Substance misuse in older adults

This chapter describes the extent and nature of substance misuse in older adults, and how practice can be adapted to meet their needs. 'Early-onset' problem drinkers comprise the remaining two-thirds, and are individuals who develop an alcohol problem earlier in life and have continued problem drinking in old age. Opioid analgesics can produce a sense of euphoria and well-being and have the potential to produce physical and psychological dependency. Some drugs containing low doses of opioids such as codeine are available without a prescription. Medication misuse by older adults is usually unintentional, and the term 'involuntary addiction' is used by some to describe the type of drug dependence which has occurred through medications taken initially to treat a medical condition. The assessment of older people with substance misuse should incorporate a range of knowledge, skills and attitudes acquired from both addiction and older people's mental health services.