Skip to main content
SpringerLink
Log in

Substance-Related and Addictive Disorders

  • Chapter
  • First Online:
Psychiatric Disorders Late in Life

  • 866 Accesses

Abstract

The prevalence of substance use among older adults aged 65 and older is increasing with great significance. The use of alcohol, tobacco, and illicit drugs coupled with increasing misuse of prescription medications in the elderly presents new challenges for providers of this population. Diagnosis of various substance use disorders should also be taken with special consideration in older adults given potential changes in physiology, cognitive functioning, and social roles. Treatment of older adults with substance use disorders can be pharmacologic or non-pharmacologic, depending on the patient’s needs. While there are several means and methods of identifying and treating substance use, much of the research and pharmacologic treatment options for older adult populations has been with alcohol use disorders. Non-pharmacologic and therapeutic treatment for various substance use disorders can be useful options in older adults as well. There is limited published research on substance use in older adults, and continued efforts to better measure this mounting public health problem and develop age-specific and culturally appropriate treatments and interventions are needed to ensure optimal health outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Schulden J, Lopez M, Compton W. Clinical implications of drug abuse epidemiology. Psychiatr Clin North Am. 2012;35(2):411–23. https://doi.org/10.1016/j.psc.2012.03.007.Clinical.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Ortman J, Velkoff V, Hogan H. An aging nation: the older population in the United States. Current population reports. http://www.census.gov/library/publications/2014/demo/p25-1140.html. Published 2014. Accessed 5 April 2016.

  3. Reynolds K, Pietrzak RH, El-Gabalawy R, Mackenzie CS, Sareen J. Prevalence of psychiatric disorders in U. S. older adults: findings from a nationally representative survey. World Psychiatry. 2015;14(1):74–81. https://doi.org/10.1002/wps.20193.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Han B, Gfroerer J, Colliver J, Penne M. Substance use disorder among older adults in the United States in 2020. Addiction. 2009;104(1):88–96.

    Article  PubMed  Google Scholar 

  5. Gfroerer J, Penne M, Pemberton M, Folsom R. Substance abuse treatment need among older adults in 2020: the impact of the aging baby-boom cohort. Drug Alcohol Depend. 2003;69(2):127–35.

    Article  PubMed  Google Scholar 

  6. Centers for Disease Control and Prevention. Vital signs: overdoses of prescription opioid pain relievers -- United States, 1999-2008. Morb Mortal Wkly Rep. 2011;60(43):1487–92.

    Google Scholar 

  7. Blazer DG, Wu L-T. The epidemiology of at-risk and binge drinking among middle-aged and elderly community adults national survey on drug use and health. Psychiatry Interpers Biol Process. 2011;166(10):1162–9. https://doi.org/10.1176/appi.ajp.2009.09010016.

    Google Scholar 

  8. U.S. 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 

  9. Oslin D. Late-life alcoholism: issues relevant to the geriatric psychiatrist. Am J Geriatr Psychiatry. 2004;12(6):571–83.

    PubMed  Google Scholar 

  10. Lynskey M, Day C, Hall W. Alcohol and other drug use disorders among older-aged people. Drug Alcohol Rev. 2003;22(2):125–33.

    PubMed  Google Scholar 

  11. Barnes AJ, Moore AA, Xu H, et al. Prevalence and correlates of at-risk drinking among older adults: the project SHARE study. J Gen Intern Med. 2010;25(8):840–6. https://doi.org/10.1007/s11606-010-1341-x.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Dinitto DM, Choi NG. Marijuana use among older adults in the U.S.A.: user characteristics, patterns of use, and implications for intervention. Int Psychogeriatr. 2011;23(5):732–41. https://doi.org/10.1017/S1041610210002176.

    Article  PubMed  Google Scholar 

  13. Blazer DG, Wu L-T. The epidemiology of substance use and disorders among middle aged and elderly community adults: national survey on drug use and health (NSDUH). Am J Geriatr Psychiatry. 2009;17(3):237–45. https://doi.org/10.1097/JGP.0b013e318190b8ef.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kuerbis A, Sacco P, Blazer DG, Moore AA. Substance abuse among older adults. Clin Geriatr Med. 2014;30(3):629–54. https://doi.org/10.1016/j.cger.2014.04.008.

    Article  PubMed  PubMed Central  Google Scholar 

  15. ProCon.org. 24 legal medical marijuana states and DC. Medical marijuana home. http://medicalmarijuana.procon.org/view.resource.php?resourceID=000881. Published 2004. Accessed 1 Jan 2016.

  16. Rimer BK, Orleans CT. Tailoring smoking cessation for older adults. Cancer. 1994;74(7 Suppl):2051–4.

    Article  CAS  PubMed  Google Scholar 

  17. Li-Tzy W, Blazer DG. Illicit and nonmedical drug use among older adults: a review. J Aging Health. 2011;23(3):481–504. https://doi.org/10.1177/0898264310386224.Illicit.

    Article  Google Scholar 

  18. Kuo YF, Raji MA, Chen NW, Hasan H, Goodwin JS. Trends in opioid prescriptions among part D medicare recipients from 2007 to 2012. Am J Med. 2015;129(221):21–30. https://doi.org/10.1016/j.amjmed.2015.10.002.

    Google Scholar 

  19. Simoni-Wastila L, Yang H. Psychoactive drug abuse in older adults. Am J Geriatr Pharmacother. 2006;4(4):380–94.

    Article  PubMed  Google Scholar 

  20. Kalapatapu RK, Sullivan MA. Prescription use disorders in older adults. Am J Addict. 2010;19(6):515–22. https://doi.org/10.1111/j.1521-0391.2010.00080.x.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Becker W, Tobin D, Feillin D. Nonmedical use of opioid analgesics obtained directly from physicians: prevalence and correlates. Arch Intern Med. 2011;171(11):1034–5.

    Article  PubMed  Google Scholar 

  22. Center for Behavioral Health Statistics and Quality Substance Abuse and Mental Health Services Administration. Treatment episode data set (TEDS). April 2016. http://wwwdasis.samhsa.gov/webt/quicklink/US13.htm. Published 2013. Accessed 1 April 2016.

  23. Volkow N, Warren K. Drug addiction: the neurobiology of behavior gone awry. In: Ries RK, Fiellin DA, Miller SC, Saitz R, editors. The ASAM principles of addiction medicine. Fifth ed. Beijing: Wolters Kluwer; 2014. p. 4–5.

    Google Scholar 

  24. Moeller FG. Drug abuse and dependence. In: Nabel E, Federman D, editors. Scientific American medicine. Hamilton, ON: Decker Intellectual Properties; 2016. p. 1–16. https://doi.org/10.2310/7900.1191.

    Google Scholar 

  25. Mavandadi S, Oslin D. Substance-related and addictive disorders. In: Steffens D, Blazer D, Thakur M, editors. The American psychiatric publishing textbook of geriatric psychiatry. 5th ed. Arlington, VA: American Psychiatric Publishing; 2015.

    Google Scholar 

  26. Ries RK, Fiellin DA, Miller SC, Saitz R. American Society for addiction medicine principles of addiction medicine. 5th ed. Philadelphia, PA: Lippincott, Williams and Wilkins; 2014.

    Google Scholar 

  27. Mulsant BH, Pollock BG. Psychopharmacology. In: Thakur ME, Blazer DG, Steffens DC, editors. Clinical manual of geriatric psychiatry. 1st ed. Washington, D.C.: American Psychiatric Publishing; 2014. p. 17–82.

    Google Scholar 

  28. American Psychiatric Association. American Psychiatric Association: diagnostic and statistical manual of mental disorders. 5th ed. (American Psychiatric Association, ed.). Arlington, VA: American Psychiatric Publishing; 2013.

    Google Scholar 

  29. Angelica MD, Fong Y. Substance abuse among older adults. 2008;141(4):520–529. https://doi.org/10.1016/j.surg.2006.10.010.Use.

  30. Koechl B, Unger A, Fischer G. Age-related aspects of addiction. Gerontology. 2012;58(6):540–4. https://doi.org/10.1159/000339095.Age-related.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Mcinnes E, Powell J. Drug and alcohol referrals : are elderly substance abuse diagnoses and referrals being missed ? Br Med J. 1994;308(6926):444–6.

    Article  CAS  Google Scholar 

  32. Gilson AM, Kreis PG. The burden of the nonmedical use of prescription opioid analgesics. Pain Med. 2009;10(S2):S89–S100. https://doi.org/10.1111/j.1526-4637.2009.00668.x.

    Article  PubMed  Google Scholar 

  33. NIAAA. Alcohol and your health. National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/older-adults. Published 2014. Accessed 1 April 2016.

  34. Adams W, Barry K, Flemin M. Screening for problem drinking in older primary care patients. J Am Med Assoc. 1996;276(24):1964–7.

    Article  CAS  Google Scholar 

  35. 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 

  36. Gómez A, Conde A, Santana JM, Jorrín A, Serrano IM, Medina R. The diagnostic usefulness of AUDIT and AUDIT-C for detecting hazardous drinkers in the elderly. Aging Ment Health. 2006;10(5):558–61. https://doi.org/10.1080/13607860600637729.

    Article  PubMed  Google Scholar 

  37. Piccinelli M, Tessari E, Bortolomasi M, et al. Efficacy of the alcohol use disorders identification test as a screening tool for hazardous alcohol intake and related disorders in primary care: a validity study. BMJ. 1997;314(7078):420–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Kan CC, Breteler MH, van der Ven AH, Zitman FG. Cross-validation of the benzodiazepine dependence self-report questionnaire in outpatient benzodiazepine users. Compr Psychiatry. 2001;42(5):433–9. https://doi.org/10.1053/comp.2001.26275.

    Article  CAS  PubMed  Google Scholar 

  39. de las Cuevas C, Sanz EJ, de La Fuente JA, Padilla J, Berenguer JC. The Severity of Dependence Scale (SDS) as screening test for benzodiazepine dependence: SDS validation study. Addiction. 2000;95(2000):245–50.

    Article  PubMed  Google Scholar 

  40. Voyer P, Roussel ME, Berbiche D, Préville M. Effectively detect dependence on benzodiazepines among community-dwelling seniors by asking only two questions. J Psychiatr Ment Health Nurs. 2010;17(4):328–34. https://doi.org/10.1111/j.1365-2850.2009.01529.x.

    Article  CAS  PubMed  Google Scholar 

  41. Arndt S, Clayton R, Schultz S. Trends in substance abuse treatment 1998-2008: increasing older adult first time admissions for illicit drugs. Am J Geriatr Psychiatry. 2011;19(8):704–11.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  43. Oslin D, Slaymaker V, Blow F, Owen P, Colleran C. Treatment outcomes for alcohol dependence among middle-aged and older adults. Addict Behav. 2005;30(7):1431–6.

    Article  PubMed  Google Scholar 

  44. Jonas D, Garbutt J, Amick H, et al. Behavioral counseling after screening for alcohol misuse in primary care: a systematic review and meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2012;157(9):645–54.

    Article  PubMed  Google Scholar 

  45. Kuerbis A, Sacco P. A review of existing treatments for substance abuse among the elderly and recommendations for future directions. Subst Abuse. 2013;7:13–37.

    PubMed  PubMed Central  Google Scholar 

  46. Alcoholics Anonymous, edoitors. Twelve steps and twelve traditions. New York: Alcoholics Anonymous; 2004.

    Google Scholar 

  47. 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. https://doi.org/10.2105/AJPH.2008.149534.

    Article  PubMed  PubMed Central  Google Scholar 

  48. 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. https://doi.org/10.1002/gps.

    PubMed  Google Scholar 

  49. Barry K, Blow F. Drinking over the lifespan. Alcohol Res. 2016;38(1):115–20.

    PubMed  PubMed Central  Google Scholar 

  50. Ramesh D, Haney M. Treatment of cannabis use disorders. In: Textbook of addiction treatment: international perspectives; 2015. P. 367–380. https://doi.org/10.1007/978-88-470-5322-9_14.

  51. Ryrie I. Motivational interviewing. In: Norman I, Ryrie I, editors. The art and science of mental health nursing: principles and practice; 2013. P. 356–366.

    Google Scholar 

  52. Petrovic M, Vandierendonck A, Mariman A, Van Maele G, Afschrift M, Pevernagie D. Personality traits and socio-epidemiological status of hospitalised elderly benzodiazepine users. Int J Geriatr Psychiatry. 2002;17(8):733–8.

    Article  PubMed  Google Scholar 

  53. Tannenbaum C, Martin P, Tamblyn R, Benedetti A, Ahmed S. Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: the EMPOWER cluster randomized trial. JAMA Intern Med. 2014;174(6):890–8. https://doi.org/10.1001/jamainternmed.2014.949.

    Article  PubMed  Google Scholar 

  54. 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. https://doi.org/10.1016/j.exger.2012.03.019.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Letizia M, Reinbolz M. Identifying and managing acute alcohol withdrawal in the elderly. Geriatr Nurs. 2005;26:176–83.

    Article  PubMed  Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

  58. Litten R, Wilford B, Falk D, Ryan M, Fertig J. Potential medications for the treatment of alcohol use disorder: an evaluation of clinical efficacy and safety. Subst Abus. 2016;37(2):286–98.

    Article  PubMed  Google Scholar 

  59. Berlin R, Butler P, Perloff M. Gabapentin therapy in psychiatric disorders: a systematic review. Prim Care Companion CNS Disord. 2015;17(5). https://doi.org/10.4088/PCC.15r01821.

  60. Cawkwell PB, Blaum C, Sherman SE. Pharmacological smoking cessation. Drugs Aging. 2015;32(6):443–51.

    Article  PubMed  Google Scholar 

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

    Google Scholar 

  62. Siu AL. Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: U.S. preventive services task force recommendation statement. Ann Intern Med. 2015;163(8):622–34. https://doi.org/10.7326/M15-2023.

    Article  PubMed  Google Scholar 

  63. Tannenbaum MD, MSc C. Inappropriate benzodiazepine use in elderly patients and its reduction. J Psychiatry Neurosci. 2015;40(3):E27–8. https://doi.org/10.1503/jpn.140355.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Shorter D, Kosten TR. Novel pharmacotherapeutic treatments for cocaine addiction. BMC Med. 2011;9(1):119. https://doi.org/10.1186/1741-7015-9-119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA

    Rachel D. Maree M.D., M.P.H. & Craig A. Riccelli M.D.

Authors
  1. Rachel D. Maree M.D., M.P.H.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Craig A. Riccelli M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rachel D. Maree M.D., M.P.H. .

Editor information

Editors and Affiliations

  1. Professor of Psychiatry, Case Western Reserve University School of Medicine, Vice Chairman for Education and Faculty Development, Residency Program Director and Chief of Geriatric Psychiatry, MetroHealth, Cleveland, Ohio, USA

    Rajesh R. Tampi

  2. Executive Vice President, Clinical Services, Diamond Healthcare, Richmond, Virginia, USA

    Deena J. Tampi

  3. Associate Clinical Professor of Psychiatry, University of Wisconsin School of Medicine and Public Health Program Director, Geriatric Psychiatry Fellowship, Madison, Wisconsin, USA

    Lisa L. Boyle

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Maree, R.D., Riccelli, C.A. (2018). Substance-Related and Addictive Disorders. In: Tampi, R., Tampi, D., Boyle, L. (eds) Psychiatric Disorders Late in Life. Springer, Cham. https://doi.org/10.1007/978-3-319-73078-3_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-73078-3_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-73076-9

  • Online ISBN: 978-3-319-73078-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation