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This publication is provided for historical reference only and the information may be out of date.

Cover of Substance Abuse Among Older Adults

Substance Abuse Among Older Adults

Treatment Improvement Protocol (TIP) Series, No. 26


Rockville (MD): Substance Abuse and Mental Health Services Administration (US); .
Report No.: (SMA) 98-3179

This TIP, Substance Abuse Among Older Adults, presents treatment providers with much-needed information about a population that is underdiagnosed and underserved. Substance abuse, particularly of alcohol and prescription drugs, often goes undetected among adults over 60 in part due to societal reasons - older adults tend to be ashamed about drinking or drug problems and see them as a moral failing. Providers, for their part, may confuse symptoms of substance use disorders with age-related changes. Because so much of older adults' substance abuse is never even identified, this TIP is aimed at not only substance abuse treatment providers but also primary care clinicians, social workers, senior center staff, and anyone else who has regular contact with older adults.

The TIP discusses the relationship between aging and substance abuse and offers guidance on identifying, screening, and assessing not only substance abuse but also disorders such as dementia and delirium that can mask or mimic an alcohol or prescription drug problem. Practical accommodations to treatment for older adults and a discussion of how to assess outcomes and treat within a managed care context round out the document.


This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. This publication was written under contract number ADM 270-95-0013. Sandra Clunies, MS, ICADC, served as the CSAT Government project officer. Writers were Paddy Cook, Carolyn Davis, Deborah L Howard, Phyllis Kimbrough, Anne Nelson, Michelle Paul, Deborah Shuman, Margaret K Brooks, Esq, Mary Lou Dogoloff, Virginia Vitzthum, and Elizabeth Hayes. Special thanks go to Roland M Atkinson, MD; David Oslin, MD; Edith Gomberg, PhD; Kristen Lawton Barry, PhD; Richard E Finlayson, MD; Mary Smolenski, EdD, CRNP; MaryLou Leonard; Annie Thornton; Jack Rhode; Cecil Gross; Niyati Pandya; Mark A Meschter; and Wendy Carter for their considerable contributions to this document.

The opinions expressed herein are the views of the Consensus Panel members and do not reflect the official position of CSAT, SAMHSA, or the U.S. Department of Health and Human Services (DHHS). No official support or endorsement of CSAT, SAMHSA, or DHHS for these opinions or for particular instruments or software that may be described in this document is intended or should be inferred. The guidelines in this document should not be considered substitutes for individualized patient care and treatment decisions.

Bookshelf ID: NBK64419PMID: 22514832


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