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)

Drug Interactions

The potential for drug interactions in older adults is rather high, considering that they account for 25 to 30 percent of all prescriptions.^11,16,49 Drug interactions can be extremely dangerous and dramatic. Although results of studies vary, older adults experience more than half of all reported adverse drug reactions leading to hospitalization.⁵²

Harmful drug combinations, such as meperidine (Demerol) and monoamine oxidase (MAO) inhibitors (e.g., Marplan), can produce effects such as:

• Marked blood pressure fluctuations
• Excitability
• Rigidity
• Hyperreflexia
• Hyperthermia
• Coma
• Death

More often, however, such interactions produce subtle or mild effects. A change in sleep, appetite, or anxiety levels may be the only sign of a problem. In response, some clinicians might increase the dose of a medication that is already contributing to an adverse reaction.