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The nature of alcohol use in New Zealand is changing. Youth, for a long time the focus of our attention, are reducing their consumption. Conversely, older adults, long assumed a population of low-level drinkers, now show a rise both in hazardous drinking and alcohol-related risk.

An editorial in the New Zealand Medical Journal draws attention to a 2015 Health Promotion Agency (HPA)-funded study led by Massey University’s Health and Ageing Research Team and the University of Auckland Centre for Addiction Research to explore drinking patterns, predictors and harms in older New Zealanders. This found alcohol to be the drug of choice for the ageing ‘Baby Boomer’ generation, which is likely to lead to more hazardous drinking and alcohol-related risk for this age group.

Our health system, particularly primary care, needs to adapt to this change, say the authors. This requires not only asking older adults about alcohol but understanding the degree to which even low-level consumption patterns raise risk of harm for those with comorbidities.

The editorial outlines how a three-module HPA-funded pilot project, now underway in Whanganui, may help address the problem.  First, this project integrates alcohol-related risk factors from a screening tool sensitive to older adults within an e-screening process to automatically identify those whose combined drinking, health and medication use place them at risk of harm. Second, this project integrates training in motivational interviewing based on Matua Raki’s Takitaki Mai guide to improve practitioner confidence in initiating and managing alcohol-related conversations with Māori and non-Māori populations. Third, a case study of the development, initiation and outcomes of this pilot project will—if successful—offer a blueprint for other district health boards to support the roll-out of this enhanced alcohol screening and management process for older drinkers.

This HPA-funded pilot is a first step in the process, say the authors. Changing our attitude towards, and understanding of, alcohol use in later life is a culture change that will take a lot longer.

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