The New Face of Older
Adult Substance Abuse
By Sarah Briley, Ed.D., LCPC, CADC
By 2050, there will be approximately 89 million Older Adults in the United States – double the number present in 2010 (CDC, 2013). As the Baby Boomer generation continues to retire and access community resources, treatment professionals need to be prepared for what they might see. It is estimated that 17% of Older Adults are at significant risk for substance abuse and/or dependence. This number is projected to increase 50% by the year 2020 (SAMHSA, 2008). More specifically, Alcohol use is high in 50+ populations – approximately 2.3 Million, or 14.1%, meet criteria for alcohol abuse/dependency. Nearly 2.8 million Older Adults have used at least one illicit substance in the last year. Of these past-year users, 16% (446,844) may have illicit drug abuse or dependence problems, which may also include abuse of prescription medication and marijuana (SAMHSA, 2008).
Until recently, there has been a large void in the literature focused directly on assessment and treatment of older adults. It has been a largely ignored topic by both the medical and psychological communities. This may be due to a number of factors including mis-diagnosis and differential diagnosis. Older adults will often access health care systems for other conditions that may or may not be directly related to their substance use, and they may feel shameful or embarrassed about their use of substances. In addition, grown children of older adults may not be willing or able to recognize that there is a problem.
As providers we can look for the warning signs and address them with our patients. Changes in memory, poor nutrition, unexplained bruising, slurred speech, falls, and poor self-care are just some of the warning signs to look for. It is also important to consider the following items when assessing an older adult:
- Show Empathy Older adults may be embarrassed and ashamed about their use. As with all patients, it is important to create a non-confrontational and supportive environment when discussing substance abuse patterns.
- Know the Cohort (i.e. the level of respect, language used, etc.) Talk to older adults in a patient and respectful manner.
- Grief/Loss Consider Grief/Loss issues that may have occurred.
- Chronic Conditions Consider chronic medical conditions. Medical concerns may make it more difficult to recognize the role of alcohol in the decrease in functioning and quality of life. Also consider how these medical concerns may impact their risk for abuse/dependence.
- Be Flexible Allow the patient the space to discuss the items that they believe are important.
- Speak to Outsiders Whenever possible, discuss the patient’s history with others who know them best. Older adults typically value relationships with medical treatment providers and may want them included in their care.
- Least Restrictive Care Recommend the least restrictive level of care that is appropriate. The Older adult patient may wish to remain as independent as they can while pursuing treatment. However, never compromise safety. If a patient is in acute withdrawal from substances, please help them access medical care quickly.
It is never too late to address substance abuse concerns. Studies show that older adults are more compliant with treatment and have treatment outcomes as good or better than those of younger patients (SAMHSA, 2008). Alexian Brothers Behavioral Health Hospital offers an Older Adult track to patients participating in any of the intensive outpatient or partial hospitalization programs. In addition to special theme-based therapy groups, patients are invited to participate in weekly psychoeducational lectures geared at their needs and interests. Skilled clinicians who consider the concerns of the older adult patient provide case management services, and patients are encouraged to involve family members in their recovery process by inviting them to family night lectures and a family session with their case manager. ---
Don't miss an excellent opportunity to learn more about this growing trend in our upcoming Webinar: The New Face of Older Adult Substance Abuse. This FREE Webinar will provide participants with an overview of the aging brain, current trends in older adult substance use, and strategieis for partnering with these clients.
1.0 CE available for Psychologists
1.0 CEU available for LCSW/LSW/LCPC/LPC
