 4.6% used respiratory agent) |
| Cousins 2013 [21] | 62.8% drank alcohol previous 6 months (72% of men & 59% of women) Heavy (>4 drinks/day or >10 drinks/week): 20% (32% of men & 11% of women) CAGE: 8% (12.2% of men & 4% of women) |
72% took one or more of the following: cardiovascular agents, CNS agents, antihistamines, Blood, antidiabetic agents, anti-infectives, GI agents, immunomodulators or muscle relaxants | Overall AI medication users concurrent use of alcohol: 60% drank alcohol (60% cardiovascular agent users, 53.5% CNS agent users (59% of NSAID users, 54% hypnotic users, 44% anxiolytic users, 52.9% antidepressant users), 66.9% antihistamine users, 58.5% blood medication users, 54% antidiabetic agent users, 47% anti-infective users, 50% GI agent users, 51% immunomodulator users &80.3% muscle relaxant users) AI medication users concurrent heavy alcohol consumption: 25% antihistamine users, 20% cardiovascular agent users, 20% blood (anti-coagulant or anti-platelet) users, 20% anti-diabetic agent users, 16% CNS agent users (13% users of anti-epileptic agents; 13% antipsychotic agents; 13% hypnotic users & 18% antidepressant users) |
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| Del Rio 1996 [23] | Approximately 20% drank alcohol at least once per day in the past 2 weeks | 75–80% took one or more medication in previous 2 weeks | 18% reported concurrent use of alcohol and AI medications | ||
| Forster 1993 [24] | 57.1% reported using alcohol 16.9% admitted to drinking enough to become “lightheaded” |
Not Reported | 25% reported concurrent use of alcohol and AI medications. Concurrent alcohol and specific AI medications: 19% OTC analgesics, 6.9% antihypertensives, 5.4% diuretics; 4.3% OTC cold preparations, 2.1% mind altering drugs, 1.5% diabetes pills, 1.5% prescription pain medication, 1.2% sleeping pills, 0.6% prescription blood thinners, 0.6% insulin & 0.3% seizure medications | ||
| Immonen 2013 [27] | 62.6% drank alcohol At risk drinking (>7 drinks/week, or ≥5 drinks on typical drinking day, or ≥3 drinks several times/week): 7.9% |
42% took one or more of the following: metronidazole, tinidazole, disulfiram, griseofulvin, prazosin, metformin & tacrolimus. CNS agents, hypoglycaemics and warfarin | Overall AI medication users: 62.2% drank alcohol | Heavy or at risk drinkers: 42.2%% took AI medications (2.2% used antipsychotics, 4.4% used anti-depressant, 6.7% used anxiolytics, 11.1% used hypnotics/sedatives, 5.6% used anti-epileptics, 3.3% used opioids, 11.1% used warfarin & 13.3% used metformin) | |
| Onder 2002 [29] | 54.2% drank ≤40 g of wine/day prior to hospital admission (68.1% of men & 42.8% of women) | 27% used diuretics, 23% digoxin, 17.7% calcium channel blockers, 16% ACE inhibitors, 15% aspirin & anti-platelets, 9% oral hypoglycaemic agents, 6% NSAIDs, 6% antibiotics, 5.2% nitrates, 5% insulin, 4% steroids & 3.2% antipsychotics | Overall wine drinkers: 26% used diuretics, 3.8% oral hypoglycaemic agents, 2.6% antipsychotics & 1.8% insulin | ||
| Pringle 2005 [30] | 20.3% drank alcohol Heavy (> 30 drinks/month): 1.2% |
77.4% used on or more AI medication | Overall AI medication users concurrent use of alcohol: 19% drank alcohol (18.4% cardiovascular agent users, 18% CNS agent users (20% of NSAID users, 16.8% anxiolytic/hypnotic/sedative users& 16% antidepressant users), 20% antihistamine users, 14% blood medication users, 13% antidiabetic agent users, 16% anti-infective users, 14% GI agent users & 16% muscle relaxant users) | ||
| Qato 2015 [31] | 41% were regular drinkers in the past 3 months (59.3% of men & 40.7% of women) Heavy (2–3 drinks/day): 19.7% |
57.7% used at least one AI medication. | 21% reported concurrent use of alcohol and AI medications | Overall drinkers (Regular drinkers): 51% used AI medications (8.4% used antidiabetic agents, 6.6% used analgesics, 2.4% used narcotics, 5.3% used acetaminophen, 26.7% used aspirin, 18.9% used psychotropic medication, 8.5% used antidepressants, 6% used anxiolytic/sedative/hypnotics & 4% used warfarin) | |
| Swift 2007 [33] | 18% drank alcohol daily in past 12 months | 87.3% used at least one AI medication in last 24 h | 35.4% reported concurrent use of alcohol and AI medications in previous 24 h | ||
| Wong 2016 [35] | 38% consumed alcohol Heavy (> 31 drinks/month): 6% |
83% reported any medication use | 31% reported concurrent use of alcohol and medications& 1.4% reported concurrent heavy alcohol consumption and medication use | ||
| Studies reporting on psychotropic medicines (n = 8 studies) | |||||
| Del Rio 2002 [22] | Not Reported | 13.4% used benzodiazepines in previous 2 weeks | Overall benzodiazepine users concurrent use of alcohol: 23% (56–66 years), approx. 15% (66–75 years) & approx. 10% (>75 years) | ||
| Du 2008 [14] | 47.3% drank alcohol at least once in the last-week Heavy drinking (≥10 g/day for women/ ≥ 20 g/day for men): 14.8% |
20% reported use of at least one psychotropic medication. | 7.4% reported concurrent use of alcohol and psychotropic medications & 2.4% reported concurrent heavy alcohol consumption and psychotropic medication use | Overall psychotropic medication users concurrent use of alcohol: 37.5% | Overall drinkers: 16% used psychotropic medication |
| Ilomaki 2008 [25] | 76.7% drank alcohol in previous year (87.5% of men & 68.9% of women) Heavy drinking (>14 units/week men & >7 units/week women): 12.6% (16.6% of men & 7.9% of women) |
11.5% reported use of at least one psychotropic medication | Overall psychotropic medication users concurrent use of alcohol: 38.9% of male users & 14.7% of female users were frequent drinkers, 25.9% of male users & 8.3% of female users were heavy drinkers | ||
| Ilomaki 2013 [26] | 33.7% drank alcohol daily in the past 12 months Heavy drinking (>2 drinks/day): 19.2% Problem drinkers (CAGE): 11% |
13.6% reported use of at least one psychotropic medication (8% reported antidepressant use, 5.7% sedative or anxiolytics use & 1.6% both drug classes) | Overall antidepressant users: 27.1% consumed alcohol daily & 15% heavy drinkers Sedative or hypnotic users: 42.7% consumed alcohol daily & 26% heavy drinkers |
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| John 2007 [28] | Prevalence not reported Risky drinking (>20 g/day women & >30 g/day men): 15.1% of men & 3.2% of women (excludes users of sedative-hypnotic-anxiolytics and opioids) |
Men: 3.8% used sedative, hypnotic, anxiolytic; 1% used opioids Women: 6.8% used sedative, hypnotic, anxiolytic; 1.6% used opioids |
Men: Risk drinkers (non-smoker) use of sedative, hypnotic or anxiolytic: 4.3% of 60–79 year olds Men: Risk drinkers (smokers) use of sedative, hypnotic or anxiolytic: 0% of 60–79 year olds Women: Risk drinker (non-smoker) use of sedative, hypnotic or anxiolytic: 13% of 60–79 year olds Women: Risk drinkers (smokers) use of sedative, hypnotic or anxiolytic: 0% of 60–79 year olds |
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| Lagnaoui 2001 [36] | 56.3% drank wine (77.2% of men & 41.1% of women) Heavy drinking >0.25 l wine/day: 15.3% (32.3% of men & 3.1% of women) |
32% used benzodiazepines | 15.7% reported concurrent use of alcohol (wine) and benzodiazepines & 2.9% reported concurrent heavy alcohol consumption (wine) and benzodiazepine use | Overall benzodiazepine users: 49% consumed wine & 9.2% heavy drinkers | Overall wine drinkers: 28.1% used benzodiazepines & heavy wine drinkers: 5.3% used benzodiazepines |
| Sheahan 1995 [32] | 38% drank alcohol in the past 12 months | 28% reported use of at least one psychotropic medication | 2% reported concurrent use of alcohol and psychotropic medication | ||
| Veldhuizen 2009 [34] | Not reported | Not reported | Overall benzodiazepine users: 33.9% consumed alcohol & 5.1% were heavy drinkers | ||