CHAPTER 22
Substance Use Disorders and the Older Adult
LEARNING OBJECTIVES
After studying this chapter, students should be able to:
•
22.1: Understand the scope of the problem of substance use and misuse in
older adults
•
22.3: Consider the challenges in detecting SUDs in older adults
•
22.4: Review the treatment of SUDs in older adults
CHAPTER OUTLINE
Scope of the Problem
What Are the Consequences of an SUD in the Older Adult?
Why Is the Detection of SUDs in Older Adults So Difficult?
Different Patterns of Alcohol/Drug Misuse in the Older Adult
Prescription Drug Misuse
The Treatment of Older Patients with SUDs
Adults over 80
CHAPTER OVERVIEW
A growing body of evidence has emerged demonstrating that the substance use disorders
(SUDs) have differing patterns and consequences in older adults. The purpose of this chapter is
DISCUSSION QUESTIONS
Break-Out Discussion:
Given what was explored in this chapter, we know that the misuse of alcohol and other
drugs, including prescription medications, is a significant concern. Detecting an SUD can
be particularly challenging. However, one of the greatest challenges may lie in realizing
that individuals in this age group should be screened for SUDs. The mindset of those
working with this age group is important to consider.
Questions
1. You may already or may in the future work with older adults. Explore your own
biases. What surprised you in your readings? What surprises might relate to your
own biases or incorrect assumptions about older adults?
2. How might your own biases impact the way in which you evaluate someone who
is in the older adult age group? Do you have a tendency to believe that those in
this age group should be allowed to misuse alcohol and other substances? Why
or why not?
3. How do you think social isolation may play into the problem with SUDs in older
adults? How might more free time play into the problem for others within this
age group?
KEY CONCEPTS AND TERMS
Late-onset alcoholism: Those individuals who did not show evidence of an AUD in young
or middle adulthood, but who did develop an AUD in late adulthood
Late-onset exacerbation: Older adults with AUDs who had intermittent problems with
alcohol in young and middle adulthood, but did not develop a habitual pattern of alcohol
misuse until late adulthood
Early-onset alcoholism: A pattern of problems with alcohol in young adulthood, which
continued through middle adulthood into the late adult years
LO/STANDARDS CORRELATION CHART
A-head
LO
Standard 1—CACREP
Scope of the
Problem
22.1:
Understand
the scope of
the problem of
substance use
and misuse in
older adults
3d: theories and etiology of addictions
and addictive behaviors
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and
behavior
What Are the
Consequences of
an SUD in the
Older Adult?
22.2:
Understand
the
consequences
of SUDs for
older adults
3d: theories and etiology of addictions
and addictive behaviors
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and
behavior
Why Is the
Detection of SUDs
in Older Adults So
22.3: Consider
the challenges
in detecting
3d: theories and etiology of addictions
and addictive behaviors
3e: biological, neurological, and
Different Patterns
of Alcohol/Drug
Misuse in the
Older Adult
Prescription Drug
Misuse
adults
development, functioning, and
behavior
3f: systemic and environmental factors
that affect human development,
functioning, and behavior
The Treatment of
Older Patients
with SUDs
Adults over 80
22.4: Review
the treatment
of SUDs in
older adults
1e: advocacy processes needed to
address institutional and social barriers
that impede access, equity, and
success for clients
5h: developmentally relevant
counseling treatment or intervention
plans