Assessment and Treatment of Alcoholism

Assessment of Alchoholism

All older adults be assessed annually for their alcohol disorders by asking about the type, frequency and quantity of alcohol used. A diagnosis of alcoholism is based on the patient interview, information from the family or others, and the CAGE screening questionnaire (see below). In addition, abnormal lab tests (e.g., deficiencies of B vitamins, liver function) may provide clues to alcohol abuse.

CAGE Questionnaire

• C: Have you ever felt you should cut down on your drinking?
• A: Have people annoyed you by criticizing your drinking?
• G: Have you ever felt bad or guilty about your drinking?
• E: Have you ever had a drink (eye opener) first think in the morning to steady your nerves or get rid of a hangover?

Drinking patterns are classified as light or heavy/high risk. A light drinker has less than seven drinks/week and their CAGE and assessment shows no evidence of alcohol disorder.

Treatment of Alcoholism

The goal of treatment is recovery in which individuals are able to maintain sobriety through abstinence. The safest way to quit drinking is to undergo a medically supervised detoxification in a hospital setting. Alcohol withdrawal must be closely monitored in older adults and they may require a longer time for detoxification than younger adults. Going "cold turkey" is not advised because withdrawal can be dangerous. Early symptoms of withdrawal include an increased heart rate, increase respirations and tremulousness. Later symptoms of withdrawal include delirium, hallucinations, and seizures. Once "detox" is over then a period of rehabilitation begins. Rehabilitation settings vary (e.g. residential, in-patient, out-patient) but they all provide psychotherapy, patient education; and access to support groups such as Alcoholics Anonymous.

 

To access additional information and Publications for the Elderly on Alcoholism, you can visit the National Clearinghouse for Alcohol and Drug Information, a service of The Substance Abuse and Mental Health Services Administration.