Research supports involving clients with SUDs in treatment decision-making processes.539 In some cases, matching clients’ substance-related treatment preferences has led to improved outcomes.540 However, shared decision making in the context of SUDs can be challenging. Clients who have SUDs may have mixed feelings about whether they can, or even want to, stop using substances. Knowing how to keep older adults interested and willing participants in the screening and assessment process (e.g., knowing what to say to older clients and how to say it). Before assessing for depression and PTSD, make sure you have a safety plan in place. This will help you respond appropriately to any client’s reports of abuse and self-harm.
- If detoxification is needed, that will be the first referral indicated, whether inpatient or outpatient.
- Make sure your primary doctor has a list of all the medications you take, even over-the-counter ones.
- “More than 80,000 people are dying of a drug overdose involving an opioid every year, while safe and effective medicines to treat opioid use disorder are sitting on the shelf unused.
- Although rare, age-specific treatment settings and programs may provide the most effective care for older clients.
Alcohol and Drug Use Screening
Chapter 3 of this Treatment Improvement Protocol (TIP) will most benefit providers. It discusses identifying, screening for, and assessing substance misuse in older clients. In the United States and elsewhere, more and more people ages 50 and older struggle with substance misuse, but many providers do not screen for, diagnose, or treat substance use disorders (SUDs) among this population. One reason is older adults disapproval of and shame about use and misuse of substances and a reluctance to seek professional help for what many in this age group consider a private matter.
Treating Substance Abuse in Older Adults
- This would lead to more person-centered care and decrease the need for multiple appointments, which can be particularly challenging for older adults.
- Understanding what steps to take in offering effective care or referral for care is a cornerstone of good clinical practice.
- Also, some individuals find treatment facility alumni programs helpful in supporting their recovery from SUDs.
- This type of disorder is particularly concerning when it affects seniors, as they can be especially vulnerable to the consequences of drug addiction.
- One of the primary reasons older people struggle with substance use disorders is a decrease in family support and social interaction as they age.
- This information will help you differentiate among substance misuse, CODs, physical conditions common in older populations, and symptoms of normal aging.
One way to think about the challenges of aging is to understand that with age comes a broad spectrum of losses and transitions that may be traumatic for the older adult. Work from a perspective of trauma-informed care, which assumes that older clients’ presenting issues, behaviors, and emotional reactions may be adaptive responses to trauma or loss and not symptoms of pathology. Older adults in recovery from substance misuse who are widows or widowers may feel guilty about surviving and lose interest in life.
Alcohol and Older People
It is important to recognize that the number of older adults who engage in unhealthy substance use is increasing dramatically, and present unique challenges for prevention and screening. There are unique physiologic and social changes with aging that need to be considered in screening older adults for unhealthy substance use behaviors, and providers need to be mindful the language used when talking about substance use and SUDs with their older patients. Finally, the potential harms of substance use in the setting of an increase in chronic medical diseases, geriatric conditions, and medication use needs to be better understood, and should be an area of priority in research. The high prevalence of isolation in older adults who misuse substances can negatively affect cognitive functioning and reduce well-being. Older adults who lack family ties or social networks may find maintaining recovery from substance misuse difficult. Healthcare, behavioral health service, and social service providers can help older adults who misuse substances reduce isolation and improve recovery outcomes by promoting broader social networks.
- Client education is a process of information exchange over time, not a single event.
- Nurses or occupational therapists, rather than behavioral health service providers, usually give assessments of ADLs and fall risk.
- Health care provided by physicians with experience and training in geriatric medicine.
- It’s essential for family members and health care providers to be aware of this risk factor so they can take steps to prevent it in their loved ones.
Connecting your older clients with recovery supports when the urge to drink or use drugs arises. Recognizing that your older clients who have experienced the death of a spouse or intimate partner are at higher risk for starting or returning to alcohol misuse or drug use. Also, some individuals find treatment facility alumni programs helpful in supporting their recovery from SUDs. what is the best treatment for substance abuse for older adults Alumni programs typically offer graduates of the same treatment facility ongoing support through organized activities, continued contact with treatment staff, and further addiction education. Active linkage to and follow-up with community-based resources, such as housing and employment services (when needed); senior centers; and fitness, health, and wellness services for older adults. The Self-Management Resource Center () offers a variety of illness self-management programs, including an online program, originally developed by and housed at the Stanford Patient Education Research Center.
The provider says, “You told me that when you first got into recovery, you felt a lot of shame. Ruth is 69 years old, is in long-term AUD recovery, and has attended AA for many years. She became the General Service Representative of her home AA group and sponsored many members over the years. Ruth frequently tells people that “smoking is a bad habit I picked up at meetings.” She recently stopped after she was diagnosed with chronic obstructive pulmonary disease (COPD). Ruth’s pulmonologist referred her to counseling at the hospital’s outpatient program given her score of 12 on the Patient Health Questionnaire, indicating moderate depression.
Treatment Planning
Older adults have higher rates of chronic pain, and opioid prescription fill rates were disproportionately higher among adults aged 65 years or older from 2008–2018 55. Han et al. found that, among adults 65 years and older, an estimated 1.2% reported past-year prescription opioid misuse in 2015–2016 56. “More than 80,000 people are dying of a drug overdose involving an opioid every year, while safe and effective medicines to treat opioid use disorder are sitting on the shelf unused.
In addition to this, only 18% of substance abuse treatment programs are specifically designed for the geriatric population. Older adults face unique barriers to treatment such as social isolation, limited mobility, financial problems, transportation issues, and shame regarding substance use 5. Choi et al. found that lack of readiness and cost/limited insurance were the most frequently mentioned barriers to treatment among older adults 85. The abundance of missed opportunities for screening and treating older adults with substance use problems will have devastating consequences if they are not appropriately addressed moving forward. Alcohol, tobacco, and SUDs are a major public health issue contributing to a devastating increase in overdose mortality, health care costs, and suffering for individuals and their communities.
Overdose Prevention
Unfortunately, chronic pain can also increase older adults’ risks of developing substance misuse issues. As they age, people may experience more aches and pains and seek out medications – both prescription and over-the-counter – to relieve their discomfort. Up to a quarter of all prescription drugs in the U.S. are used by older adults, and this increased exposure to drugs increases the risk of addiction or other negative consequences. Maintaining recovery from substance use can be harder for older adults who have trouble understanding and using health information. It may also be more difficult for those with limited self-management skills (e.g., difficulty engaging in regular exercise, healthy eating, or medication adherence).
Health Care Providers
More research should be done to evaluate the efficacy of such therapeutic modalities specifically in older adults.
