At Any Age, It Does Matter:
Substance Abuse and Older Adults
(for Professionals)
Screening Guidelines
It is preferable to use standardized screening questionnaires. However, friendly visitors, Meals-On-Wheels volunteers, caregivers, and health care providers can interject screening questions into their normal conversations with older, homebound adults.
Comfort with this line of questioning will depend on the person’s relationship with the older person and the responses given. Direct questions may be useful or indirect questions may be used if direct questioning feels uncomfortable or inappropriate.
If the questioner suspects that prescription drug abuse may be occurring, a clinician should probably be notified if any of the following are true about the older adult:
- Defensive about his or her use
- Confused about various prescription drugs
- Seeing more than one doctor
- Using more than one pharmacy
Several warning signs may emerge in conversation and should prompt a more indepth screen or an assessment:
- Withdrawing from family, friends, and neighbors
- Withdrawing from normal and lifelong social practices
- Sleeping during the day and other sleep disturbances
- Experiencing bruises, burns, fractures, or other trauma, particularly if the individual does not remember how and when they were acquired
- Changing personal grooming and hygiene
- Being expelled from housing
In addition, warning signs specific to alcohol or prescription drugs may emerge.
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Last Updated: 07-03-2002
SAMHSA is an Agency of the U.S. Department of Health & Human Services
