affected . ‘ During that period of lockdown , the percentage change in people drinking over 50 units a week was consistently higher among 65 to 74-year-olds , which is very surprising ,’ says Rao .
While public health campaigners consistently urge the government to tighten up what are seen as the toothless regulations around alcohol marketing , most proposals to do so tend to focus on young people – as is reflected in the consultation being carried out by the Scottish Government at the moment , with its plans to tackle sports and events sponsorship and statement that marketing is ‘ associated with an increased likelihood that children and young people will start to drink alcohol ’ ( www . drinkanddrugsnews . com / scots-consult-on-alcoholmarketing-curbs ). Given this ongoing generational shift in drinking patterns , are they maybe barking up the wrong tree ?
‘ Definitely ,’ Rao states . ‘ We had the Drink Wise , Age Well project that lasted for seven years , but what I think we urgently need now is a nationwide public health campaign to show older people not only the extent of the problem but also how they can play a part in their own harm reduction .’
While Dry January is very much based around people who are already health-aware , what ’ s needed with older people is something to raise that awareness of harm , he stresses . ‘ I think older people still see this kind of mind shift among younger people as very woke , very nanny state , because they don ’ t appreciate the true extent [ of the harm ] – “ It ’ s not my problem , it ’ s someone else ’ s problem .” There ’ s all this ONS data
and the media stories around it saying that younger people are drinking less – and that ’ s all well and good – but what they ’ re not saying is that older people are drinking far more compared to the same generation 50 years ago .’ It ’ s an issue that has to be tackled on two fronts , he believes . ‘ We need a public health campaign on alcoholrelated harm , but we also need to develop clinical services so there ’ s better screening and brief intervention . Not just because it would help to catch things early , but it would help to give addiction services a better understanding of the extent of the problem .’ And within those services there needs to be a multi-disciplinary approach , he adds . ‘ You need the medical side to look at mental health disorders , the nursing and psychology side to engage people in reducing stigma and opening up about their drink problem , and then you need the social focus on community integration and recovery . It can take decades to achieve that kind of thing .’
DR TONY RAO is consultant old-age psychiatrist and visiting research fellow at South London and Maudsley NHS Foundation Trust . For over 20 years he has published widely on the subject of alcohol misuse in older people .
He has acted as specialist advisor to the All Party Parliamentary Group on Alcohol Misuse , the Institute of Alcohol Studies and Alcohol Change UK . He also chaired the Substance Misuse in Older People Working Group at the Royal College of Psychiatrists from 2012-2017 , and currently chairs the South London and Maudsley NHS Foundation Trust Dual Diagnosis Group for the Psychological
Approximately one in seven of all adults in the UK said they planned to take part in Dry January . This dropped to one in ten for the over 55s .
DOES DRY JANUARY WORK ? So does Dry January itself work , or is it just a way for people to think ‘ I ’ ve done that , now I can go back to bingeing on 1 February ?’ ‘ There ’ s always this misconception with alcohol , because it ’ s such a stigmatising subject , that either you drink or you ’ re abstinent ,’ he states . ‘ But I think the longerterm impact for a large number of people is that it ’ s given them the chance to reflect on having healthier lifestyles and really looking at the part that alcohol plays in their lives .’ Alcohol Change UK , however , found that just 10 per cent of over-55s were planning to take part , a missed opportunity given they ’ ve often ‘ been quite hedonistic , and are quite healthnaïve ’, he says .
While there ’ s obviously still large numbers of young people who drink heavily , it ’ s looking as though this overall shift in drinking patterns may well turn out to be permanent . One factor may be something as simple as alcohol not being seen as cool anymore among a growing
Medicine and Older Adults Clinical Academic Group .
proportion of younger people – for a generation whose every action is scrutinised on social media , getting drunk and losing control perhaps isn ’ t something particularly attractive . ‘ I think there are three components ,’ says Rao . ‘ There ’ s seeing parents and grandparents who ’ ve suffered from alcohol problems , there ’ s the health aspect – they ’ re a much more health-aware population – and then there ’ s the cost of living . They can ’ t afford to – they ’ re probably more likely to go and have a craft beer every month than drink every week .’
LOUD AND CONSISTENT In terms of where alcohol health campaigns should now be turning their focus , it doesn ’ t help of course that there ’ s been no alcohol strategy for a decade . And when one does finally come it ’ s highly likely to focus on young people , Rao points out . ‘ So we need louder and more consistent voices for the older population , who are suffering . I really don ’ t think that at a political level , or a clinical level or a public health level , it ’ s really been taken seriously enough . I think the other reason is that there ’ s probably an attitude – not just among older people that they don ’ t want to change their habits – but among society as a whole of “ why shouldn ’ t older people be allowed to enjoy themselves ?”’ But what we know from definitive and robust reviews is that older people tend to do much better in terms of treatment and recovery than younger people . So it ’ s never too late .’ DDN
‘ My overall aim has always been to ensure that older people can live healthy lifestyles in their own homes . Living healthily with alcohol and free from drug-related harm requires a better understanding of the relationship between substance use and health .’ maudsleylearning . com
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