Alcohol use and alcohol-use disorders among older adults in India: a literature review.

OBJECTIVES: With changing attitudes to alcohol and an increasing life span in India, the prevalence of alcohol use and misuse in successive cohorts of older people is likely to increase. In this paper, we attempt to review the most recent evidence covering alcohol use and alcohol-use disorders in the Indian elderly. METHODS: PubMed, PsycINFO and Indmed databases were searched using relevant keywords. Papers meeting eligibility criteria were selected through a sequential process of screening title, abstract and full text. Data were extracted into Excel sheets. RESULTS: There was a dearth of pan-national studies. There were several methodological issues with many studies especially related to measurement. A substantial proportion of individuals above the age of 50 years are current consumers of alcohol and the prevalence is generally higher in urban compared to rural areas. Older women are generally likely to be alcohol abstainers. The general trend appears to be a reduction in current drinking among successive age cohorts over the age of 50. Alcohol consumption in the older adults is associated with educational status, health status, chronic morbidity, employment status, socioeconomic status, auditory/locomotor impairment and asthma. CONCLUSION: Alcohol use and misuse is a problem among the Indian older adults. With socio-demographic changes that will further increase longevity, this problem is likely to increase and policy-makers need to plan for it. Future research needs to improve validity and reliability in study methodology, as well as add to the current evidence base

Awareness of the need for safe storage of Methadone at home is not improved by the use of protocols on recording information giving

<p>Abstract</p> <p>Background</p> <p>Methadone is a synthetic, narcotic analgesic used in the treatment of drug misuse. Tragedies involving children being poisoned by the accidental ingestion of methadone are no longer a rare occurrence. Following an audit of the effectiveness of the provision and recall of information to patients attending an NHS Methadone Clinic a protocol was introduced to ensure that staff documented the provision of such information and patients gave a written confirmation that they had received the information.</p> <p>Methods</p> <p>The study was undertaken in the setting of an NHS methadone clinic with the aim of re- auditing the storage of methadone at home following the introduction of the new protocols. 174 patients completed an anonymous questionnaire regarding where they store methadone at home and whether they recall being given advice about safe storage. Community pharmacists were contacted by telephone to assess the level of advice given to methadone patients regarding safety.</p> <p>Results</p> <p>Only 49 (28.2%) patients recalled being given advice about safe storage, 24 (13.8%) recalled that information was provided by clinic staff. 170 (97.7%) patients regard methadone as being dangerous. (28.2%). Methadone is most commonly stored in a cupboard (37.9%). All methadone is dispensed in a bottle with a child resistant cap on it. All patients reported they stored their methadone in the original bottle provided by the pharmacist.</p> <p>Conclusion</p> <p>Recall of information on safety issues is very poor. Provision of written as well as verbal information is needed. The use of printed safety information cards which patients can take away for future reference may be of use. It is the responsibility of health professionals to ensure they provide information and advice to methadone users on the safe storage of their methadone at home.</p

Epidemiological issues in mental health-substance use:a case for a life course approach to chronic disease epidemiology

This chapter identifies problems with definitions and other basic methodological considerations when studying the epidemiology of comorbidity. Mental health and substance use problems are a major public health issue. Pressures on health services and the emergence of competing approaches, such as the organisation of mental health services, have both served to emphasise this burden. Many people reporting substance use have experienced mental health problems at some point in their lives, and many individuals with a mental health problem have a history of past or current substance use. Professionals face a particular challenge from mental health-substance use problems, as they combine to produce greater impairment of function and poorer health outcomes than a single diagnosis alone. Life course epidemiology in mental health-substance allows investigators to start testing for intergenerational exposure disease association. Mental health-substance use conditions tend to present with more severe mental health problems.</p

Epidemiological issues in mental health-substance use:A case for a life course approach to chronic disease epidemiology

This chapter identifies problems with definitions and other basic methodological considerations when studying the epidemiology of comorbidity. Mental health and substance use problems are a major public health issue. Pressures on health services and the emergence of competing approaches, such as the organisation of mental health services, have both served to emphasise this burden. Many people reporting substance use have experienced mental health problems at some point in their lives, and many individuals with a mental health problem have a history of past or current substance use. Professionals face a particular challenge from mental health-substance use problems, as they combine to produce greater impairment of function and poorer health outcomes than a single diagnosis alone. Life course epidemiology in mental health-substance allows investigators to start testing for intergenerational exposure disease association. Mental health-substance use conditions tend to present with more severe mental health problems.</p