Recent advances in treatment for older people with substance use problems: An updated systematic and narrative review

Background: Substance use disorders among the elderly are a growing public health concern but there is a limited evidence base on interventions designed specifically for this population group. This review aims to update the review by Moy et al., 2011, by examining recent advances in the treatment of substance use disorders in the elderly. Methods: Medline, Embase, PsycInfo, and Cochrane Library databases were searched. Appropriate inclusion and exclusion criteria were applied and eligible papers were selected through a sequential screening process. Data were extracted using a standard data extraction form, and synthesised. Results: Thirteen papers were eligible for inclusion in the review. All the studies were conducted in developed countries. The interventions included pharmacological and psychological treatments for alcohol consumption, cigarette smoking, and prescription medication use, all delivered in a range of healthcare settings. The evidence for treatments of alcohol use related problems supports psychological interventions for reducing alcohol consumption. Studies on the treatments for tobacco use point towards the strength of cognitive behavioural therapy and combined treatments for smoking cessation. For prescription medications, counselling interventions were found to be effective. Conclusion: Older people were reported to have responded to interventions such as brief interventions, multicomponent interventions, educational interventions, counselling, amongst others. There remain limitations in this field of research, as the studies were undertaken only in developed countries, using psychological interventions with varying characteristics, and short follow-up periods. (C) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.