Taking steps now will also help prepare for the growing numbers of older adults who will need MH/SU services in the future. There also exist disparities in completion of substance use treatment programs. Suntai et al. found that, among older adults, Black older adults were 37% less likely to complete a substance use treatment program than Whites, while Hispanic older adults were 26% more likely to complete a substance use treatment than Whites 84. These results are similar to the results shown in studies of younger adults, suggesting that racial disparities must be addressed in substance use treatment across ages. Healthcare professionals must acknowledge cultural barriers in order to increase completion of substance use treatment programs in older adults.
Depression Screening
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) single-item screener is a single question used to screen for unhealthy alcohol use that has been validated in the primary care setting. It asks patients how many times in the past year they have had five (for men) or four (for women) or more drinks in a day 12. However, it is important to note that the NIAAA also recommends that adults age 65 or older limit their alcohol consumption to 1 standard drink per day or 7 standard drinks per week with no more than 3 drinks per occasion 13. Recognizing this growing concern, Wellbridge offers treatment and support to seniors battling addiction and dual diagnosis issues.
Co-Occurring Mood Disorders
This can happen when older adults have access to different medicines prescribed by multiple doctors. When patients abuse their drugs – either intentionally or accidentally, it increases their risk of developing addictions. Family members and physicians need to educate seniors on proper medication usage and side effects so they can avoid any potential misuse down the line. When seniors lack meaningful relationships or become socially isolated, it can lead to feelings of loneliness, which increases their risk for developing mental health issues like depression – all of which can contribute to higher rates of substance abuse. According to Office of State Budget and Management 2013 Facts and Figures Report, 20% of substance abuse in older adults adults were over the age of 60.
Outpatient Treatment
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 https://ecosoberhouse.com/ 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. Substance abuse overall may increase the risk of fractures secondary to recurrent falls, memory loss, sleep disturbances, anxiety, and depression. In this article, we will review the signs and symptoms, risk factors, screening tools, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria, and challenges of treating substance abuse in the older adults.
- Brief interventions use motivational interviewing principles and nonjudgmental language, eliciting the potential to change and/or consider change.
- If you answered “yes” to any of these questions, you may want to assess the client for fall risk.
- Furthermore, recent cohorts of individuals ages 65 and older tend to show a higher prevalence of lifetime substance use than that seen in prior generations (Chhatre et al., 2017).
- Substance use disorders are characterized by intense, uncontrollable cravings for drugs and compulsive drug-seeking behaviors – even in the face of devastating consequences.
- A study of anxiety among older adults in seven countries (China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru) also found that urban-dwelling older adults were nearly three times more likely than their rural counterparts to experience anxiety.
- Some people naturally feel more comfortable sharing information in writing than verbally.
- However, using these drugs as prescribed by a doctor does not seem to exacerbate this risk.
- For instance, because older adults metabolize drugs more slowly than young people, those who undergo medical detox may need to remain in this treatment phase longer than other participants.
- Some will not be available in many localities, but online and telephone meetings may be available.
- A “yes” response on any of the questions can mean substance misuse is present.
Furthermore, the use of biologic screening (ie, laboratory tests) has limited utility and can be problematic in older adults, as isolating impaired bodily functions (ie, liver function) as the result of alcohol or other substances versus prescribed medications may be difficult. Each of the instruments listed next have strengths and weaknesses related to resources required to implement them or applicability to older adults. Older adults may be more likely to experience mood disorders, lung and heart problems, or memory issues. Drugs can worsen these conditions, exacerbating the negative health consequences of substance use.
Older Adult Mental Health
- The exact link between these issues remains unclear, but many researchers believe that people with mood disorders often use substances as a form of self-medication.
- Your practice should also identify steps to take when screening tests are positive (see the section “Communicating Screening Results”).
- This section discusses examples of substance misuse screening instruments useful for older adults.
Efforts to increase older adults’ access to psychosocial interventions for MH/SU problems should focus on integrating ageing, health, and MH/SU services and using technology to deliver services. Information on MH/SU screening and assessment tools and evidence-based psychosocial interventions should be disseminated to health clinics and social care settings serving older adults. The US Institute of Medicine recommends that all primary care clinicians, nurses, care managers, allied health care professionals, and social service providers who care for older adults receive training in Halfway house evidence-based treatment of MH/SU disorders17. Successful programmes in India, Chile, Pakistan, and Uganda18,19 also point out that clinical capacity can be increased by developing a workforce of health coaches and lay community health workers trained to provide screening and brief interventions for geriatric MH/SU disorders. Telemental health services can provide treatment and prevention to patients in remote locations at substantially lower costs with significantly fewer service providers. Telemental health services also address the strong stigma older adults often hold about MH/SU problems, since they can receive help in the privacy of their home.
Choose a method for drug and alcohol screening that you can use with all older clients. Be aware of your beliefs about/attitudes toward older clients that make you not screen for substance misuse. Chapter 3 offers a wide range of information and strategies to help you screen, assess, and treat older clients for substance misuse.
Mixing alcohol and psychoactive medications such as benzodiazepines, sedatives, and opioid analgesics has the potential for very serious negative outcomes that prescribing physicians should discuss with older adult patients. These older clients can come to session with issues that present similarly to common mood disorders such as depression, anxiety, post-traumatic stress disorder, or even bipolar disorder, when in reality, there is a veiled issue of co-occurring substance abuse just under the surface. Therapists or counselors may be met with challenges of stigma, denial, or even anger if older clients are not met with person-centered language and strategic intervention including thoughtful and discerning assessment. Referral to mental health services is appropriate if the severity or type of mental illness is beyond what you can treat.