Most older adults at risk for substance misuse do not need formal specialized SUD treatment. However, many clients can benefit from education to prevent problems before they occur. For instance, SBIRT that involves basic education as an intervention has been shown to help reduce older adults’ risky alcohol use.454,455 Educate clients on risky alcohol use as a prevention measure and an intervention. This section discusses examples of substance misuse screening instruments useful for older adults.
Changes in the Delivery of Mental Health and Substance Use Disorder Services
Further, negative mental health impacts have been more pronounced among several populations, including communities of color, young adults and children – populations which have historically experienced increased barriers to care. Finally, the COVID-19 public health emergency will end in May 2023, which may at least partially unravel steps taken toward delivering mental health services via telehealth and improving access to substance use disorder services. Unfortunately, chronic pain can also increase older adults’ risks of developing substance misuse issues.
Treating Substance Use Disorder in Older Adults: Updated 2020 [Internet].
For this reason, seniors who consume alcohol are at an increased risk for accidents, including falls, fractures, and car crashes. The Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institute on Drug Abuse (NIDA) collect various data pieces on how to better serve the elderly population that may be suffering from co-occurring disorders. Substance abuse, particularly of alcohol and prescription drugs, among adults 60 and older is one of the fastest growing health problems facing the country.
Conducting Full Assessments for Substance Misuse
There’s no “right or wrong way” for them to talk about their experiences. Tell clients that they can answer whichever questions they wish, however they wish. Use a checklist or question list to make sure you cover all possible traumas and substance abuse in older adults not just ones that are commonly thought of (like physical and sexual abuse). You can find more information about Adverse Childhood Experiences (ACEs) on the CDC’s website (/violenceprevention/childabuseandneglect/acestudy/index.html).
- It’s important to watch for signs and symptoms of depression or suicide.
- This is because substance use can often affect chronic pain in positive ways, even though the substance itself is harmful.
- Primary care providers, general internists, family medicine practitioners, trained pharmacists, advanced practice registered nurses, and physician assistants.
- Notably, self-harm and suicidal ideation has increased among adolescent females.
Make sure you know your state’s laws about responding to reports of abuse and self-harm. Older clients may be more likely to talk about physical symptoms than emotional ones. Decide whether medical conditions are present that need to be addressed during treatment. Make the right diagnosis (whether it be an SUD, a mental disorder, or a cognitive disorder).
Even if a person does not meet criteria for PTSD, experiencing a traumatic event at any point in one’s life raises the risk for substance misuse.398,399 As with any other clients, explore whether older clients have a history of trauma. The CAGE (Cut down, Annoyed, Guilty, Eye opener) Questionnaire is widely used to screen for risk of alcohol misuse. A “yes” response on any of the questions can mean substance misuse is present. However, the CAGE-AID does not ask about certain important aspects of substance use, including past substance use, frequency of use, and effects of using the substance.
The client might need a treatment provider who has experience working with older clients with cognitive problems. Individual treatment rather than group treatment might also be a better choice. Clients who have SUDs may have mixed feelings about whether they can, or even want to, stop using substances.
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.
- 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.
- If a client answers “yes” to the question about using illegal drugs, follow up by giving a slightly longer screening tool called the NIDA-Modified ASSIST V2.0.
- This test measures a person’s ability to stand from a sitting position, walk a short distance (10 feet), turn around, and walk back to where the individual was sitting.
Who Is Most at Risk?
- Assessment of skills used in everyday living, like dressing, bathing, shopping, and managing money.
- This makes them more vulnerable to risky behaviors like substance misuse.
- Stressing the importance of continuing with treatment when discussing progress with the client.
- « The aging process is complicated and many people struggle with health-related concerns that take an emotional and physical toll, » Dr. Bulat says.