Skip to main content

Table 3 Summary of results; prevalence of alcohol consumption, alcohol interactive medication use and concurrent use among older adults

From: Concurrent use of alcohol interactive medications and alcohol in older adults: a systematic review of prevalence and associated adverse outcomes

Study Prevalence of alcohol consumption in older adults (gender);
Heavy/Problem drinking (gender)
Prevalence of alcohol interactive medication use: Concurrent use reported among:
Total sample of older adults
Concurrent use reported among:
AI medication users
Concurrent use reported among:
Current drinkers
Studies reporting on a wide range of alcohol interactive (AI) medicines (n = 13 studies)
Adams 1995 [18] 47% drank alcohol in previous 6 months
Heavy (>7 drinks/week): 8%
80% used one or more of the following in the last 6 months: NSAIDS, aspirin, sedatives, narcotics, antidepressants, anti-hypertensives, antacids, H2 blockers, warfarin & meds for congestive heart failure, gout or diabetes 38% reported concurrent use of alcohol and AI medications, 6% reported concurrent heavy alcohol consumption and AI medications   Overall drinkers: 80% used an AI medication (50% used anti-hypertensives, 27% used aspirin, 20% used NSAIDs, 18% used chronic heart failure drugs, 11% used sedatives; 5% used narcotics, 5% used warfarin, 4% used diabetic drugs, 3% used antidepressants, 3% used drugs for gout)
Heavy drinkers: 80% used an AI medication (48% used anti-hypertensives, 28% used aspirin, 16% used NSAIDs, 16% used chronic heart failure drugs, 4% used sedatives, 4% used narcotics, 4% used warfarin, 8% used diabetic drugs, 12% used antidepressants, 4% used drugs for gout)
Aira 2005 [19] 44% drank alcohol in previous 12 months (66% of men & 37% of women)
Heavy (>7 units/week): 7% of men & 0% of women
90% used one or more of the following regularly or as needed: acetaminophen, anticonvulsants, antidepressants, antihistamines, benzodiazepines, histamine H2 receptor agonist, neuroleptics, nitrates, NSAIDs, opiates or warfarin 39% reported concurrent use of alcohol and AI medications, 1.9% reported concurrent heavy alcohol consumption and AI medications. Concurrent alcohol and specific AI medications: 7.5% acetaminophen, 0.19% anticonvulsants, 5.16% antidepressants, 0.76% antihistamines, 11% benzodiazepines, 1.15% histamine H2 receptor agonist, 2.29% neuroleptics, 23% nitrates, 29% NSAIDs, 3.8% opiates & 3.6% warfarin Overall AI medication users: 44% drank alcohol (36% acetaminophen users, 17% anticonvulsants users, 40% antidepressants users, 21% antihistamines users, 38% benzodiazepine users, 43% histamine H2 receptor agonist users, 25% neuroleptic users, 43% nitrate users, 46% NSAID users, 38% opiate users & 40% warfarin users) Overall drinkers: 88% used AI medications
Breslow 2015 [20] 47% drank alcohol in previous 12 months (55% of men & 39.7% of women) 78.6% used one or more of the following: cardiovascular agents, CNS agents, coagulation modifiers, GI agents, metabolic agents, psychotherapeutic agents, respiratory agents 35% reported concurrent use of alcohol and AI medications. Concurrent alcohol and specific AI medications: 28% cardiovascular agents, 10% CNS agents (1.8% anticonvulsants, 2% anxiolytic/sedative/hypnotic, 2% narcotics, 2.2% NSAIDs), 3% coagulation modifiers, 2.2% GI agents, 16.9% metabolic agents, 3.9% psychotherapeutic agents (3.8% antidepressants), 2.1% respiratory agents Overall AI medication users: 45% drank alcohol (44% cardiovascular agents users, 40% CNS agent users (34% anticonvulsants, 40% anxiolytic/sedative/hypnotic, 43% NSAID), 44% coagulation modifier users, 43% GI agent users, 43% metabolic agent users, 41% psychotherapeutic agent users (42% antidepressants), 48% respiratory agent users) Overall drinkers: 77.8% took AI medications (61.3% used cardiovascular agents,
22% used CNS agent (3.9% used anticonvulsants, 4.6% used anxiolytic/sedative/hypnotic, 4.8% used NSAID), 6% used coagulation modifier, 4.7% used G I agent users, 36.5% used metabolic agent, 9.6% used psychotherapeutic agent (9.2% used antidepressants), 4.6% used respiratory agent)
Cousins 2013 [21] 62.8% drank alcohol previous 6 months (72% of men & 59% of women)
Heavy (>4 drinks/day or >10 drinks/week): 20% (32% of men & 11% of women)
CAGE: 8% (12.2% of men & 4% of women)
72% took one or more of the following: cardiovascular agents, CNS agents, antihistamines, Blood, antidiabetic agents, anti-infectives, GI agents, immunomodulators or muscle relaxants   Overall AI medication users concurrent use of alcohol: 60% drank alcohol (60% cardiovascular agent users, 53.5% CNS agent users (59% of NSAID users, 54% hypnotic users, 44% anxiolytic users, 52.9% antidepressant users), 66.9% antihistamine users, 58.5% blood medication users, 54% antidiabetic agent users, 47% anti-infective users, 50% GI agent users, 51% immunomodulator users &80.3% muscle relaxant users)
AI medication users concurrent heavy alcohol consumption: 25% antihistamine users, 20% cardiovascular agent users, 20% blood (anti-coagulant or anti-platelet) users, 20% anti-diabetic agent users, 16% CNS agent users (13% users of anti-epileptic agents; 13% antipsychotic agents; 13% hypnotic users & 18% antidepressant users)
 
Del Rio 1996 [23] Approximately 20% drank alcohol at least once per day in the past 2 weeks 75–80% took one or more medication in previous 2 weeks 18% reported concurrent use of alcohol and AI medications   
Forster 1993 [24] 57.1% reported using alcohol
16.9% admitted to drinking enough to become “lightheaded”
Not Reported 25% reported concurrent use of alcohol and AI medications. Concurrent alcohol and specific AI medications: 19% OTC analgesics, 6.9% antihypertensives, 5.4% diuretics; 4.3% OTC cold preparations, 2.1% mind altering drugs, 1.5% diabetes pills, 1.5% prescription pain medication, 1.2% sleeping pills, 0.6% prescription blood thinners, 0.6% insulin & 0.3% seizure medications   
Immonen 2013 [27] 62.6% drank alcohol
At risk drinking (>7 drinks/week, or ≥5 drinks on typical drinking day, or ≥3 drinks several times/week): 7.9%
42% took one or more of the following: metronidazole, tinidazole, disulfiram, griseofulvin, prazosin, metformin & tacrolimus. CNS agents, hypoglycaemics and warfarin   Overall AI medication users: 62.2% drank alcohol Heavy or at risk drinkers: 42.2%% took AI medications (2.2% used antipsychotics, 4.4% used anti-depressant, 6.7% used anxiolytics, 11.1% used hypnotics/sedatives, 5.6% used anti-epileptics, 3.3% used opioids, 11.1% used warfarin & 13.3% used metformin)
Onder 2002 [29] 54.2% drank ≤40 g of wine/day prior to hospital admission (68.1% of men & 42.8% of women) 27% used diuretics, 23% digoxin, 17.7% calcium channel blockers, 16% ACE inhibitors, 15% aspirin & anti-platelets, 9% oral hypoglycaemic agents, 6% NSAIDs, 6% antibiotics, 5.2% nitrates, 5% insulin, 4% steroids & 3.2% antipsychotics    Overall wine drinkers: 26% used diuretics, 3.8% oral hypoglycaemic agents, 2.6% antipsychotics & 1.8% insulin
Pringle 2005 [30] 20.3% drank alcohol
Heavy (> 30 drinks/month): 1.2%
77.4% used on or more AI medication   Overall AI medication users concurrent use of alcohol: 19% drank alcohol (18.4% cardiovascular agent users, 18% CNS agent users (20% of NSAID users, 16.8% anxiolytic/hypnotic/sedative users& 16% antidepressant users), 20% antihistamine users, 14% blood medication users, 13% antidiabetic agent users, 16% anti-infective users, 14% GI agent users & 16% muscle relaxant users)  
Qato 2015 [31] 41% were regular drinkers in the past 3 months (59.3% of men & 40.7% of women)
Heavy (2–3 drinks/day): 19.7%
57.7% used at least one AI medication. 21% reported concurrent use of alcohol and AI medications   Overall drinkers (Regular drinkers): 51% used AI medications (8.4% used antidiabetic agents, 6.6% used analgesics, 2.4% used narcotics, 5.3% used acetaminophen, 26.7% used aspirin, 18.9% used psychotropic medication, 8.5% used antidepressants, 6% used anxiolytic/sedative/hypnotics & 4% used warfarin)
Swift 2007 [33] 18% drank alcohol daily in past 12 months 87.3% used at least one AI medication in last 24 h 35.4% reported concurrent use of alcohol and AI medications in previous 24 h   
Wong 2016 [35] 38% consumed alcohol
Heavy (> 31 drinks/month): 6%
83% reported any medication use 31% reported concurrent use of alcohol and medications& 1.4% reported concurrent heavy alcohol consumption and medication use   
Studies reporting on psychotropic medicines (n = 8 studies)
Del Rio 2002 [22] Not Reported 13.4% used benzodiazepines in previous 2 weeks   Overall benzodiazepine users concurrent use of alcohol: 23% (56–66 years), approx. 15% (66–75 years) & approx. 10% (>75 years)  
Du 2008 [14] 47.3% drank alcohol at least once in the last-week
Heavy drinking (≥10 g/day for women/ ≥ 20 g/day for men): 14.8%
20% reported use of at least one psychotropic medication. 7.4% reported concurrent use of alcohol and psychotropic medications & 2.4% reported concurrent heavy alcohol consumption and psychotropic medication use Overall psychotropic medication users concurrent use of alcohol: 37.5% Overall drinkers: 16% used psychotropic medication
Ilomaki 2008 [25] 76.7% drank alcohol in previous year (87.5% of men & 68.9% of women)
Heavy drinking (>14 units/week men & >7 units/week women): 12.6% (16.6% of men & 7.9% of women)
11.5% reported use of at least one psychotropic medication   Overall psychotropic medication users concurrent use of alcohol: 38.9% of male users & 14.7% of female users were frequent drinkers, 25.9% of male users & 8.3% of female users were heavy drinkers  
Ilomaki 2013 [26] 33.7% drank alcohol daily in the past 12 months
Heavy drinking (>2 drinks/day): 19.2%
Problem drinkers (CAGE): 11%
13.6% reported use of at least one psychotropic medication (8% reported antidepressant use, 5.7% sedative or anxiolytics use & 1.6% both drug classes)   Overall antidepressant users: 27.1% consumed alcohol daily & 15% heavy drinkers
Sedative or hypnotic users: 42.7% consumed alcohol daily & 26% heavy drinkers
 
John 2007 [28] Prevalence not reported
Risky drinking (>20 g/day women & >30 g/day men): 15.1% of men & 3.2% of women (excludes users of sedative-hypnotic-anxiolytics and opioids)
Men: 3.8% used sedative, hypnotic, anxiolytic; 1% used opioids
Women: 6.8% used sedative, hypnotic, anxiolytic; 1.6% used opioids
   Men: Risk drinkers (non-smoker) use of sedative, hypnotic or anxiolytic: 4.3% of 60–79 year olds
Men: Risk drinkers (smokers) use of sedative, hypnotic or anxiolytic: 0% of 60–79 year olds
Women: Risk drinker (non-smoker) use of sedative, hypnotic or anxiolytic: 13% of 60–79 year olds
Women: Risk drinkers (smokers) use of sedative, hypnotic or anxiolytic: 0% of 60–79 year olds
Lagnaoui 2001 [36] 56.3% drank wine (77.2% of men & 41.1% of women)
Heavy drinking >0.25 l wine/day: 15.3% (32.3% of men & 3.1% of women)
32% used benzodiazepines 15.7% reported concurrent use of alcohol (wine) and benzodiazepines & 2.9% reported concurrent heavy alcohol consumption (wine) and benzodiazepine use Overall benzodiazepine users: 49% consumed wine & 9.2% heavy drinkers Overall wine drinkers: 28.1% used benzodiazepines & heavy wine drinkers: 5.3% used benzodiazepines
Sheahan 1995 [32] 38% drank alcohol in the past 12 months 28% reported use of at least one psychotropic medication 2% reported concurrent use of alcohol and psychotropic medication   
Veldhuizen 2009 [34] Not reported Not reported   Overall benzodiazepine users: 33.9% consumed alcohol & 5.1% were heavy drinkers