Many of us are familiar with the phenomena of binge drinking among college students. It means consuming multiple alcoholic beverages in one evening as a form of social bonding. Binge drinking in that context is risky: it can lead to minor and major injuries, poor academic performance, and in the worst of circumstances, accidental death.
While it’s a topic of concern for most parents, administrators, and students themselves, most everyone expects college students to outgrow the binge drinking phase.
Even so, many campus awareness campaigns actively address binge drinking in order to prevent it, and organized prevention and education strategies are more and more common on campuses across the country.
Still – it’s generally thought of as a college or young adult problem.
The latest data, however, says that might be changing – and we need to pay attention.
Binge Drinking in Older Adults
Binge drinking and people 65 or older is not an association we often make.
We should, though, because it’s a growing reality.
Medical researchers from the Department of Geriatrics at New York University report that binge drinking among older people in the U.S. is on the rise. In fact, epidemiologists recently discovered that high-risk drinking among older Americans dramatically increased 107% from 2001-2013.
A statistical analysis of survey data from the National Survey on Drug Use and Health (NSDUH) during the period of 2015-2017 revealed that 10% of all people in the U.S. age 65 or older engage in binge drinking.
Binge drinking – especially if combined with prescription drug use or cannabis use – threatens injuries and the intensification of chronic illnesses. Binge drinking, quite simply, can lead to premature deaths for a population that should be enjoying longer lives given so many medical advances.
For the purpose of this NYU study, researchers defined binge drinking as consuming five or more drinks in one setting for men and four or more for women. These thresholds for binge drinking are likely too high, especially for older populations.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends lowering thresholds, given that alcohol consumption impairs judgment, motor coordination, and lowers inhibitions that typically keep people from engaging in risky behavior. The NIAAA recommends no more than three drinks a day, maximum.
Lowering the limit to no more than three drinks make sense because of the number of prescribed medications and the increased likelihood of developing chronic diseases among this population.
Binge drinking among people over age 65 is less frequent among those with serious chronic illnesses or those who have two or more chronic illnesses. The current study, however, found a significant correlation among older binge drinkers – specifically African American men – and the following three chronic illnesses:
- Hypertension (41.4%)
- Cardiovascular Disease (23.1%)
- Diabetes (17.7%)
NYU researchers found less binge drinking in people over age 65 who were diagnosed with the following chronic illnesses:
- Chronic obstructive pulmonary disease
- Cirrhosis of the liver
- Hepatitis B and C
One explanation for lower rates in these cases, as well as among those with two or more chronic illnesses is the “sick quitter hypothesis.” Essentially, people in this category tend to recognize the seriousness of their illnesses and quit drinking as part of an overall approach to improving their health.
Risk Factors Predicting Binge Drinking
NSDUH’s data set is compiled self-reported answers to computer-generated questions. The questions cover a variety of topics, such as the prevalence of serious mental illness, misuse of prescription drugs, use of illicit substances, diagnosis of chronic illnesses, and frequency of visits to Emergency Departments (EDs).
NSDUH’s survey is representative of U.S. demographics. Individuals from both sexes, from all racial/ethnic groups, levels of education, levels of annual household incomes, and all states and the District of Columbia are included.
The NYU study, using statistical methods designed to find patterns among older binge drinkers, demographics, and presence of other medical and psychiatric conditions, identified the following prevalent characteristics among older binge drinkers:
- African American (Non-Hispanic)
- High school was highest level of education attained
- Earned less than $20,000 a year
- Higher cannabis/marijuana use
- Higher Tobacco use
Because older binge drinkers also tend to use cannabis and tobacco, they’re at increased risk of developing or intensifying chronic conditions already associated with this population, such as hypertension or cardiovascular disease.
The fact that people over age 65 use cannabis at higher rates may be a consequence of tow factors: changing norms – i.e. greater public acceptance of cannabis use – and legalization in several states. Because of changing perceptions toward cannabis use, some researchers theorize that older Americans may be less likely to perceive the associated risks, especially when combined with alcohol and tobacco use.
This theory may explain why older individuals who use alcohol and cannabis are more likely to increase their consumption of both substances. Unfortunately, it’s a real possibility that increasing use of both will degrade cognitive abilities and lead to judgment and behavior that can, in turn, lead to significant harm.
By significant harm, we mean health problems up to and including death. People over age 65 who binge drink, use cannabis, and smoke tobacco – three behaviors that the NYU study found to be present at the same time – increase their risk of developing cardiovascular disease, diabetes, and hypertension.
All three of those conditions increase risk of early mortality. And when untreated and combined with binge drinking, cannabis use, and tobacco use, the risks increase dramatically.
Future Study and Prevention Tactics
This snapshot of binge drinking and associated harmful behaviors begs further research into the unique features and demographic shifts in our aging population. Not only do researchers need to study the impact of increased cannabis use in people over 65, but also the increasing prescription rates for psychotherapeutic medications, opioids, stimulants, and benzodiazepines.
In a climate of changing perceptions toward some illicit drugs (cannabis) and the availability of prescription opioids, public health scientists recognize the need to target awareness campaigns toward vulnerable populations. Many people over age 65 may not yet perceive the harms and risks associated with combining prescription medication, cannabis, and alcohol use.
Therefore, public health campaigns targeting older adults – particularly those from with demographic characteristics that predict risk – should be tailored to better educate our older citizens on the risks of binge drinking, especially when combined with tobacco, cannabis, and prescription medications.