Older clients may be more likely to talk about physical symptoms than emotional ones. Decide whether medical conditions are present that need to be addressed during treatment. Make the right diagnosis (whether it be an SUD, a mental disorder, or a cognitive disorder). Co-occurring illnesses or conditions may be made worse by continuing to drink or use drugs. This may mean giving a full diagnostic interview, perhaps at another appointment.

Co-Occurring Mental Disorders

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. The myth that older adults do not use substances and/or do not use substances problematically has been dispelled. Older-adult substance users may not present with the same symptoms as their younger counterparts and, therefore, may be more difficult to identify.

Chapter 3 Resources

Belonging to an older cohort decreased the probability of ever receiving treatment (Blanco et al., 2015). Consistent with this study, NSDUH data indicate that among adults ages 65 and older with SUD, in 2018, 24 percent received treatment for drug use disorders, and 16.8 percent received treatment for alcohol use disorders (Center for Behavioral Health Statistics and Quality, 2019). The NSDUH does not publish disaggregated treatment data on individuals ages 65 and older. However, the Treatment Episode Data Set (TEDS), which collects data on publicly funded substance use treatment admissions, found that individuals ages 65 to 69 represented only 1.18 percent of the total admissions. Among those admitted, 38.8 percent were for alcohol, 33 percent for opioids, and 5 percent for cocaine (TEDS-2017, 2017).

You are unable to access americanaddictioncenters.org

Also, baby boomers (those born between 1946 and 1964) came of age when opinions about alcohol, marijuana, and other drugs were changing. Some medications can cause side effects that are similar to symptoms of depression (like trouble sleeping or feeling low energy). Physical health issues (e.g., severe liver disease) that affect whether medications can be given for certain SUDs, such as opioid use disorder. Make sure you have the required training and qualifications before assessing for or diagnosing SUDs. If no providers in your program have the necessary licenses and qualifications to assess for and diagnose mental disorders, make referrals as necessary to providers who can do so. Guide treatment planning, including giving clients the right level of care in the right setting.

Looking for Treatment?

(See Chapter 4 for examples of how DSM-5 criteria for AUD might not be age appropriate.) For instance, tolerance is a DSM-5 criterion for an SUD diagnosis. But older people are more likely to achieve alcoholism: causes risk factors and symptoms tolerance faster and on smaller amounts of the substance than younger adults. Therefore, tolerance in an older individual does not necessarily mean that they are dependent on the substance.

Other special physical and mental factors (e.g., whether a mental or physical disorder is present that could be making the person’s substance-related symptoms worse). Some people naturally feel more comfortable sharing information in writing than verbally. Have paper-and-pencil or computerized self-report trauma measures on hand for clients who would rather not take part in a clinical interview. Use a checklist or question list to make sure you cover all possible traumas and not just ones that are commonly thought of (like physical and sexual abuse).

  1. Check for possible drug-drug interactions with clients’ other medications.
  2. An important future direction will be to expand the evidence-base for the treatment of older adults.
  3. He has had older patients whose heart problems, liver disease and cognitive impairment were most likely exacerbated by substance use.

Knowing why, how, and whom to screen for substance misuse and co-occurring mental or neurocognitive disorders will help you provide more complete care. It also increases the chances of clients receiving the correct diagnosis and needed treatment. There is little study of lifetime trauma exposure among individuals engaged in medication treatment for opioid use disorder (MOUD). A multisite study provided the opportunity to examine the prevalence of lifetime trauma and differences by gender, PTSD what are the immediate short-term effects of heroin use status, and chronic pain. This chapter of TIP 26 will help behavioral health service providers, social service providers, and other healthcare providers who work with older adults better understand how, when, and why to use screening and assessment to address substance misuse in their older clients. There were distinct gender differences in trauma exposure, the most striking being the higher number of women who reported sexual abuse in childhood and sexual assault in adulthood compared to men.

Although group treatment can reduce isolation and shame related to substance use and is often the preferred method of providing substance abuse treatment, the lack of elder-specific treatment available in the community113 may actually enhance feelings of isolation and shame in a group context. Older adults may not easily relate to or feel uncomfortable discussing their problems with younger persons. Individual therapy provides a private and confidential forum for older adults to explore their unique issues, without these same risks. It is important to note that many of the health benefits of moderate alcohol use for older adults may come with negative trade-offs. Older adults may be more likely to experience mood disorders, lung and heart problems, or memory issues. Drugs can worsen these conditions, exacerbating the negative health consequences of substance use.

Keep in mind that almost all clients will have mixed feelings about their substance use. They will find some aspects of it pleasant and beneficial but other aspects difficult, painful, or harmful. You can help clients discover their own reasons for wanting to change by talking about these mixed feelings and pointing out problem areas. Per SAMHSA, it is a clinical approach genetics of alcohol use disorder national institute on alcohol abuse and alcoholism niaaa to helping clients make positive changes in their behavior. MI involves techniques like showing concern and empathy, avoiding arguing, and supporting a client’s self-efficacy (a person’s belief that he or she can successfully make a change). Explain what will take place during and after the screening and assessment so that the individual knows what to expect.

You can find more information about Adverse Childhood Experiences (ACEs) on the CDC’s website (/violenceprevention​/childabuseandneglect​/acestudy/index.html). Living in the home with someone who misuses substances or has a mental disorder. Having physical conditions negatively affected by drinking (like high blood pressure and diabetes).

Post a comment

Your email address will not be published.

Related Posts