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)

Patterns of Onset

Alcohol problems can also be classified in terms of duration or frequency of onset. It is important to understand whether the problem is of recent origin or is longstanding, because the pattern of drinking tends to affect medical and psychosocial problems. It also can help determine the best type of treatment and ways to prevent problems. However, the origin of the alcohol problem rarely affects treatment compliance or outcome.

All drinking patterns have the following in common: denial by the person and the family (alcoholism has been called the disease of denial); depression (depression and alcoholism frequently coexist); and enabling behaviors of others.

The patterns of onset are:

• Early onset
• Late onset or “reactor”
• Intermittent
• Focal problem drinking

Also see Clinical Characteristics of Early- and Late-Onset Problem Drinkers.