Substance Use Disorders

Substance Use Disorders

Many people think that alcohol are drug abuse and dependence are a problem of the young. However, there are as many older adults hospitalized for alcohol-related problems as for heart attacks (Weintraub et al., 2002), and older adults who abuse substances are 2.5 times more likely than non abusers to die prematurely (Moos, Mertens, & Brennan, 1994). Estimates of alcohol and drug abuse among older adults range from 13 percent to 17 percent (Weintraub et al.; Rigler, 2000), and fewer than half of these people are referred for treatment (Weintraub et al.). After alcohol, the most common substances to be abused are benzodiazepines (Finlayson, 1995). Recent studies have also shown surprisingly high usage rates of cocaine (10 percent), marijuana (2 percent), and even heroin (8 percent) (Weintraub et al.). Rates of drug use among future generations of older Americans will likely increase as baby boomers reach old age.

Although symptoms of physiological dependence on or withdrawal from specific substances vary somewhat, criteria for substance dependence include the following:

  • development of a tolerance for the substance (need for increasing amounts to achieve the desired effect or diminished effect with the same amount over time)
  • substance withdrawal symptoms, such as trembling, sweating, heart palpitations, nausea, headache, and insomnia
  • considerable time spent obtaining, consuming, and recovering from using the substance
  • desire or unsuccessful efforts to reduce the amount of the substance or stop taking it
  • use of larger amounts of the substance over a longer period of time than was intended
  • giving up or decreasing involvement in important social, occupational, or recreational activities because of the substance use
  • continuation of substance use despite problems that it may be causing

Like younger adults, some older adults may need to be initially detoxified from an abused substance. This may involve hospitalization, particularly if the older adult has other medical problems that require observation during withdrawal. Once the individual has been detoxify, psychotherapeutic treatment focuses on building coping skills and changing activity patterns so that the individual does not return to substance use. This treatment often enlists family members and friends to assist in preventing relapse. There is a little evidence for the effectiveness of medications for older adult substance abusers (Bartels et al., 2002).

The above information was provided by the Society of Certified Senior Advisors (SCSA)