Alcoholism in the elderly. How to spot and treat a problem the patient wants to hide.

Alcoholism is a disease that warrants a complete medical workup and vigorous intervention in all age-groups, including the elderly. Increased awareness of the problem, with early diagnosis and treatment, can reduce mortality and morbidity. Alcoholics are at risk for relapse, so physicians should be patient and positive in their approach. Especially in the elderly, obtaining a list of all prescribed and over-the-counter medications used is an important starting point. Nonessential drugs should be discontinued and use of any others closely monitored. If a withdrawal syndrome results from discontinuation of alcohol, thiamine, multivitamins, and sedatives should be prescribed as clinically indicated. Treatment of any underlying psychiatric disorder is important. Psychosocial intervention is essential in dealing with recovering elderly alcoholics to overcome loneliness and to enhance sobriety. A formal rehabilitative effort is mandatory. Long-term rehabilitation focuses on group support and may include use of disulfiram (Antabuse).