Using alcohol during COVID-19: What older adults need to know

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Alcohol is the most common drug used and misused among older adults (65+).1  A recent poll showed that 1 in 10 Canadians who are 55 and older are drinking more alcohol during the COVID-19 pandemic.2  Some people have turned to alcohol to cope with the stress, loneliness in isolation and the uncertainty caused by the pandemic.2,3  Some older adults may also drink to deal with the loss of a loved one or of their daily routine.4 However, drinking can be harmful and it’s important to be aware of the facts.

What are the facts? 

Alcohol can be harmful to you and the people around you.

  • It can lead to more traffic accidents and family violence.5
  • Over time, drinking too much alcohol can:
    • lead to certain cancers, liver and brain damage
    • make health conditions you may already have worse, such as high blood pressure, stroke, diabetes, ulcers and low or anxious mood
    • lead to confusion and memory loss in older adults, which is sometimes mistaken for Alzheimer's disease.6

Older adults are more sensitive to the effects of alcohol.

  • As you get older, your body processes alcohol more slowly.1 This can lead to an increased risk of accidents, falls and the worsening of some health issues.1,4 
  • Many older adults also have multiple prescriptions, which can be harmful when mixed with alcohol.1

Drinking alcoholic products does not prevent or treat COVID-19.

  • Drinking alcohol, especially in high amounts, weakens the immune system and makes it harder for your body to fight off infectious diseases.7
  • Drinking high amounts of alcohol can increase your risk of respiratory distress syndrome (ARDS). ARDS is a very serious complication of COVID-19.7
  • Highly concentrated alcohol (60% +) in products, such as sanitizer, disinfects your skin. It is harmful if ingested.7

Alcohol is not a good coping strategy to deal with stress.

  • Drinking alcohol can make symptoms of panic, anxiety and depression worse.7
  • Drinking to help you cope with stress is also connected with a risk of developing alcohol-related problems.3
  • Drinking can increase your distress in the long term.3

How much is too much?

The only way to avoid all risk is by not drinking alcohol. If you choose to drink, below are some guidelines for safer use.

In Canada, a standard drink is the equivalent of:

  • 330ml (12 oz.) bottle of beer, cider or cooler at 5% alcohol
  • 142ml (5 oz.) glass of wine at 12% alcohol
  • 43ml (1.5 oz.) distilled alcohol at 40% alcohol.

The Canadian Coalition for Seniors’ Mental Health have recommended the following low risk drinking guidelines for older adults (65 +):1

  • Women: no more than 1 standard drink per day with no more than 5 alcoholic drinks per week
  • Men: no more than 1–2 standard drinks per day, with no more than 7 per week in total is recommended. 
  • It is recommended to have days that you don’t drink every week.

Depending on your age, health and medication use, consider drinking less often, lowering how much you drink or not drinking at all.1 It is recommended to not drink at all while caring for others or when using medications that interact with alcohol (e.g., sleeping tablets, painkillers, anti-depressants, etc.).1,7 Talk to your health care provider about your alcohol use and setting your limits.

What can I do instead of drinking alcohol?7, 8

  • Try to maintain a daily routine and focus on what you can control. For example, doing daily exercises, making time for hobbies or building good sleep habits. 
  • Practice calming activities, such as deep breathing or muscle relaxation exercises. Access example relaxation techniques.
  • Go for a walk or try an indoor workout to help pass the time. Physical activity boosts our immune system and is important for your overall health. See an example of a seated stretching exercise.
  • Prioritize buying healthy foods. Stockpiling alcohol may increase how much you drink at home. Read food and nutrition tips during COVID-19.
  • Stay connected to loved ones. You can write, call or video chat with friends, neighbours and family.

How do I know if I have a problem?

Older adults who feel they need to drink, even when it is causing problems in their lives, may have an unhealthy relationship with alcohol.  Signs that someone has a problem include:

  • falling
  • slurred speech
  • problems sleeping
  • poor personal care
  • others pointing out that you are drinking too much 
  • not eating well
  • depression
  • confusion
  • lack of interest in normal activities.9, 10

What steps should I take if I need help?

If you notice these signs in yourself or others, it’s important to take action. 

  • Talk to your healthcare provider before you stop drinking. Stopping immediately could lead to complications with withdrawal and symptoms, such as seizures.11
  • Contact information and referral lines.
    • Drug and Alcohol Registry of Treatment (DART) (1 800 565-8603 or www.dart.on.ca). DART provides information and referrals to alcohol treatment services in Ontario. It is free, confidential and open 24 hours a day, seven days a week.
    • ConnexOntario (1-866-531-2600 or www.connexontario.ca) . ConnexOntario is an information line to learn about mental health and addiction services in Ontario. It is free, confidential and open 24 hours a day, seven days a week.
  • Access emergency services. When unsure about the symptoms you are experiencing and unable to connect with a professional, go to the emergency department or call 9-1-1.

References

  1. Butt, P.R., White-Campbell, M., Canham, S., Johnston, A.D., Indome, E.O., Purcell, B., et al. (2019). Canadian Guidelines on Alcohol Use Disorder Among Older Adults. Toronto, Canada: Canadian Coalition for Seniors’ Mental Health. Available: https://ccsmh.ca/wp-content/uploads/2019/12/Final_Alcohol_Use_DisorderV6.pdf Accessed July 15, 2020.
  2. Canadian Centre on Substance Use and Addiction. (2020). COVID-19 and Increased Alcohol Consumptions: NANOS Poll Summary Report. CCSA. Canadian Centre on Substance Use and Addiction.
  3. Rodriguez, L.M., Litt, D.M. & Stewart, S.H. (2020). Drinking to cope with the pandemic: The unique associations of COVID-19-related perceived threat and psychological distress to drinking behaviors in American men and women. Addictive Behaviors, 110, 10653.
  4. Kelly, S., Olanrewaju, O., Cowan, A., Brayne, C. & Lafortune, L. (2018). Alcohol and older people: A systematic review of barriers, facilitators and context of drinking in older people and implications for intervention design. PloS One, 13 (1), e0191189. Available: https://doi.org/10.1371/journal.pone.0191189. Accessed July 15, 2020.
  5. Nutt, D.J., King, L.A. & Phillips, L.D. (2010). Drug harms in the UK: A multicriteria decision analysis. The Lancet, 376 (9752), 1558–1565.
  6. National Institute on Aging. (2017). Facts About Aging and Alcohol. Available: https://www.nia.nih.gov/health/facts-about-aging-and-alcohol. Accessed July 15, 2020.
  7. World Health Organization. (2020). Alcohol and COVID-19: What You Need to Know. Available: https://www.euro.who.int/__data/assets/pdf_file/0010/437608/Alcohol-and-COVID-19-what-you-need-to-know.pdf. Accessed July 16, 2020.
  8. Centre for Addiction and Mental Health. (2020). Coping With Stress and Anxiety. Available: http://www.camh.ca/en/health-info/mental-health-and-covid-19/coping-with-stress-and-anxiety. Accessed July 20, 2020.
  9. Centre for Addiction and Mental Health. (n.d.) Alcohol Use in Older Adults. Available : https://www.camh.ca/en/health-info/guides-and-publications/alcohol-use-in-older-adults. Accessed July 16, 2020.
  10. DiBartolo, M.C. & Jarosinski, J.M. (2017). Alcohol use disorder in older adults: Challenges in assessment and treatment. Issues in Mental Health Nursing, 38 (1), 25–32.
  11. Bertram, J. & Conn, D. K. (2018). Consequences of Alcohol and Drug Use in Older Adults. In Flint, A., Merali, Z. & Vaccarino, F. (Eds.), Substance use in Canada: improving quality of life: substance use and aging. Canadian Centre on Substance Use and Addiction.