Understanding these effects is crucial in developing effective treatment approaches for this population. In the next sections, we will explore the impact of substance abuse on older adults, approaches to treatment, challenges in treatment, and the importance of support systems in addressing substance abuse in this population. Use of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria alone to diagnose SUD in older adults is difficult and lacks accuracy. The DSM-5 criteria are not relevant to biologic and social factors seen in aging older adults.
Recovery Management
As substance use among older adults continues to rise, effective screening and diagnosis will become increasingly critical. The benefits of early detection and treatment of SUDs can have dramatic implications for overall physical and mental wellbeing in older adults. When examining SUD treatment admissions, patients were mostly referred by an individual (patient or other non-provider) or the criminal justice system. Healthcare providers accounted for only 12.8% of referrals for older adults to substance abuse treatment programs, perhaps suggesting that there is room for improvement in the screening and discussion of SUDs in older adults 6. While office assessment through history taking might elicit discussion of substance use, this is limited by patient discomfort with reporting stigmatized behavior; however, barriers to more formal screening include lack of time and challenges integrating screening into clinic workflow 7.
PREVALENCE OF SUBSTANCE USE AMONG OLDER ADULTS
According to the NIAAA, men and women aged 65 or older should consume no more than 1 drink daily and a maximum of 2 drinks on any occasion. Once an addiction is identified, it is critical to seek out a treatment center that has specific experience working with seniors facing addiction. Barb’s group counseling at the older adult program includes focused topic groups for older adults, relapse prevention coping skills groups, and a DBT group. The DBT group teaches her mindfulness skills for distress tolerance, emotional regulation, and effective interpersonal interactions.
How do I pay for recovery care?
For an AUD diagnosis, your client must have at least 2 out of 11 symptoms listed in DSM-5. Exhibit 4.3 summarizes the physical, cognitive, and social aspects of aging you should think about when using these criteria to assess and diagnose AUD in older adults. Researchers at the University of Michigan developed the MAST-G, a 24-item screening instrument specifically for use with older adults. Education about low-risk levels of alcohol use and about alcohol-drug https://www.maranhao.classijobs.com.br/sober-living/high-functioning-alcoholism-what-you-need-to-know interactions can be a powerful brief intervention as well as a prevention tool in keeping seniors safe. In addition to societal stigma, there may be personal barriers that older adults face when seeking treatment.
In addition, many physiological changes naturally take place during the aging process; clients need to understand that drinking can accelerate these health-related changes. The sixth section presents clinical scenarios to show how to match treatment approaches to a client’s level of alcohol misuse, from those who are abstinent (not drinking at all) for health reasons to those with AUD requiring inpatient rehabilitation and ongoing recovery management. In addition to family and social support, there are numerous community resources available marijuana addiction to older adults seeking treatment for substance abuse.
Medical Marijuana
- Older adults may face specific challenges, such as stigma, comorbidity, and the need for additional support systems.
- In addition, many physiological changes naturally take place during the aging process; clients need to understand that drinking can accelerate these health-related changes.
- This medication can be used off-label for alcohol use disorder, as studies have found it to help with mild alcohol withdrawal syndrome and neuropathic pain 46, 47.
- There exist numerous screening and diagnostic tools for alcohol and substance use in the general population; however, these tools must be validated in the geriatric population due to the unique social characteristics of older adults.
By combining medical interventions with behavioral therapies, treatment providers can offer comprehensive and individualized care to support older adults on their journey to recovery. On the other hand, having strong social connections can improve mental health and reduce the risk of substance use disorders. Studies have found that increased social interaction among seniors has been linked with positive outcomes such as improved cognitive functioning and lower rates of depression and anxiety. 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.
What types of treatment options are available?
Even though more people recognize the need for older adult-focused addiction treatment, most clinics haven’t yet made that shift. This study highlights the key challenges, like lack of staff training, limited medical services, and insurance barriers, that need to be addressed. Substance use disorders (SUDs) in adults aged 50 and older are one of the fastest-growing health problems in the U.S. Between 2000 and 2020, the number of older adults with SUDs rose from 1.7 million to 5.7 million, partly because the “Baby Boom” generation has had higher rates of drug use across their lives than previous generations. There are a variety of treatment options available to older adults, each providing unique strategies to support recovery.
Identifying Substance Abuse & Addiction in Seniors
- This would lead to more person-centered care and decrease the need for multiple appointments, which can be particularly challenging for older adults.
- The brain does not finish developing until an individual reaches their mid to late 20s.
- Substance use disorders are becoming increasingly prevalent in the geriatric population, necessitating an updated understanding of the existing literature.
- 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.
His PCP refers him to a geriatric psychiatrist for medication management of his major depression. Carl currently takes one tricyclic antidepressant—which, when taken with alcohol, increases his risk for oversedation and low blood pressure—and a blood pressure medication, which can lower his blood pressure even more. The psychiatrist gives Carl the clinical interview version of the AUDIT as part of the initial psychiatric evaluation. Carl’s score on the AUDIT is a 9 and includes positive responses to daily drinking and binge drinking about once a month. As part of the health history questionnaire, which includes the AUDIT, George says that he does not currently drink, but he was injured earlier because of his drinking.
It’s essential to understand why seniors are increasingly suffering from addiction so we can better prevent it in older adults. The questions can be adapted to a specific substance, such as a prescription medication, and they can be asked either in the substance abuse in older adults context of an interview or self-administered. Psychometric properties of the CAGE-AID have not been reported, yet the CAGE has been extensively studied. Because of the brief nature of the CAGE-AID, it can be a useful screening tool; but it should not be a substitute for a more thorough assessment, such as consumption levels, consequences of use, and functional deficits.
For example, certain medications used to treat substance abuse may interact with medications prescribed for other conditions. Additionally, the physical and psychological effects of substance abuse can exacerbate existing health issues. Treatment for AUD is offered in more settings than just specialty addiction programs. Primary care professionals can offer medications for AUD along with brief counseling.
- MAT involves the use of medications to manage withdrawal symptoms, treat co-occurring disorders, and reduce cravings.
- On the other hand, having strong social connections can improve mental health and reduce the risk of substance use disorders.
- In rehab, seniors can acquire the skills needed to stop substance abuse and carry on healthy and productive lives.
- Give the person in your life an opportunity to connect with peers and contribute to the health and well-being of others.
- This tool has many of the advantages of the CAGE, such as ease of administration and low cost.
Barb is carefully watched throughout detoxification at the facility; she is then transferred to the rehabilitation program, which includes an age-specific track for older adults. All too often, spouses of people who misuse alcohol drink as a shared social activity with their spouse. For older spouses, this can easily turn into their own health risk behavior, particularly if, to reduce the stress of being a caregiver, they take medication that negatively interacts with alcohol. The following scenario focuses on the importance of assessing family members’ alcohol and medication use while at the same time addressing their needs as caregivers.