Substance Abuse Among Older Adults Stevie Hansen, B.A., LCDC, NCACI Chief, Addiction Services

The Baby Boomers A 2010 SAMHSA study indicates that the aging of the baby boom generation is resulting in a dramatic increase of illicit drug use among adults 50 and older.

SAMHSA Short Report A recent SAMHSA short report shows that an estimated 4.3 million adults aged 50 or older (4.7%) used an illicit drug in the past year. 8.5% of men aged 50-54 used marijuana in the past year 3.9% of women aged 50-54 used marijuana in the past year

The Risks Substance abuse at any age is associated with numerous health and social problems, but age related physiological and social changes make older adults more vulnerable to the harmful effect of illicit drug use. Older adults have increased medication sensitivity, slower metabolism and elimination, elevated rates of pain, sleep disorders/insomnia, anxiety and cognitive decline all which could lead to improper use of medications.

Prescription Drug Use Among Adults 65+ Older adults use 1.5 billion or 30% of all prescription drugs and 40% of all over-the-counter drugs (USFDA, 2004) Estimates vary of the average number of medications older adults take each day – up to 20 or more Approximately 25% of older adults use psychoactive medications and are likely to take them for long periods of time

Over-the-Counter Drug Use Among Adults 65+ 87% of older individuals 70+ years reported regular use of at least one OTC medication 57% reported taking five or more OTC medications daily

Life changes associated with SA in older adults

Assisted Living & Residential Care residents 4.4% of residents were found to have substance abuse disorders 4% of residents were found to have alcohol dependence 0.5% were found to have drug dependence or abuse

Screenings BRITE Brief Intervention & Treatment for Elders CAGE Questionnaire MAST-G Michigan Alcoholism Screening Test – Geriatric AUDIT Alcohol Use Disorders Identification Test

Executive Summary & Recommendations Researchers are only beginning to realize the pervasiveness of SA among people 60+ years. Alcohol and drug use affecting 17% of older adults was not discussed in SA or gerontological literature until recently. Reasons for the silence: Overlooked by healthcare providers, mistaken for depression/dementia Older adults hide their abuse, less likely to seek help Relatives of these older adults are ashamed and choose not to address it. The SAMHSA TIP series #26 is for anyone having regular contact with older adults and aims to advance the understanding of the relationship between aging and SA to provide practical recommendations for incorporating that understanding into practice.

Conducting Brief Interventions

Intervention & Motivational Counseling

Detoxification

Treatment Settings & Treatment Approaches

Treatment Approaches (cont’d)

Panel Recommendations

Panel Recommendations (cont’d)

Staffing Considerations

Prehistoric Intervention

BRITE Project (Florida) http://brite.fmhi.usf.edu/Files/BRITEWorkbook-English.pdf

Fran’s Story Let me tell you about Fran…

Expanding older adult Peer led support programs The demand for more consumer-led, recovery-oriented services has increased in past decades and continues to grow, and evidence supporting the benefits of these services is emerging. However, information on the availability and impact of MH/SU peer support for older adults is sparse, although some noteworthy programs provide consumer-oriented, peer-led MH/SU support to older adults, including programs associated with larger establishments like Alcoholics Anonymous (AA) and the VHA. Seniors in Sobriety (SIS) is a coalition of AA members who are concerned with spreading the message of sobriety to older adult alcoholics (SIS, 2012). SIS, originally called Sober over Sixty, began in 1990 in southeastern New York (SIS, 2012). The reach of SIS has grown, as more communities recognize the unique concerns of older adult alcoholics. According to the 2004 AA Membership Survey, 16 percent of AA members are over age 60, and 23 percent are ages 51 through 60 (Alcoholics Anonymous, 2008).

Oceans Behavioral Hospital http://oceansfortworth.com/

Grapevine Publication www.aagrapevine.org

Sources of Information & Resources Sources for Information and Data used in this presentation MH and SA Workforce Older Adults (Institute of Medicines of The National Academies)   SAMSHA TIP 26 Substance Abuse among Older Adults Handouts Tools and Scales National Institute on Aging – Alcohol use in Older People: http://www.nia.nih.gov/health/publication/alcohol-use-older-people Other useful information BRITE handbook: http://brite.fmhi.usf.edu/Files/BRITEWorkbook-English.pdf SAMHSA SBIRT webinar: http://www.integration.samhsa.gov/images/res/SBIRT%20Webinar,%20PPP%20final.pdf

Questions ? Thank you for the opportunity to share information with you today. Stevie Hansen, MHMR Addiction Services stevieh@mhmrtc.org