Alcohol and drug misuse

What is alcohol and drug misuse?

Many people like to have a drink sometimes or use recreational drugs, such as cannabis or cocaine. Or you may have bought or been prescribed medication that can be addictive. Alcohol and other drugs become a problem when you continue to use them in a way that is harmful. This is when use becomes misuse.

The drugs that older people most commonly misuse are alcohol, prescribed painkillers, and medication for anxiety and sleep problems. Alcohol is the most common.

What leads to alcohol and drug misuse?

Some people turn to alcohol or drugs to help them cope with life changes, such as a bereavement, retirement, ill-health, or mobility problems. If you’re lonely, you may use alcohol or drugs to help you deal with boredom or depression. You may use them if you can’t sleep well or you’re in pain. You may lose track of how your medication should be taken.

Drug and alcohol misuse is often a hidden problem for older people. You may feel ashamed and reluctant to ask for help. You may not be aware that there’s a problem. If you’re not coming into contact with other people, it can go unnoticed. It can also be missed by health professionals, who may assume your problem is the result of another health issue, such depression or dementia.

Understanding the risks

It’s important to be aware of the risks of drinking or taking drugs, including prescription and over-the-counter medication as well as illegal drugs.

Government guidelines suggest that men and women shouldn’t regularly drink more than 14 units per week. However, even these amounts may be too much for older people. It can be difficult to work out how many units you’re drinking. It depends on the strength of the alcohol and the size of the glass, for example. Use online calculators, such as the ones on Alcohol Change UK and Drink Wise Age Well to check how much you’re drinking, or ask your GP or health professional for advice.

You can find out more about prescription drugs or over-the-counter medication on the electronic Medicines Compendium or ask your pharmacist. Keep the written information that comes with your medication for future reference. 

You can get detailed information about recreational drugs from the national drugs service Frank.

Signs that you may have a problem

If you’re worried, ask yourself the following:

• Do you find it difficult to set limits or to stop yourself drinking or using drugs, even if you want to or you’re experiencing unpleasant side-effects?
• Have you been taking a prescription drug for longer than you were advised?
• Have you lost interest in things you used to enjoy because of drinking or drugs?
• Do you have trouble managing your daily life – for example, washing, cooking, cleaning?
• Do you spend a lot of time thinking about alcohol or drugs?
• Is drink or drug use affecting your relationships with those around you?
• Have your family or friends raised concerns about your drug or alcohol use?
• Have you had an accident as a result of alcohol or drugs?

If you answered yes to some of those questions, you may have a problem. See below for where you can get help.

How you might be affected

Problem drinking or drug use can harm your physical and mental health, cause difficulties in your daily life and affect the people around you.

Your physical health

Not everyone will be affected, but you will be at increased risk of the following:

• problems with your balance, which could lead to falls and injury 
• incontinence
• problems sleeping and tiredness during the day
• blackouts or fits
• medical conditions such as high blood pressure, cancer, liver disease, heart disease or stroke
• other medication you’ve been prescribed not working as well as it should
• loss of appetite, which could lead to malnutrition.

Your mental health

All drugs and alcohol have some effect on your mental health, changing your mood and the way you see things. The effects depend on what you’re using but could lead to:

• anxiety - especially as the effects of the substance wear off, making you want more to curb this feeling
• depression 
• confusion 
• memory loss and dementia. Contact the Alzheimer's Society for information about alcohol and dementia.

You can find out more about the effects of alcohol misuse on the NHS website. The National drugs service Frank has more information about the short and long-term effects of specific drugs.

Where to get support

Start by talking to your GP, even if you’re just a little bit worried. Try to be honest about how much and how often you’re drinking or using drugs. If necessary, your GP can refer you for specialist assessment or treatment.

If you’re not comfortable talking to your GP, you can contact local treatment services yourself. You can find directories of drug treatment services on Frank and the NHS website.

For alcohol support services, visit the NHS website or call Drinkline – a free, confidential helpline – on 0300 123 1110. You could also contact support organisations such as Alcoholics Anonymous or Narcotics Anonymous.

Types of treatment

Your treatment will depend on what you’re using and what you want to achieve. You might just want help to cut down or you may need to stop completely. Treatment may include:

• psychological or talking therapies, such as counselling or cognitive behavioural therapy (CBT), which can help change the way you think and act. This may be one-to-one or in groups
• detoxification (detox) treatments to help you stop drinking or using drugs. You may have to do this in a hospital or clinic
• medication – you may need medication to control cravings or to help with withdrawal symptoms, which could include anxiety, sweating, tremors, or nausea.

Private treatment is also available but can be very expensive. You might be able to get a referral from the NHS.

Managing pain

If you’ve become addicted to a prescription drug such as an opioid painkiller, you may need another way to deal with pain. Your GP may refer you to a pain clinic, where you could be offered a pain management programme.

Contact the British Pain Society or Pain Support for information. Or you could try The Pain Toolkit.

Managing your medication

It can be difficult to keep track of your medication, especially if you’re taking more than one. If you’re concerned, speak to your GP or pharmacist. You may be able to get help to manage your medication such as a Medicines Use Review.

Many people buy prescription medication online, but this can be dangerous. Follow the advice on the NHS website.

Tips for cutting down

• Set yourself goals.
• Reduce your intake gradually. It can be dangerous to stop suddenly. Make sure you get help.
• Set a budget so you know how much you’re spending.
• Let people know – tell family and friends, and explain why you’re cutting down so they can support you.
• Keep track of how much you’re using by writing it down.
• Keep a diary to help you work out the things that make you want to take a drug or have a drink.
• If you’re tempted, remind yourself of the negative consequences and why you want to change.
• Reward your progress – for example, you could spend the money you save on something for yourself.

Aftercare

Drug and alcohol dependency is a long-term condition and relapse is common. If you’re affected, you’ll probably need ongoing support. Rehabilitation and recovery programmes can help you stay on track.

Don’t be hard on yourself if you have setbacks. You might find it helpful to attend meetings such as those run by UK Smart Recovery or Alcoholics Anonymous. See our guide Understanding alcohol and drug misuse for details of other support organisations.

Your friends and family may be able to help you to find ways to keep busy that don’t involve alcohol or drugs. Go back to a hobby or take up a new one that helps to distract you.

If you're worried about someone

Try speaking to them and encourage them to get help. Be patient – it can take time for someone to admit they have a problem. Reassure them that they won’t be judged. See our page If you're worried about someone's mental health for general advice on helping somebody else.

Many people recover from drug or alcohol problems, but it can take a long time. If they have setbacks, encourage them to return to their recovery plan.

Look after yourself

Living with someone who is misusing drugs or alcohol can be extremely stressful. You may feel worried and alone. Make sure you get support for yourself as well.

Some organisations have support groups or helplines specifically for families and carers affected by someone’s drinking or drug use, including Al-Anon family groups and DrugFAM. You can also find a useful guide for family, friends and carers at Drink Wise, Age Well.