CONTENTS

Table of Contents
Introduction

1. Overview
2. Recognizing Alcohol Misuse and Abuse in Older Adults
3. Alcohol and Aging
4. Diagnosing Alcohol Problems in Older Adults
5. Recognizing Other Forms of Substance Abuse
6. Prevention and Early Intervention Strategies
7. Treatment
8. Outcomes and Cost Issues in Alcohol Treatment for Older Adults
9. Legal and Ethical Issues

Supplements
Resources

At Any Age, It Does Matter:
Substance Abuse and Older Adults (for Professionals)

Prescription Drugs

In addition to increased risks from alcohol use, older adults face dangers associated with prescription drugs. For example, almost 40 percent of benzodiazepine prescriptions are for older adults.⁶ The dangers associated with prescription drugs include problematic effects due to age-related changes in drug metabolism, interactions among prescriptions, and interactions with alcohol.

Unfortunately, psychoactive drugs, especially those with longer half-lives, often result in unwanted side effects that influence functional capacity and cognition. These side effects increase the risk of falls and institutionalization.⁷

Older users of psychoactive drugs experience more adverse effects than do younger adults, including:

• Excessive daytime sedation
• Ataxia
• Cognitive impairment

Attention, memory, physiological arousal, and psychomotor abilities are often impaired as well. In addition, drug-related delirium or dementia may wrongly be diagnosed as Alzheimer’s disease.