Substance-Use Disorders in Later Life

Alcohol-use disorder, prescription-drug misuse, and illicit-drug use are growing health problems in later life yet may be overlooked by health care providers. All clinicians who care for older adults must be alert for possible signs and symptoms of substance-use disorders in their patients. Use of prescription-drug monitoring programs will help identify persons who obtain multiple prescriptions for medications with high misuse potential. Although opioid abuse is growing among older adults, marijuana is currently the most frequently used illicit substance in this age group. However, alcohol-use disorder remains the most prevalent substance-use disorder in later life. The fact that rates of alcohol-use disorder are increasing among older adults is cause for alarm. Research is needed to develop targeted screening methods and to identify the best treatment models for substance-use disorders in older adults. Treatment plans must encompass care for older patients with coexisting medical and psychiatric illnesses. New models of care may need to be created that allow for both coordination of services in integrated health care settings and treatment programs tailored for older patients. Copyright © 2018 Massachusetts Medical Society.