TIP 26: Treating Substance Use Disorder in Older Adults SAMHSA Publications and Digital Products

Addressing the nation’s mental health crisis and drug overdose epidemic are core pillars of the Biden-Harris Administration’s Unity Agenda. These investments enabled the expansion of lifesaving prevention, treatment, and recovery services and supports in communities throughout the country, including the transition to the 988 Suicide & https://ecosoberhouse.com/ Crisis Lifeline in July 2022. The 2021 NSDUH national report  includes selected estimates by race, ethnicity, and age group. It is the most comprehensive report on substance use and mental health indicators that SAMHSA has released to date. TEDS data are collected through state administrative systems and then are submitted to SAMHSA.

• The item scores are added to produce a total score ranging from 16 to 80, with higher scores reflecting more worry.
• Some medications can cause side effects that are similar to symptoms of depression (like trouble sleeping or feeling low energy).
• Common physical conditions and symptoms of normal aging that can be confused for substance misuse include low energy, memory changes, sleep problems, and decreased appetite.
• Lehmann points out that it’s common for primary care providers, specialists and emergency physicians to prescribe opioids and benzodiazepines on a long-term basis.
• Collaborative models of care can achieve this goal either in-person or with the use of digital technologies (Ramuji et al., 2019).

Medical Marijuana

Choose a method for drug and alcohol screening that you can use with all older clients. Understand the relationship between substance misuse and depression, anxiety, trauma, and problems with thinking (also called cognitive impairment). The main reason for screening and assessment is to help you decide whether, where, and how to address substance misuse. Increased Sensitivity to AlcoholAging can lower the body’s tolerance for alcohol.

Substance Use Disorders in Older Adults: Overview and Future Directions

• (Note that even without alcohol, the risk of a car accident goes up starting at age 55.) Also, older drivers tend to be more seriously hurt in crashes than younger drivers.
• If the depression screen is negative and the client has few or no symptoms of depression, you can continue screening on a yearly basis.
• Sometimes, families, friends, and health care workers may overlook the concerns about older people drinking.
• Many, she says, came of age during an era of substance experimentation and have been “using” for decades.

This test measures a person’s ability to stand from a sitting position, walk a short distance (10 feet), turn around, and walk back to where the individual was sitting. Instructions for how to give the Timed Up & Go are available online (/steadi/pdf/TUG_Test-print.pdf). If you answered “yes” to any of these questions, you may want to assess the client for fall risk. Keeping your clients safe isn’t just the right thing to do—it’s the law.

TIP 35: Enhancing Motivation for Change in Substance Use Disorder Treatment

Level of safety at home, especially in terms of potential for violence. Note that substance use greatly increases the risk of intimate partner violence. Screen all women who seek SUD treatment for intimate partner abuse, regardless of their age.512 Substance use increases the risk of abuse toward older adults,513 and experiencing elder abuse can contribute to substance misuse among older adults. If you suspect an older adult is misusing substances, screen for elder abuse. The section on health history and the physical exam discusses disordered sleep and pain because these are common physical conditions seen in older people who misuse substances.

The severity of substance use (including what, how often, and how much the client uses). You may need to schedule another visit substance abuse in older adults for this longer assessment. Physical conditions that are often alcohol or drug related (e.g., high blood pressure, insomnia).

As with any client, you should make appropriate referrals for medical care that is beyond what your practice setting offers. Positive screens for substance misuse require follow-up, but next steps may not be immediately clear. Decisions about follow-up care depend on how much time and effort you can expend, how much training and experience you have in drug and alcohol counseling, and your program’s treatment abilities. Also essential are the client’s agreement, engagement level, and preferences. If a cognitive screener is positive, you should refer the client for further testing by a behavioral health service provider with special training in diagnosing clients with dementia and MCI.