Recent research has found that people addicted to cocaine in their youth may have an accelerated age-related decline in temporal lobe gray matter, which increases their risk of addiction. This is because cocaine use during adolescence and young adulthood can cause brain structure and function changes that persist into later life. Here are a few key factors contributing to the growing substance abuse problem among seniors.

NSDUH data are collected through face-to-face, computer-assisted interviews at the respondent’s place of residence. TEDS is a nationwide compilation of data on the demographic and substance use characteristics of admissions to substance abuse treatment. TEDS data are reported to SAMHSA by state substance abuse agencies and include information on admissions aged 12 and older to facilities that receive some public funding. DAWN was a public health surveillance system that monitored drug-related morbidity and mortality.9 DAWN used a probability sample of hospitals to produce annual estimates of drug-related ED visits for the United States and selected metropolitan areas. When assessing or speaking to older adults about substance use, some general considerations should apply. Of particular concern, more than one half of respondents who reported past–30-day prescription drug misuse reported using the drugs alone.

TIP 42: Substance Use Treatment for Persons With Co-Occurring Disorders

Being married, of minority racial or ethnic ancestry, having attained less than a high school education, and earlier age of SUD onset also tend to lower treatment rates (Blanco et al., 2015). Lack of knowledge about services available can also impede treatment-seeking among older adults (Choi et al., 2014). By contrast, having had previous treatment contact for SUD tends to increase the probability of seeking treatment for another SUD. Family, friends, and doctors often don’t know when older people have a problem with alcohol and drugs.

• This report provides evidence-based practices for screening and assessment of adults in the justice system with mental illness, substance use disorders, or both.
• Reducing stress and promoting mental health among adolescents might lessen motivations for substance use.
• Provides information about the scope of substance use in older adults, the risk factors for substance use disorders in…
• Although alcohol caused very few deaths in this age group, the rates have increased in recent years.
• Unfortunately, social isolation is common among older adults as family members and friends move away or pass away.
• This trend concerns family members of older Americans, as well as healthcare providers and social workers who work with this vulnerable population.

Overall, the most common reasons adolescents reported for using substances were to feel mellow, calm, or relaxed (73%), to have fun or experiment (50%), to sleep better or to fall asleep (44%), to stop worrying about a problem or to forget bad memories (44%), to make something less boring (41%), and to help with depression or anxiety (40%). Because comorbid psychiatric disorders, such as anxiety, depression, and personality disorders, are common and recognized among younger adults, it is assumed that these comorbidities also continue into late life. For example, older adults may be more likely to disclose depressive symptoms and present to primary care settings rather than mental health or substance abuse treatment settings. Unfortunately, chronic pain can also increase older adults’ risks of developing substance misuse issues.

Symptoms of Substance Abuse

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. Problem substance use is characterized by those individuals who are already experiencing problems in the aforementioned areas as a result of their use.

As a result, older adults are more likely to be referred to SUD treatment from other sources such as community social service providers than from healthcare providers (Sahker et al., 2015). The 2018 NSDUH estimated that for adults ages 65 and older the prevalence of alcohol, tobacco, cannabis, and opioid (including prescription opioids) use in the past twelve months were 43 percent, 14 percent, 4.1 percent, and 1.3 percent, respectively. The twelve-month prevalence of alcohol use disorder (AUD) and drug use disorder (DUD) (the NSDUH does not publish disaggregated information on specific drugs for adults ages 65 and older), were 1.6 percent and .4 percent, respectively.

Resources for Older Adults

This type of treatment offers a safe, structured environment with constant access to medical professionals, counselors, and other mental health professionals with expertise in treating older adults suffering from addiction. https://ecosoberhouse.com/ Hand-in-hand with prescription drug misuse is the prevalence of chronic pain in aging populations. Chronic pain is a common issue among senior citizens and can seriously impact their overall quality of life.

Because of small sample sizes, “average day” estimates of crack, heroin, hallucinogens, and inhalants could not be produced. The data used in the “average day” estimates are not collected for the nonmedical use of prescription-type pain relievers, tranquilizers, stimulants, and sedatives; therefore, those estimates are also not presented. 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. Lehmann hopes further research on older adults with substance use disorders will lead to better-targeted screening methods and new models of care.

The Michigan Alcohol Screening Test-Geriatric Version

Better integration of SUD and general medical treatment, and increased attention to social determinants of health, are important future directions for research and treatment of SUD in elders. Mental health conditions such as depression or anxiety can affect how a person perceives and responds to stimuli, making them more vulnerable to risky behaviors like substance misuse. Seniors with co-occurring psychiatric disorders may be more likely to try drugs or alcohol as a means of self-medicating to cope with their symptoms. It’s essential for family members and healthcare providers alike to be aware of this risk factor so they can take steps to prevent it in their loved ones. As with younger populations, formal substance abuse treatment of older adults is provided on a continuum of intensity depending on problem severity, ranging from detoxification to outpatient treatment or aftercare.44 All treatment plans should be individualized and flexible according to the specific needs of the client. Because of the unique issues facing older adults, both individual and group treatments are recommended.

The ASSIST has yet to be validated among older adults, and there is at least anecdotal evidence that it underperforms in this population in part because of the same limitations with a formal DSM diagnosis; the criteria do not apply in the same way for older adults as they do with younger adults. This guide helps professional care providers and administrators understand the role of culture in the delivery of mental health and substance use services. It describes cultural competence and discusses racial, ethnic, and cultural considerations.

Statistics on Seniors and Substance Abuse

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. Furthermore, the advancement and development of interventions that may be more useful for, effective for, and desired by this incoming generation of older adults than previous generation, such as mobile interventions, will be crucial to alleviating the projected pressures on the health care system.

Harm reduction education specifically tailored to adolescents has the potential to discourage using substances while alone and teach how to recognize and respond to an overdose in others, which could thereby prevent overdoses that occur when adolescents use drugs with friends from becoming fatal. Public health action ensuring that youths have access to treatment and support for mental health concerns and stress could reduce some of the reported motivations for substance use. These interventions could be implemented on a broad or local scale to improve adolescent well-being and reduce harms related to substance use.