Many people enjoy an alcoholic beverage or two on occasion with friends or family, but alcohol can be addictive. As we age, alcohol consumption can also make existing health problems worse and have dangerous interactions with some medications. Anyone at any age can develop an unhealthy reliance on alcohol.

Sometimes, families, friends, and health care workers may overlook the concerns about older people drinking. This can be the case because the side effects of drinking in older adults are mistaken for other conditions related to aging, for example, a problem with balance. But how the body handles alcohol changes with age.

The effects of alcohol change as we age

As you grow older, health problems or prescribed medicines may require that you drink less alcohol or avoid it completely. You may also notice that your body’s reaction to alcohol is different than before. Some older people feel the effects of alcohol more strongly without increasing the amount they drink. This can make them more likely to have accidents such as falls, fractures, and car crashes. Also, older women are more sensitive than men to the effects of alcohol.

Other people develop a harmful reliance on alcohol later in life. Sometimes this is a result of major life changes, such as the death of a spouse or other loved one, moving to a new home, or failing health. These kinds of changes can cause loneliness, boredom, anxiety, or depression. In fact, depression in older adults often aligns with drinking too much.

People who drink daily do not necessarily have alcohol use disorder. And not all who misuse alcohol or have alcohol use disorder drink every day. But heavy drinking, even occasionally, can have harmful effects.

How does drinking damage the body?

Drinking too much at one time or on any given day, or having too many drinks over the course of a week, increases the risk of harmful consequences, including injuries and health problems. People who consistently misuse alcohol over time are also at greater risk of developing alcohol use disorder.

Drinking too much alcohol over a long time can:

• Lead to some kinds of cancer, liver damage, immune system disorders, and brain damage
• Worsen some health conditions such as osteoporosis, diabetes, high blood pressure, stroke, ulcers, memory loss, and mood disorders
• Make some medical conditions hard for doctors to accurately diagnose and treat. For example, alcohol causes changes in the heart and blood vessels. These changes can dull pain that might be a warning sign of a heart attack.
• Cause some older people to be forgetful and confused — symptoms that could be mistaken for signs of Alzheimer’s disease or a related dementia.

Cautions about mixing alcohol and medicines

Many medicines — prescription, over the counter, or herbal remedies — can be dangerous or even deadly when mixed with alcohol. Many older people take medications every day, making this a particular concern.

Before taking any medicine, ask your doctor or pharmacist if you can safely drink alcohol.

Here are some examples of potential dangers caused by mixing alcohol with some medicines:

• If you take aspirin and drink, your risk of stomach or intestinal bleeding increases.
• When combined with alcohol, cold and allergy medicines (antihistamines) may make you feel very sleepy.
• Alcohol used with large doses of acetaminophen, a common painkiller, may cause liver damage.
• Some medicines, such as cough syrups and laxatives, have a high alcohol content. If you simultaneously drink alcohol, that will add to the effects.
• Alcohol used with some sleeping pills, pain pills, or anxiety/anti-depression medicine can be deadly.

Learn more about mixing alcohol with medicines.

How alcohol affects safety

Drinking even a small amount of alcohol can lead to dangerous or even deadly situations because it can impair a person’s judgment, coordination, and reaction time. This increases the risk of falls, car crashes, and other accidents.

Alcohol is a factor in about 30% of suicides and fatal motor vehicle crashes, 40% of fatal burn injuries, 50% of fatal drownings and homicides, and 65% of fatal falls. People should not drink alcohol if they plan to drive, use machinery, or perform other activities that require attention, skill, or coordination.

In older adults, especially, too much alcohol can lead to balance problems and falls, which can result in hip or arm fractures and other injuries. Older people have thinner bones than younger people, so their bones break more easily. Studies show that the rate of various types of fractures in older adults increases with heavy alcohol use.

Adults of all ages who drink alcohol and drive are at higher risk of traffic accidents than those who do not drink. Drinking slows reaction times and coordination, and interferes with eye movement and information processing. People who drink even a moderate amount are at higher risk for traffic accidents, possibly resulting in injury or death to themselves and others. (Note that even without alcohol, the risk of a car accident goes up starting at age 55.) Also, older drivers tend to be more seriously hurt in crashes than younger drivers. Alcohol adds to these age-related risks.

In addition, alcohol misuse or alcohol use disorder can strain relationships with family members, friends, and others. At the extreme, heavy drinking can contribute to domestic violence and child abuse or neglect. Alcohol use is often involved when people become violent, as well as when they are violently attacked. If you feel that alcohol is endangering you or someone else, call 911 or obtain similar help right away.

What are signs of alcohol misuse or alcohol use disorder?

Alcohol misuse or alcohol use disorder is a pattern of drinking that can cause harm to a person’s health and social relationships. Drinking too much at one time or on any given day or having too many drinks over the course of a week increases the risk of harmful consequences, including injuries and health problems. Men should not have more than two drinks a day and women only one. Drinking less alcohol is better for health than drinking more.

The definition of “one drink” means:

• One 12-ounce can or bottle of regular beer, ale, or hard seltzer
• One 8- or 9-ounce can or bottle of malt liquor
• One 5-ounce glass of red or white wine
• One 1.5-ounce shot glass of 80-proof distilled spirits like gin, rum, tequila, vodka, or whiskey.

Understanding these “standard” drink sizes can make it easier to follow health guidelines. Another thing to keep in mind is that drinks may be stronger than you think they are if the actual serving sizes are larger than the standard sizes. In addition, drinks within the same beverage category, such as beer, can contain different percentages of alcohol. It’s important to read the label to understand and be aware of how much you’re actually drinking.

Getting the help you need for alcohol misuse or alcohol use disorder

Some people have no trouble cutting back on their drinking. But others will need to stop drinking completely. Alcohol problems can happen to people from all walks of life at any age, and, each year, millions of people seek help for alcohol problems.

If you or someone you love is thinking of changing their habits around alcohol, the “Rethinking Drinking” website, hosted by NIH’s National Institute on Alcohol Abuse and Alcoholism (NIAAA), provides information on signs of a problem and tools that can help lead to better health.

Making a change in your drinking habits can be hard. Don’t give up! If you don’t reach your goal the first time, try again. The good news is you’re not in this alone. Don’t be afraid to talk with a doctor and ask your family and friends for help.

Here are some approaches to try to get started:

• Ask your doctor about advances in medication that might help you stick with alcohol abstinence longer or reduce cravings. Your health care professional may also be able to give you advice about treatment.
• Talk to a trained counselor who knows about alcohol problems in older people.
• Find a support group for older people with alcohol problems. Many people find group counseling sessions or meetings helpful.
• Choose individual, family, or group therapy, depending on what works for you.
• Check out an organization such as Alcoholics Anonymous that offers support and programs for people who want to stop drinking.
• Consider websites or mobile applications that can help you track your alcohol intake and offer positive support as you make progress toward your goals.

Strategies to help cut back or quit drinking

Many older adults decide to quit drinking in later life. You can do it, too. Here are some ways to cut back or stop drinking:

• Count how many ounces of alcohol you are getting in each drink.
• Keep track of the number of drinks you have each day.
• Decide how many days a week you want to drink. Plan some days that are free of alcohol.
• In place of alcohol, try drinking water, juice, or soda. You could also try nonalcoholic “mocktails” or low-alcohol beer.
• Remove alcohol from your home.
• Ask for support from your family and advice from your health care provider. Get the help you need to cut back or quit.

Learn your patterns and plan ahead

As you evaluate your alcohol use, you may find that you drink more often in particular settings or in reaction to certain emotions, such as stress or boredom. Take time to learn about your habits and plan ahead on ways to make a change. Here are some ideas:

• Develop interests that don’t involve alcohol.
• Avoid people, places, and situations that may trigger your drinking.
• Avoid drinking when you’re angry or upset or if you’ve had a bad day.
• Plan what you will do if you have an urge to drink.
• Learn to say “no, thanks” when you’re offered an alcoholic drink.
• Remember to stay healthy for the fun things in life, such as the birth of a grandchild, a long-anticipated trip, or a holiday party.

Your body changes as you get older and that can affect daily routines. Be alert to these changes and think about adjusting your alcohol use so you can enjoy your life to the fullest.

Learn more about available types of alcohol treatment. To find alcohol treatment for yourself or a loved one, visit the NIAAA Alcohol Treatment Navigator.