Substance Use in Older Adults DrugFacts National Institute on Drug Abuse NIDA

Thinking about the role of chronic physical conditions in older clients’ misuse of substances (e.g., use of substances to manage chronic pain). Such conditions can also affect symptoms of substance misuse and treatment response. Some health experts have called older adults who misuse substances an “invisible” population.307,308 Although older adults have frequent medical visits, behavioral health or healthcare providers often do not recognize substance misuse in their older clients. Most brief interventions are described as using aspects of motivational interviewing (MI)118 or motivational enhancement therapy (MET),119 which encourages a client-centered, nonjudgmental approach to discussing substance use and encouraging positive, healthy changes to the individual’s life. Older adults may be more likely to experience mood disorders, lung and heart problems, or memory issues.

If you answered “yes” to any of these questions, you may want to assess the client for fall risk. Remember the importance of helping clients feel safe physically and emotionally. In addition, ask about periods following treatment where clients were successful (e.g., what worked for them). Reasons for starting and continuing to use the substance, which may change over time.

Opioid Pain Medicines

Seniors take more prescription medications than younger adults, increasing the risk of misuse and harmful interactions. A community-based cross-sectional study of 3005 persons between the ages of 57 and 85 found that 36% of women and 37.1% of men used at least five prescription drugs concurrently. The study also showed that about 1 in 25 of those surveyed faced a high risk of a drug interaction. The misuse of prescription medications is another prevalent issue among seniors since they often have access to different medicines prescribed by multiple doctors.

substance abuse in older adults

Substance misuse can make everyday living even more difficult, including ADLs and instrumental activities of daily living (IADLs). ADLs are basic everyday tasks like dressing, using the toilet, using the phone, and feeding oneself. As part of assessing substance misuse, measure clients’ ability to complete substance abuse in older adults ADLs and IADLs without help. Past-year PTSD occurs in only about 0.4 percent to 2.6 percent of people ages 65 and older.401,402 Many people with trauma do not meet criteria for PTSD but do meet criteria for depression.403
Thus, depression screening is important in older clients who misuse substances.

The Impact of Prescription Drugs​

Make sure you have the required training and credentials or licensure before performing screening, assessment, or diagnosis. If no providers in your program have appropriate licenses or credentials to screen, assess, or diagnose clients for mental disorders, refer clients to another program for those needs. Also make sure you review the training requirements on administration and scoring; formal training may be required prior to using some instruments.

Because of the diagnostic challenges outlined earlier, the MAST-G focuses more on potential stressors and behaviors relevant to alcohol use in late life, as opposed to questions toward family, vocational, and legal consequences of use. This tool has many of the advantages of the CAGE, such as ease of administration and low cost. Although useful as an indicator of lifetime problem use, it lacks information about frequency, quantity, and current problems important for intervention. Brief screening instruments can assess the level of risk caused by alcohol and drugs. Some screening tools are adaptations of instruments created for younger adults, and others have been designed for older adults. Interview screening tools or global selfreport measures are less intrusive or burdensome to the older adult than blood or urine tests.

Guide to Substance Abuse in Older Adults: Risks, Warning Signs, and Treatments

As a result, the elderly have higher blood alcohol concentrations than younger adults, suffer more significant impairment, and are less aware of it. Alcoholism in the elderly is more likely to cause functional impairment, compromising their ability to perform everyday tasks such as shopping, cleaning, and cooking. Moreover, they can unknowingly become addicted to these medications, making it another cause of substance abuse in the elderly. Here are a few key factors contributing to the growing substance abuse problem among seniors. Increased Sensitivity to Alcohol
Aging can lower the body’s tolerance for alcohol.

These include various levels of care and different substance abuse services. However, research on mental health among older people indicates that when these adults do experience mood disorders, they experience more negative health outcomes as a result. Generally, older adults are less likely than young people to misuse drugs and alcohol. As people age, factors such as risk-taking behavior decline, providing some protection against addiction. Calls to our general hotline may be answered by private treatment providers.

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