‘Calling Time – Addressing ageism and age discrimination in alcohol policy, practice and research’, authored by the Substance Misuse and Ageing Research Team at the University of Bedfordshire, Addaction and the International Longevity Centre-UK (ILC-UK) for ³Drink Wise, Age Well asserts that some policies and practices are actually in breach of Equality and Human Rights legislation.

It calls on UK governments to develop alcohol strategies that recognise that older adults’ needs may be different to those of younger people.

The report is being launched at the House of Lords tomorrow (21 November) and is based on extensive review of UK strategies, policies and legislation, published literature and data on clinical trials, as well as a polling of professional opinion and focus groups with problematic drinkers.

Dr Sarah Wadd who led the research team said: “This report reveals extensive age discrimination towards older adults which is a significant barrier to reducing harm from alcohol and breaches equality legislation.  

“This is particularly worrying because older adults now drink more, are more likely to exceed the recommended drink limits, be admitted to hospital or die as a result of alcohol than any other age group.  Older adults deserve better.  We hope that the report’s recommendations will be implemented at the earliest opportunity.”

The report finds:

• ¹Three out of four residential rehab services in England exclude older people    
• ²ONS figures show 45% rise in alcohol-specific deaths in UK 50+ since 2001  
• “Older adults with alcohol problems among most vulnerable in society”  

⁴Higher risk drinking is declining in the UK except among people who are age 50 and over and with an ageing population the trend is of major concern, not least to the World Health Organisation (WHO) which has set a target of at least 10% relative reduction in harmful use of alcohol by 2025.

Recent ONS figures further underline the urgency of the situation. ^‘ONS Alcohol-specific deaths in the UK: registered in 2016’ show a 45% increase in alcohol-specific deaths in the over 50s in the past 15 years (2001 - 2016).  

The new report, however, states that “Ageist policies can be identified easily and abolished in a relatively short period… with very little impact on resources”.

Its main findings include:

• Practitioners discriminating against older adults including managing issues relating to alcohol use (e.g. vitamin injections) rather than referring them for alcohol treatment and young adults being prioritised over older people;
• Some of the reasons given are perceptions that older people are too old to change and that it’s not worth intervening because of life expectancy. There is also a sense that the care needs of older people are too complex for treatment;
• A ¹study for Alcohol Research UK featured in the report found that “three out of four residential alcohol rehab services in England exclude older people based on arbitrary age limit”;
• The Equality Act 2010 states that “services must provide equal services regardless of age or disability”. It is therefore unlawful for services “to provide inferior services, or refuse to provide services because of a person’s age, unless there is a good or sufficient reason”;
• Age is no predictor of care needs. It is quite possible that the needs of a 40 year-old will be higher than those of a 65 year-old;
• Adults over the age of 65 are excluded from 46% of clinical trials for alcohol treatment/interventions.

Writing in the report foreword Baroness Hayter who is a member of the All-Party Parliamentary Group on Alcohol Harm said: “Contrary to popular belief, harmful drinking is not the preserve of the young. In fact, many young people have followed advice and favour the gym or sports field over the pub and have been brought up never to drink and drive. Indeed, the only age group in the UK where drinking has increased  is the 65-74 year-old. So our consideration – and prevention – of problem drinking has to turn to the retired, or those who’ll approach it over the coming years.

“Drink Wise Age Well has drawn up guidance and recommendations for a swathe of organisations and professions, providing a vital tool in promoting health, happiness and a productive retirement for a growing generation.”

Key recommendations include:  

• Remove arbitrary age limits for alcohol services;
• UK governments should develop alcohol strategies which incorporate age as a cross-cutting theme and explicitly recognise that older adults’ needs may be different from those of younger adults;
• Following the example of the Welsh Government, convene an advisory panel to develop substance misuse guidance focused specifically on older adults;
• Inform alcohol services of their legal obligation to provide equitable care and take action if services are consistently discriminating against older adults;
• Ensure decisions on whether or not to refer someone to rehab is made on ability to benefit. Age alone should not be a barrier to referral;
• Ensure older adults are included in clinical trials and research studies unless there is good justification for not doing so.

Notes to Editors

• ¹Of the 118 services surveyed - excluding those specifically for people under 18 - three quarters said they had an upper age limit of anywhere between 50-90 years.  By the time someone has reached the age of 66, more than half of the rehabs (55%) exclude them.
• ^{2ONS Alcohol-specific deaths in the UK: registered in 2016}
• ³Led by the behaviour change charity Addaction and supported by the Big Lottery Fund, Drink Wise, Age Well was established in 2014 to help people aged 50+ make healthier choices about alcohol as they age.
• The seven-year programme is being delivered across five “demonstration” areas – Glasgow, Sheffield, Devon, Cwm Taf University Health Board area in Wales and the Western Trust Health & Social Care area in Northern Ireland covering the Foyle area, Fermanagh and Tyrone.  
• The Drink Wise, Age Well programme offers an integrated, community-based approach around four main activities: prevention and campaigning; delivering one-to-one support; developing individual and community resilience to alcohol misuse and training and workforce skills development.  
• ⁴The United Kingdom is currently experiencing a generational shift in terms of alcohol use.  Harmful use of alcohol is declining across the whole population but increasing among older adults.  In England, those aged 65-74 are the only age group where daily alcohol consumption is increasing digital.nhs.uk/catalogue/PUB23940
• In Scotland, harmful, hazardous and binge drinking is increasing amongst those aged 65-74 but decreasing in other age groups www.gov.scot/Topics/Statistics/Browse/Health/scottish-health-survey/Publications/TrendTables15
• In Wales, those aged 65 and over are the only age group where drinking above the daily guidelines is increasing gov.wales/statistics-and-research/welsh-health-survey/?tab=previous&lang=en
• In Northern Ireland, the most noticeable increases in alcohol consumption in recent years have been amongst those aged 60-75 www.health-ni.gov.uk/publications/adult-drinking-patterns-northernireland-
• Of equal concern is the population that will soon make the transition into old age.  Today, for the first time in recent history, drinkers aged 55-64 in England and Scotland drink more and are more likely to exceed the recommended weekly guidelines than any other age group www.content.digital.nhs.uk/catalogue/PUB22616