Nordic Studies on Alcohol and Drugs

This study accounts for how people aged 55-69 with ongoing long-term alcohol problems conceptualize past, present and future.

A total of 19 interviews were performed, from which reflective life reviews were obtained and analyzed as narrative life accounts. Three structuring thematic traits were identified: resentment of life, acceptance of life and gratitude towards life.

The study shows how past, present and future intertwine into meaningful entities incorporating certain governing master narratives about recovery, familiar for example from expert discourse and the AA movement. When it comes to the theme of resentment, the participants articulated disappointment over what life had become and emphasized especially the missed work-related opportunities that the drinking had caused. In the theme of acceptance letting go of the past was viewed as important for creating a sober future. Within the dimension of gratitude the past was seen as a resource for self-development and future recovery.

How long-term alcohol problems are conceptualized in the long view of a life narrative may have great implications for outlooks of a sober future. A closer look at the social and cultural material incorporated in the stories of this age group is an important task for future research.

Sedative-hypnotic drugs (i.e., tranquilizers and sleeping pills) are more often used among the elderly compared to other age groups. Concomitant use of alcohol and sedative-hypnotic drugs constitutes a particularly high risk factor for accidental injuries among the elderly. However, few studies have addressed the prevalence of concomitant alcohol and sedative-hypnotic drug use and knowledge about the characteristics of such use is meagre.

To assess the prevalence of concomitant alcohol and sedative-hypnotic drug use among elderly people and to explore the characteristics of such concomitant use.

Data stemmed from cross-sectional population surveys in Norway, conducted in the period 2012–2015 (sub-sample 60–79 years: N = 1920).

Respondents reported frequencies of use of sedatives (tranquilizers), hypnotics (sleeping pills) and alcohol consumption in the preceding 12 months. Sedative-hypnotic drug use was reported by 25%, and 19% reported both such drug use and alcohol use in the past year. Concomitant use, suggesting simultaneous intake of alcohol and drugs, was reported by 6%.

Concomitant use was more often reported by women, hazardous alcohol users, non-working respondents, and by those in the lower income groups and those living alone. Health personnel need to take into consideration the risks associated with concomitant use and to inform their patients accordingly.

This qualitative study is concerned with the motivations that lead older adults to enter treatment for alcohol problems. There is a need to expand our understanding of the unique characteristics and problems of this population to be able to devise specialised and effective treatments and preventive measures.

We conducted an analysis of secondary findings from interview data collected in a qualitative interpretative phenomenological analysis (IPA) study. Our participants were 12 elderly people aged 60 years or more who had experienced late-onset alcohol use disorder. Transcription, categorisation, collapsing and analysis were conducted rigorously in accordance with the IPA standards.

Family can function as a pressure structure in terms of fostering motivation for treatment. Participants were to a certain extent ambivalent about treatment, which led them to devaluing treatment and its effects. Our results are on par with comparable results from other studies.

Older adults who experience very-late-onset of alcohol use disorder experience familial pressure and health concerns which lead them to enter treatment. Our participants seemed ambivalent about treatment and its necessity, which seems to lead to a devaluation of therapy.

The aim of this study was to investigate how care managers went about in their work with older people living at home and having alcohol abuse problems.

Six focus group interviews and one interview with two participants were carried out. In total, 23 care managers from five different municipalities participated.

The care managers all stressed the fact that within home care, no addiction treatment was conducted. The role of home care was to provide good care helping older people in their everyday lives irrespective of their problems. The care managers had to push the limits for the available services to be able to help older people with alcohol abuse problems. The services offered are however strictly regulated in guidelines. Many older people with alcohol abuse problems were not interested in receiving home care, and they were seldom interested in having contact with the addiction unit. The self-determination of older people in need of home care is strongly stressed in legislation. If the older person did not want any help, there was not much the care managers could do.

Since older people today drink more alcohol than earlier generations, there is a need for services and addiction treatment specifically directed at older people with alcohol abuse problems suitable for their needs.

Although alcohol and prescribed psychotropic drug use has increased among older people, the usefulness of information provided about these substances in patients’ referrals to departments of old-age psychiatry (OAPsy) is unknown.

To examine whether patients’ self-reported elevated use of alcohol and prescribed psychotropic drugs corresponds with information provided in the referrals to OAPsy departments and to explore the factors associated with elevated self-reported use of these substances.

We recorded the information provided in referrals about the elevated use of alcohol and psychotropic drugs in a sample of 206 patients (69 men) from 12 OAPsy departments. The Alcohol Use Disorders Identification Test (AUDIT) and Drug Use Disorders Identification Test (DUDIT) helped to assess self-reported use. We also collected demographic data, as well as information about cognitive functioning and symptoms of anxiety and depression.

Seventy-three patients (35%) scored above the cut-off for alcohol use for women/men (AUDIT ≥ 3/4) or psychotropic drugs (DUDIT ≥ 6/8), if not both. Twenty patients (10%) reported an elevated use of both alcohol and psychotropic drugs, and the referrals for eight (40%) and ten (50%) of them, respectively, included information about this use. There was a significant association between self-reported use of alcohol above the cut-off and information about elevated use in the referrals. However, no such association was found between information in the referrals and self-reported use of prescribed psychotropic drugs. Elevated alcohol use was associated with more years of education, while elevated use of psychotropic drugs was associated with younger age and severe symptoms of anxiety and depression.

The information reported in referrals about the elevated use of alcohol and psychotropic drugs demonstrated a trend in associations with self-reported use. However, the risk factors for elevated use of alcohol and psychotropic drugs in the elderly need to be examined further.

Opioid maintenance treatment (OMT) secures a low mortality in a vulnerable population and is often a lifelong treatment. One would therefore expect an increasing prevalence of OMT among the elderly. This article describes a study with three elements; a literature review, an investigation of occurrence and an exploration of elderly patients’ needs and experiences.

PsycINFO, Ovid Medline and Embase were searched with reference words for opioid maintenance and age. Norway has a national cohort study of patients in OMT describing recruitment, retention in treatment, age and mortality. A prognosis of numbers in treatment older than 50 and 60 years were extrapolated based on probabilistic premises. Finally, a qualitative interview study of OMT patients in two municipalities near Oslo was performed. Five OMT patients aged between 58 and 64 years were interviewed with open questions on thoughts, needs and experiences.

The review points to an increasing population with psychiatric and somatic comorbidities and diverse needs. Their opinions and experiences seem largely unexplored. The population estimates indicate that Norway by 2018 will have between 3084 and 3567 individuals older than 50 years and between 201 and 302 individuals older than 60 years in OMT. The qualitative study demonstrated that the elderly OMT patient typically attributes their being alive to OMT. It is a life with a high prevalence of ailments and diseases. Their somatic diseases are mostly adequately treated by their GP, but they feel left alone with a high level of mental problems and loneliness. They miss follow-up from the OMT and social services and are not met on existential thoughts and sorrow for their life. A wish to end OMT during their lifetime is noteworthy. This would necessitate a close collaboration with the OMT services and support from a social network.

The study points to insufficient knowledge of and strategies to meet an increasing number of individuals with composite problems in OMT. The numbers will remain too small to warrant specially designed local projects, but large enough to necessitate awareness and competencies in the ordinary municipal health and social services.