Treatment of Substance Use Disorders Overdose Prevention

Inpatient treatment is an option for older adults who need around-the-clock care and support while they undergo detoxification and treatment for their substance abuse problems. This type of treatment offers a safe, structured environment with constant access to medical professionals, counselors, and other mental health professionals with expertise in treating older adults suffering from addiction. But a major hurdle across the care spectrum is that substance use disorder in older adults remains a hidden problem because of lack of screening in primary care and few guidelines for assessing older adults who might be using. Lehmann points out that it’s common for primary care providers, specialists and emergency physicians to prescribe opioids and benzodiazepines on a long-term basis. That practice, she says, can lead to dependence as well as negative cognitive effects. Access to health information, a key component of health literacy, enables people to better manage their health and sustain recovery.

• Connecting your older clients with recovery supports when the urge to drink or use drugs arises.
• Despite increasing rates of substance use in older adults, the number of referrals made by healthcare providers for substance use treatment has been declining 6.
• Examples of sterile fluids include intravenous (IV), irrigation and dialysis fluids.
• Experts recommend that older people have no more than seven alcoholic drinks per week.

Screening Instruments and Other Tools

It is administered as either a self-report questionnaire or a structured interview.1227 The HELP screening tool is a short version of the comprehensive assessment. It is quick and easy to understand when administered to older adults as a self-report review of health-related lifestyle and wellness factors. (See page 32 of /Assets/csudh-sites/ot/docs/3%20Health%20Enhancement%20Lifestyle%20Profile%20(HELP)-Guide%20for%20Clinicians-2016.pdf for the screening tool.) The questions focus on exercise, nutrition, social support, recreational activities, and spirituality. Help older clients learn which health and wellness activities will help them prevent return to substance misuse, broaden social networks, build resilience, and give meaning and purpose to ongoing recovery.

Provider Resources

For example, many older clients start taking pain medication to reduce physical discomfort. However, they may continue taking the medication to also manage emotional pain or to reduce withdrawal symptoms that occur when they try to stop taking it. Clients may misuse both prescribed and nonprescribed substances, such as alcohol, for such reasons. Thinking about the role of chronic physical conditions in older clients’ misuse of substances (e.g., use of substances to manage chronic pain). Such conditions can also affect symptoms of substance misuse and treatment response.

Positive Results

Three what is the best treatment for substance abuse for older adults key elements of preventive care for older adults in recovery from substance misuse are nutrition, exercise, and fall prevention. You don’t need to be an expert in nutrition or fitness to provide older adults with accurate information about health. Just knowing a few things about these elements of wellness for older adults can help you get the conversation started. Chapter 7 addresses promoting social support and other health and wellness strategies relevant to older adults in recovery from substance misuse. Providers need to engage older adults in illness management and relapse prevention activities specific to substance misuse with a focus on health and wellness.

Treating Substance Use Disorder in Older Adults: Updated 2020 Internet.

• Make referrals to medical services that provide respectful, consistent physical health care.
• Ask clients what worked and did not work, and help them adjust the change plan while making progress toward change goals.
• When possible, help facilitate these referrals by offering a “warm handoff” of clients to the referred provider, which helps ensure that clients are able to successfully access mental health services.
• Indeed, recent projections show that by 2020, substance use disorders among adults over age 50 will increase to 5.7 million, up from 2.8 million in 2006.
• For more information about alcohol screening, see the “Screening and Assessment” section in Chapter 4 of this TIP.

Other drugs, such as opioids and benzodiazepines can cause or exacerbate respiratory depression. Injection drug use can cause a variety of infections (e.g., endocarditis), which are more likely to occur in individuals with general medical conditions. Substance use also can trigger or intensify medical conditions such as diabetes or cardiovascular disease, which are common among older adults (Satre, 2015). Belonging to an older cohort decreased the probability of ever receiving treatment (Blanco et al., 2015). Consistent with this study, NSDUH data indicate that among adults ages 65 and older with SUD, in 2018, 24 percent received treatment for drug use disorders, and 16.8 percent received treatment for alcohol use disorders (Center for Behavioral Health Statistics and Quality, 2019).

Addresses ways to build structure into daily routines to support clients’ ability to manage symptoms while emphasizing recovery and wellness activities (e.g., take medication as scheduled, have lunch with a friend, attend AA meetings or other support groups). Explores with clients how having a chronic condition affects them and how, if not properly managed, the condition may interfere with recovery from substance misuse. The first section of Chapter 7 describes the importance of social support in promoting and maintaining health, wellness, and recovery among older adults who misuse substances. Having a first-degree relative (i.e., a parent, child, sister, or brother) who misuses substances. For instance, a person has five times the risk of developing alcohol dependence if he or she has any first-degree relative with alcohol dependence.516 The client’s misuse may have a basis in genetic factors, modeling of behavior of others, or both. These include drug-drug interactions, fall risk, driving risks, and safe storage of opioid medications.

Support groups are vital for older adults suffering from substance abuse issues. They offer a safe and comfortable space to talk freely and openly about one’s experiences. They can provide an opportunity for older adults to connect with peers who have gone through similar struggles, providing a forum to share advice and strategies that have proven successful in managing their addiction. Family, friends, and doctors often don’t know when older people have a problem with alcohol and drugs. Once you retire, problem drinking or drug use doesn’t interfere with your job. Sometimes, people notice but ignore it, thinking it’s best for older people to keep doing what makes them happy.