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Substance Use in Older Adults

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Substance and Non-Substance Related Addictions

Abstract

There is an increased incidence of substance use in adults aged 65 or older. Substance use is often underdiagnosed and rarely screened for in older adults. However, ongoing substance use can lead to medical and psychiatric complications and require treatment in the forms of both psychopharmacology as well as talk therapy. This chapter describes different substance use disorders in older adults, screening for the same, symptoms present, and treatment which focuses on both talk therapy and pharmacology.

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References

  1. US Census Bureau. Census.gov. The baby boom cohort in the United States: 2012 to 2060. Current Population reports. By Sandra L. Colby and Jennifer M. Ortman. Issued may 2014.

  2. Maree RD, Ricelli CA. Substance related and addictive disorders. Psychiatric Disorders Late in Life- A Comprehensive Review.

    Google Scholar 

  3. Han B, Gfroerer JC, Colliver JD, Penne MA. Substance use disorder among older adults in the United States in 2020. Addiction. 2009b;104(1):88–96.

    Article  PubMed  Google Scholar 

  4. Mavandadi S, Oslin DW. substance related and addictive disorders. The American Psychiatric Publishing Textbook of Geriatric Psychiatry. 2015.

    Google Scholar 

  5. Cummings SM, Bride B, Rawlins-Shaw AM. Alcohol abuse treatment for older adults: a review of recent empirical research. J Evid Based Soc Work. 2006;3(1):79–99.

    Article  Google Scholar 

  6. US. Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMSHA). Results from the 2013 national survey on drug use and health: summary of national findings. Rockville, MD; 2013.

    Google Scholar 

  7. Borok J, Galier P, Dinolfo M, Welgreen S, Hoffing M, Davis JW, Ramirez KD, Liao DH, Tang L, Karno M, Sacco P, Lin JC, Moore AA. Why do older unhealthy drinkers decide to make changes or not in their alcohol consumption? Data from the healthy living as you age study. J Am Geriatr Soc. 2013;61(8):1296–302.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Thun MJ, Peto R, Lopez AD, et al. Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N Engl J Med. 1997;337(24):1705–14.

    Article  CAS  PubMed  Google Scholar 

  9. Kennedy GJ, Efremova I, Frazier A, et al. The emerging problems of alcohol and substance abuse in late life. J Soc Distress Homel. 1999;8(4):227–39.

    Article  Google Scholar 

  10. Kirchner J, Zubritsky C, Cody M, et al. Alcohol consumption among older adults in primary care. J Gen Intern Med. 2007;22:92–7.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Rehm J, Hasan O, Black SE, Shield KD, Schwarzinger M. Alcohol use and dementia: a systematic scoping review. Alzheimers Res Ther. 2019;11(1):1. https://doi.org/10.1186/s13195-018-0453-0.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Moore AA, Whiteman EJ, Ward KT. Risks of combined alcohol-medication use in older adults. Am J Geriatr Pharmacother. 2007;5:64–74.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Blazer DG, Wu L-T. The epidemiology of alcohol use disorders and subthreshold dependence in a middle-aged and elderly community sample. Am J Geriatr Psychiatry. 2011;19(8):685–94.

    Article  PubMed  PubMed Central  Google Scholar 

  14. American Psychiatric Association. Diagnostic and Statistic Manual DSM 5.

    Google Scholar 

  15. Han B, Moore A. Prevention and screening of unhealthy substance use by older adults. Geriatr Med. 2018;34:117–29.

    Article  Google Scholar 

  16. Yoast RA, Wilford BB, Hayashi SW. Encouraging physicians to screen for and intervene in substance use disorders: obstacles and strategies for change. J Addict Dis. 2008;27(3):77–97.

    Article  PubMed  Google Scholar 

  17. Ewing JA. Detecting alcoholism. The CAGE questionnaire JAMA. 1984;252(14):1905–7.

    CAS  PubMed  Google Scholar 

  18. Stewart D, Oslin DW. Recognition and treatment of late-life addictions in medical settings. J Clin Geropsychol. 2001;7(2):145–58.

    Article  Google Scholar 

  19. Babor TF, Higgins-Biddle JC, Saunders JB, et al. The alcohol use disorders identification test (AUDIT): guidelines for use in primary care. 2nd ed.

    Google Scholar 

  20. Gómez A, Conde A, Santana JM, Jorrín A, Serrano IM, Medina R. The diagnostic use- fulness of AUDIT and AUDIT-C for detecting hazardous drinkers in the elderly. Aging Ment Health. 2006;10(5):558–61.

    Article  PubMed  Google Scholar 

  21. Blow FC, Brower KJ, Schulenberg JE, et al. The Michigan alcohol screening test: geriatric version (MAST-G): a new elderly specific screening instrument. Alcohol Clin Exp Res. 1992;16:172.

    Google Scholar 

  22. Blow FC, Gillespie BW, Barry KL, et al. Brief screening for alcohol problems in elderly populations using the short Michigan alcoholism screening test-geriatric version (SMAST-G). Alcohol Clin Exp Res. 1998;22(Suppl):131A.

    Google Scholar 

  23. O’Connell H, Chin A, Hamilton F, et al. A systematic review of the utility of self-report alcohol screening instruments in the elderly. Int J Geriatr Psychiatry. 2004;19(11):1074–86.

    Article  PubMed  Google Scholar 

  24. Chapman SL, Wu LT. Epidemiology and demography of illicit drug use and drug use disorders amongst adults. Substance Use and Older People. 2014.

    Google Scholar 

  25. Alcoholics Anonymous, editor. Twelve steps and twelve traditions. New York: Alcoholics Anonymous; 2004.

    Google Scholar 

  26. Merrick EL, Horgan CM, Hodgkin D, et al. Unhealthy drinking patterns in older adults: prevalence and associated characteristics. J Am Geriatr Soc. 2008;56:214–23.

    Article  PubMed  Google Scholar 

  27. Moore AA, Blow FC, Hoffing M, et al. Primary care-based intervention to reduce at-risk drinking in older adults: a randomized controlled trial. Addiction. 106(1):111–20.

    Google Scholar 

  28. Schonfeld L, King-Kallimanis BL, Duchene DM, et al. Screening and brief intervention for substance misuse among older adults: the Florida BRITE project. Am J Public Health. 2010;100(1):108–14.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ayalon L, Jin C, Mcculloch CE, et al. Integrated specialty mental health care among older minorities improves access but not outcomes: results of the PRISMe study. Int J Geriatr Psychiatry. 2008;23(August):1086–92.

    PubMed  Google Scholar 

  30. Stahl S. Stahl’s essential psychopharmacology - prescriber's guide. 5th ed. New York: Cambridge University Press; 2014.

    Google Scholar 

  31. Substance Abuse and Mental Health Services Administration. Incorporating alcohol pharmaco- therapies into medical practice treatment improvement protocol (TIP) series, no. 49. Rockville, MD; 2009.

    Google Scholar 

  32. Caputo F, Vignoli T, Leggio L, Addolorato G, Zoli G, Bernardi M. Alcohol use disorders in the elderly: a brief overview from epidemiology to treatment options. Exp Gerontol. 2012;47(6):411–6.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kuerbis A, Sacco P, Blazer DG, Moore AA. Substance abuse among older adults. Clin Geriatr Med. 2014;30(3):629–54.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Berlin R, Butler P, Perloff M. Gabapentin therapy in psychiatric disorders: a systematic review. Prim Care Companion CNS Disord. 2015;17(5).

    Google Scholar 

  35. Mason BJ, Quello S, Shadan F. Gabapentin for the treatment of alcohol use disorder. Expert Opin Investig Drugs. 2017;27(1):113–24.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Hock B, Schwarz M, Domke I, et al. Validity of carbohydrate-deficient transferrin (%CDT), gamma-glutamyl transferase (gamma-GT) and mean corpuscular erythrocyte volume (MCV) as biomarkers for chronic alcohol abuse: a study in patients with alcohol dependence and liver disorders of non-alcoholic and alcoholic origin. Addiction. 2005;100(10):1477–86.

    Article  CAS  PubMed  Google Scholar 

  37. Moore AA, Karno MP, Grella CE, Lin JC, Warda E, Liao D, Hu P. Alcohol, tobacco and non-medical drug use in U.S. adults aged 65 years and older: data from the 2001-2002 National Epidemiologic Survey of alcohol and related conditions. J Am Geriatr Soc. 2009;57(12):2275–81.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Hall SM, Humfleet GL, Munoz RF, et al. Extended treatment of older cigarette smokers. Addiction. 2009;104:1043–52.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Oslin DW, Pettinati H, Volpicelli JR. Alcoholism treatment adherence: older age predicts better adherence and drinking outcomes. Am J Geriatr Psychiatry. 2002;10(6):740–7.

    Article  PubMed  Google Scholar 

  40. Oslin DW, Liberto JG, O’Brien J, et al. Naltrexone as an adjunctive treatment for older patients with alcohol dependence. Am J Geriatr Psychiatry. 1997;5(4):324–32.

    Article  CAS  PubMed  Google Scholar 

  41. Anstey KJ, von Sanden C, Salim, A.,& O’ Kearney, R. Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. Am J Epidemiol. 2007;166:367–78.

    Article  PubMed  Google Scholar 

  42. Rapuri PB, Gallagher JC, Smith LM. Smoking is a risk factor for decreased physical performance in elderly women. J Gerontol A Biol Sci Med Sci. 2007;62(1):93–100.

    Article  PubMed  Google Scholar 

  43. Humeniuk R, Henry-Edwards S, Ali R. et al. Geneva (Switzerland): World Health Organization; 2010. The alcohol, smoking, and substance involvement screening test (ASSIST).

    Google Scholar 

  44. Hokanson JM, Anderson RL, Hennrikus DJ, et al. Integrated tobacco cessation counseling in a diabetes self-management training program: a randomized trial of diabetes and reduction of tobacco. Diabetes Educ. 2006;32:562–70.

    Article  PubMed  Google Scholar 

  45. Hartmann-Boyce J, Aveyard P. Drug for smoking cessation. Br Med J. 2016;352(571):1–5.

    Google Scholar 

  46. Cawkwell PB, Blaum C, Sherman SE. Pharmacological smoking cessation. Drugs Aging. 2015;32(6):443–5.

    Article  PubMed  Google Scholar 

  47. Garrison GD, Dugan SE. Varenicline: a first-line treatment option for smoking cessation. Clin Ther. 2009;31(3):463–91.

    Article  CAS  PubMed  Google Scholar 

  48. Han BH, Sherman S, Mauro PM, et al. Demographic trends among older cannabis users in the United States, 2006-2013. Addiction. 2016;112(3):516–25.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Kaskie B, Ayyagari P, Milavetz G, Shane D, Arora K. The increasing use of Cannabis among older Americans: A public health crisis or viable policy alternative? The Gerontologist. 2017;57(6):1166–72.

    PubMed  Google Scholar 

  50. Choi NG, Di Nitto DM, Marti CM, Choi BY. Relationship between marijuana and other illicit drug use and depression/suicidal thoughts among late middle-aged and older adults. Int Psychogeriatr. 2015;27:1–13.

    Google Scholar 

  51. Black P, JosephL J. Still dazed and confused: midlife marijuana use by the baby boom generation. Deviant Behav. 2014;35:822–84.

    Article  Google Scholar 

  52. Colliver JD, Compton WM, Gfroerer JC, Condon T. Projecting drug use among aging baby boomers in 2020. Ann Epidemiol. 2006;16:257–65.

    Article  PubMed  Google Scholar 

  53. Wu LT, Blazer DG. Illicit and nonmedical drug use among older adults: a review. J Aging Health. 2010;23(3):481–504.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Center for Substance Abuse Treatment. Substance abuse relapse prevention for older adults: A group treatment approach. Rockville, MD: Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services; 2005.

    Google Scholar 

  55. Center for Substance Abuse Treatment. Substance abuse among older adults; treatment improvement protocol (TIP) series 26. Rockville, MD: Substance Abuse and Mental Health. Services Administration, U.S. Department of Health and Human Services; 1998.

    Google Scholar 

  56. Achildi O, Leong SH, Maust DT, et al. Patterns of newly-prescribed benzodiazepines in late life. Am J Geriatr Psychiatry. 2013.

    Google Scholar 

  57. Culberson JW, Ziska M. Prescription drug misuse/abuse in the elderly. Geriatrics. 2008;63(9):22–31.

    PubMed  Google Scholar 

  58. Dowling GJ, Weiss SR, Condon TP. Drugs of abuse and the aging brain. Neuropsychopharmacology. 2008;33:209–18.

    Article  CAS  PubMed  Google Scholar 

  59. Schutte K, Lemke S, Moos RH, Brennan PL. Age-sensitive psychosocial treatment for older adults with substance use. In: Substance use and older adults. 1st ed; 2015.

    Google Scholar 

  60. Three-year incidence and predictors of first-onset of DSM-IV mood, anxiety, and substance use disorders in older adults: results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2011:72(2);144–55.

    Google Scholar 

  61. Schlaerth KR, Splawn RG, Ong J, Smith SD. Change in the pattern of illegal drug use in an inner city population over 50: an observational study. J Addict Dis. 2004.

    Google Scholar 

  62. Arndt S, Turvey CL, Flaum M. Older offenders, substance abuse, and treatment. Am J Geriatr Psychiatr. 2002;10:733–9.

    Article  Google Scholar 

  63. Woo BK, Chen W. Substance misuse among older patients in psychiatric emergency service. Gen Hosp Psychiatry. 2010;32(1):99–101.

    Article  PubMed  Google Scholar 

  64. Lin JC, Karno MP, Grella CE, Ray LA, Liao DH, Moore AA. Psychiatric correlates of alcohol and tobacco use disorders in U.S. adults aged 65 years and older: results from the 2001– 2002 National Epidemiologic Survey of alcohol and related conditions. Am J Geriatr Psychiatry. 2014;22(11):1356–63.

    Article  PubMed  Google Scholar 

  65. Ty S. Schepis, Linda Simoni-Wastila, Sean Esteban McCabe. Prescription opioid and benzodiazepine misuse is associated with suicidal ideation in older adults. Int J Geriatr Psychiatry. 2019;34:122–9.

    Article  Google Scholar 

  66. Spinelli MA, Ponath C, Tieu L, Hurstak EE, Guzman D, Kushel M. Factors associated with substance use in older homeless adults: results from the HOPE HOME study. Subst Abus. 2016;38(1):88–94.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Yarns BC, Abrams JM, Meeks TW, Sewell DD. The mental health of older LGBT adults. Curr Psychiatry Rep. 2016;18:60.

    Article  PubMed  Google Scholar 

  68. McCabe SE, Hughes TL, Bostwick WB, West BT, Boyd CJ. Sexual orientation, substance use behaviors and substance dependence in the United States. Addiction. 2009;104(8):1333–45.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Blow FC, Barry KL. Substance misuse and abuse in older adults: what do we need to know to help? Generations. 2014;38(3):53–67.

    Google Scholar 

  70. Sorrell JM. Substance use disorders in long-term care settings: a crisis of care for older adults. J Psychosoc Nurs Ment Health Serv. 2017;55(1):24–7.

    Article  PubMed  Google Scholar 

  71. Plotkin AF 2015, January 21. Jewish Home launches first in nation nursing home based geriatric substance abuse program.

    Google Scholar 

  72. Derek D, Satre Matthew E, Hirschtritt Michael J, Silverberg Stacy A. Sterling Addressing Problems With Alcohol and Other Substances Among Older Adults During the COVID-19 Pandemic. Am J Geriatr Psychiatr. 2020;28(7):780–783. https://doi.org/10.1016/j.jagp.2020.04.012.

Recommended Reading

  • Substance Use and Older Adults First Edition John Wiley and Sons 2015.

    Google Scholar 

  • Psychiatric Disorder Late in Life: A Comprehensive Review 2016.

    Google Scholar 

  • The Mental Health and Substance Use Workforce for Older Adults: In whose hands? 2012.

    Google Scholar 

  • The American Publishing Textbook of Geriatric Psychiatry.

    Google Scholar 

  • Treatment of Patients with Mental Illness Amid A Global COVID-19 Pandemic.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Bellevue Hospital Center, New York University Grossman School of Medicine, New York, NY, USA

    Paroma Mitra

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  1. Paroma Mitra
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Correspondence to Paroma Mitra .

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Editors and Affiliations

  1. Department of Psychiatry New Jersey Medical School, Rutgers University, Newark, NJ, USA

    Evaristo Akerele

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Mitra, P. (2022). Substance Use in Older Adults. In: Akerele, E. (eds) Substance and Non-Substance Related Addictions. Springer, Cham. https://doi.org/10.1007/978-3-030-84834-7_3

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  • DOI: https://doi.org/10.1007/978-3-030-84834-7_3

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