The Silver Tsunami: Understanding Substance Use Disorders in Later Life

The Silver Tsunami: Understanding Substance Use Disorders in Later Life Dr. John Dyben DHSc, CAP, CMHP

Defining the Older Adult Many studies include anyone over 50 U.S. retirement age is 65-67 World Health Organization-2 Categories: Older adult = 65-79 Elderly = 80 and older

Population Trends By 2030, one-fifth of US population >65 Life span expectations >85 Longer living also means more chronic illness Substance abuse a major factor in this equation

Older Adult Substance Abuse Common problem amongst older adults Less likely to be recognized or addressed Causes and exacerbates health problems Correlates with hip fractures and dementia

Alcohol Abuse

Alcohol Abuse More than 2.5 Million older adults today Expected to double by 2020 Number one drug of choice for older adults AGA recommends annual screenings A continuum of progression into addiction

Prescription Drug Abuse

Prescription Drug Abuse More prevalent in older adults Increased access Multiplicity of medications Creeping up on alcohol s #1 spot Disagreements in medical community

Illicit Drugs Estimated 4.8 million older adults in 2010 Marijuana by far most common illicit drug of abuse. The face of drug abuse is changing!

Treatment Differentiations Older adults have unique treatment needs Private treatment centers: 18% address older adult needs in any way Roughly 5% have tracts Full programs so rare they are not even mentioned

Treatment Needs of Older Adults

Effective Treatment Models Tailored to address issues of aging Include friends, family and other support Respectful, non-confrontational Peer support

Treatment Needs of Older Adults Physical needs More likely to have 2+ chronic medical conditions More likely to have severe physical impairment Slower metabolism Detox and treatment will take longer

Treatment Needs of Older Adults Psychological Needs Depression, anxiety, dementia Relevant approaches: Practiced physical activity Cognitive Behavioral Therapy Problem Solving Therapy Interpersonal Therapy

Treatment Needs of Older Adult Social Needs of Older Adults Major Changes Changing social status Deaths of loved ones Changes in social support Social environment influences use

Treatment Needs of Older Adult Social Needs of Older Adults Treatment should: Support long-term social support systems Be age specific Be cohort driven

Generational Cohorts Groups of people born within a given time frame Experienced common events Lives shaped by formational experiences Effects remain through lifespan Relevant for cultural awareness

The Good Warriors Born 1908 to 1929 World War II The Great Depression Prohibition Institutional authority trusted

The Baby Boomers Born between 1946 to 1964 Vietnam Civil Rights Movement Sex, Drugs, & Rock and roll Institutional authority feared and distrusted

Treatment Needs of Older Adult Spiritual Needs Socially supportive spiritual practices Reframe past and current struggles Not necessarily religious but may be Most significant predictor of healthy adjustment

Conclusions The older adult population is growing Substance abuse and addiction are common These problems are under recognized Screening and assessment imperative Treatment for this problem must be specialized

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