Weekly Health Digest: Rising Alcohol Consumption and the Ethics of Extending Cancer Chemotherapy

Why are older Americans drinking so much? 

By Paula Span, New York Times

Alcohol-related deaths are becoming increasingly more common. In particular, the relationship between older populations and alcohol over-consumption is troubling. A National Institute on Alcohol Abuse and Alcoholism study showed that people above 65 comprised 38% of alcohol-related deaths in 2020. 

These increasing numbers may be partly explained by our increasing older population, but this doesn’t tell the whole story. Over the past decade, the number of older Americans who binge drink has sky-rocketed by 40%. Even though older people report drinking less than other age groups, those who do drink are often drinking large quantities of alcohol. 

Experts posit that some of this increase may be due to the COVID-19 pandemic. People have been more isolated and have been experiencing intense stressors. Additionally, higher alcoholism rates in older people may come down to drinking attitudes. Keith Humphreys, a psychologist at Stanford, described Boomers as a generation with more substance use than other generations. 

It’s important to note that alcohol can have more intense effects on older bodies. It increases the chances of cardiovascular issues, as well as falls. Alcohol can also react badly with prescription drugs, which older people are more likely to be taking. Currently, Medicare doesn’t have to provide the same coverage for mental health treatment as for other medical concerns. Reform must be undertaken to make alcoholism treatment more accessible to older people.

— by Lydia King

Cancer patients often want ‘one more round.’ Should doctors say no?

By Mikkael A. Sekeres, The Washington Post

Dr. Sekeres is faced with the dilemma of administering another round of chemotherapy treatment, or realizing treatment is futile. His patient, diagnosed with Leukemia five years prior, has been in and out of remission. Oncologists are known to be willing to recommend treatment, even if its rate of success is low. Statistically, 39 percent of cancer patients receive treatment within 30 days of death, and 17  percent within two weeks. To combat this, the Center for Medicare and Medicaid (CMS) has put a payment incentive. If a patient receives chemotherapy treatment within two weeks of death, it is deemed a poor quality indicator and can negatively impact payment. Despite CMS’s efforts, patients receiving cancer treatment towards the end of life have increased. Cancer patients who receive treatment within the last two weeks are more likely to be admitted to the hospital or ICU and have worse quality and duration of life. 

With all of these reasons pointing towards not administering care, oncologists still do not want to have to face a patient and tell them there is no hope. Physicians never want to tell their patients that there is no treatment left, but administering toxic and futile therapies also can negatively impact the patient. Overall, a patient’s autonomy to decide their end-of-life care, whether that includes continued treatment is what is most important.

— by Caroline Hansen

Items summarized by: Lydia King, Caroline Hansen