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

2. 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.

3. 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 used marijuana in the past year
3.9% of women aged used marijuana in the past year

4. 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.

5. 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

6. 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

7. Life changes associated with SA in older adults

8. 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

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

10. 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.

11. Conducting Brief Interventions

12. Intervention & Motivational Counseling

13. Detoxification

14. Treatment Settings & Treatment Approaches

15. Treatment Approaches (cont’d)

16. Panel Recommendations

17. Panel Recommendations (cont’d)

18. Staffing Considerations

19. Prehistoric Intervention

20. BRITE Project (Florida)

21. Fran’s Story
Let me tell you about Fran…

22. 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).

23. Oceans Behavioral Hospital

24. Grapevine Publication

25. 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:
Other useful information
BRITE handbook:
SAMHSA SBIRT webinar:

26. Questions ?
Thank you for the opportunity to share information with you today.
Stevie Hansen,
MHMR Addiction Services