Caregiving responsibilities (e.g., whether the client cares for a child or other dependent). Their history of using support groups and community support and in what ways such supports were (or were not) helpful. Periodically review the ongoing need for the opioid medication, and consider whether the dose can be reduced, tapered, or discontinued. Second, use a pain rating scale to learn the intensity of your client’s pain. Worsening of sleep apnea and other breathing-related sleep conditions.

• Keeping your clients safe isn’t just the right thing to do—it’s the law.
• You can find more information about Adverse Childhood Experiences (ACEs) on the CDC’s website (/violenceprevention​/childabuseandneglect​/acestudy/index.html).
• It’s essential to understand why seniors are increasingly suffering from addiction so we can better prevent it in older adults.

Co-Occurring Psychiatric Disorders

• Develop personal and meaningful reasons for wanting to change their behaviors.
• This report did not provide comparable information on frequency of prescription drug misuse.
• If your program cannot offer treatment for SUDs, refer your clients to counseling and tailored psychosocial supports that have the capacity to meet older adults’ unique needs.

Support groups are vital for older adults suffering from substance abuse issues. They offer a safe and comfortable space to talk freely and openly about one’s experiences. They can provide an opportunity for older adults to connect with peers who have gone through similar struggles, providing a forum to share advice and strategies that have proven successful in managing their addiction.

Substance Abuse and Addiction in Older Adults

Tactful and appropriate screening is an instrumental element in ensuring that older persons with substance use disorders receive the sensitive support that they need. Concurrent illnesses and other chronic conditions may mask substance abuse. Older folx facing major life transitions or changes could be a key to unlocking and eventually treating underlying SUDs in older populations. One reason is older adults disapproval of and shame about use and misuse of substances and a reluctance to seek professional help for what many in this age group consider a private matter. Many relatives of older individuals with substance use disorders, particularly their adult children, are also ashamed of the problem and choose not to address it. There is an unspoken but pervasive assumption that it’s not worth treating older adults for substance use disorders.

• On the other hand, having strong social connections can improve mental health and reduce the risk of substance use disorders.
• At first, the staff had thought he was suffering a heart attack, but a CT scan found that part of his small intestine had been perforated.
• Treatment for depression is usually covered by private insurance and Medicare.
• A score of 50 or higher by an older person could mean significant worries are present, but research on cutoff scores in older people is too limited to know for certain.396 Do not assume that an older client who scores below 50 does not have anxiety.

Information for Providers

The sections do not cover questions about a client’s recreational, military, occupational, or avocational/retirement history. Sharing information that is specific to older clients, such as guidelines about low-risk levels of substance use for older adults or physical effects of substance misuse. You can also give a substance-related, depression, or trauma screener substance abuse in older adults again if the client experiences major changes that could lead to substance misuse, depression, anxiety, or PTSD. Such changes include the death of someone significant to the client, a transition to an assisted living residence or nursing home, or retirement. Substance misuse affects older adults differently than it does middle-aged and younger adults.

These negative mental health and substance use outcomes have disproportionately affected some populations, particularly communities of color and youth. As the end of the declaration of the public health emergency nears – on May 11, 2023 – many people continue to grapple with worsened mental health and well-being and face barriers to care. Although steps have been taken to address negative mental health impacts stemming from the pandemic, mental health and substance use concerns remain elevated. Heightened racism and increasing gun violence may also contribute to poor mental health outcomes.

According to the CDC, alcohol was an underlying cause of death for 11,616 adults aged 65 and over in 2020. Although alcohol caused very few deaths in this age group, the rates have increased in recent years. In fact, the number of older adults dying from alcohol-related causes rose by 18.2 percent between 2019 and 2020. Mutual-help programs offer older adults a network of peers with whom they can relate.

Among older people assessed for treatment for alcohol misuse,387 the most commonly reported reason for using alcohol among women (24 percent) was “to reduce tension or anxiety.” This was also the second-most-common reason reported by men (20 percent). Chapter 3 will help you decide which screening tools to use, how and when to administer them, and who should do so. Every practice should select screening tools and develop procedures for who will give the screenings and when to give them. You can select screening measures based on which substances you want to ask about (Exhibit 3.2). Be aware that not all of these measures have been validated—in other words, tested and approved for use—in older adults. Your practice should also identify steps to take when screening tests are positive (see the section “Communicating Screening Results”).

New Items from SAMHSA for Professionals Serving Older Adults

Provide a paper or digital tablet version for clients to complete by themselves. USPSTF recommends electronic screening and brief intervention as an effective strategy to prevent excessive alcohol use.320 Some older adults may not be comfortable using computers or tablets. Be sensitive to each client’s skills and abilities when selecting screening formats.