This report provides evidence-based practices for screening and assessment of adults in the justice system with mental illness, substance use disorders, or both. It discusses the importance of instrument selection for screening and assessment and provides detailed descriptions of recommended instruments. The DSM criterion related to continued use of the substance despite recurrent or persistent problems may not apply to many seniors who do not realize that these problems, such as depression, are related to alcohol use or misuse of prescription drugs. But a major hurdle across the care spectrum is that substance use disorder in older adults remains a hidden problem because of lack of screening in primary care and few guidelines for assessing older adults who might be using. Lehmann points out that it’s common for primary care providers, specialists and emergency physicians to prescribe opioids and benzodiazepines on a long-term basis.

It’s a big and sometimes scary step to take, and most people would prefer to skip it altogether if they could get sober independently. Since most people can’t, treatment is usually the answer, and it’s almost always the correct answer. And buprenorphine, naloxone, and methadone are used in opiate, methamphetamine, and heroin use disorders. BZD use disorder, specifically, needs to be medically supervised with a slow taper spanning at least four weeks.3 See table 2 for more information about the pharmacologic treatment. If you’re worried about an older loved one’s use of alcohol or drugs, talk to them about it. If that doesn’t work, consider asking their doctor, minister, or a longtime friend to approach them instead.

More help for substance use disorder in 2024

In fact, the number of older adults dying from alcohol-related causes rose by 18.2 percent between 2019 and 2020. It is possible to have a mild substance use disorder where you might still be able to control it on your own with family support or counseling. Other times it can be more severe and require professional help such as inpatient treatment or medication to recover. Early recognition and treatment are some of the best ways to help anyone struggling with substance abuse issues.

• Unfortunately, social isolation is common among older adults as family members and friends move away or pass away.
• Of course, slurred speech, smelling of alcohol, and change in physical appearance are all signs that a person needs help and treatment.
• A 2020 review of CBD research found that it is well-tolerated with few serious adverse effects but that interactions with other medications should be monitored closely.
• Trained Drug Abuse Warning Network (DAWN) staff reviewed medical records (charts) of emergency department (ED) visits on an ongoing basis at a nationally representative sample of hospitals to find drug-related ED visits that met the DAWN case criteria.
• The most common substances abused are alcohol, prescription drugs such as opiates and benzodiazepines (BZD), and over-the-counter (OTC) medications.

A key consideration in the treatment of older adults with SUD is that they often have co-occurring general medical illnesses (Wu and Blazer, 2014). Substance use can complicate the course and management of existing illnesses and they, in turn, can worsen the consequences of substance use and SUD. Societal norms tend to reinforce the perception that older adults do not have SUD (Kuerbis and Sacco, 2013). This belief can be internalized by older adults, leading them to avoid treatment. On the positive side, because individuals ages 65 and older are eligible for Medicare, insurance is less often a barrier to care. Some fell off the wagon after retirement or during the pandemic, when they suddenly had more free time and little structure and lost access to treatment because of shutdowns and fear of infection.

A Day in the Life of Older Adults: Substance Use Facts

With an estimated prevalence of 4%, substance abuse amongst persons who are 65 years and older is increasing. The most common substances abused are alcohol, prescription drugs such as opiates and benzodiazepines (BZD), and over-the-counter (OTC) medications. This increase is believed to be partially endorsed by the baby boomer generation, born between 1946 to 1964, who had significant exposure to alcohol and drugs at a younger age. Substance abuse is difficult to recognize in the older adults, but once identified, presents its own challenges as only 18% of substance abuse treatment programs are designed for this growing population.

Drug and alcohol abuse have impacted seniors in the United States as it has among younger Americans. Over 5,000 people ages 65 and over in the U.S. died of a drug overdose in 2020, and more than twice that many (11,616) died of alcohol-induced substance abuse in older adults causes. The data are featured in two new reports released today by CDC’s National Center for Health Statistics (NCHS). Many behavioral therapies and medications have been successful in treating substance use disorders in older adults.

Treating Substance Abuse in Older Adults

There is an unspoken but pervasive assumption that it’s not worth treating older adults for substance use disorders. There is an impression that alcohol or substance abuse problems cannot be successfully treated in older adults, there is the assumption that treatment for this population is a waste of health care resources. As people age, their bodies undergo changes that can affect their physical and mental health. Blood flow can decrease, and relationships between neurons can change, influencing cognitive function. Some experience a decrease in serotonin and dopamine, neurotransmitters responsible for regulating moods and emotions.

Health care professionals need to continue to do as thorough of assessments as possible and enlist the help of formal measures, Web-based assessment, and build in the questions outlined earlier as routine. As the baby boom generation ages, the health care system will be challenged to provide culturally competent services to this group, as they are a unique generation of older adults. Knowledge about older-adult substance use and the issues that contribute to late onset or maintained addiction in late life will need to be continually updated as we learn how and why this generation of adults uses substances.

Medical Marijuana

Alcohol and opioids can interact poorly with prescription medications that many older adults take for common conditions like hypertension, diabetes and mood disorders. Misuse can lead to falls and injuries, exacerbate underlying https://ecosoberhouse.com/ medical conditions and worsen declines in cognition. Therefore, the review of interventions discussed later is of those treatments for which there is some initial evidence of efficacy and/or effectiveness among this population.