Addiction in the Older Patient

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Addiction in the Older Patient

Edited by Maria Sullivan and Frances Levin

Abstract

Addictive disorders in older adults are underdiagnosed and undertreated. An important reason for this lack of recognition of a serious health problem is a paucity of clinical knowledge about how such disorders present in this population. The presentation for alcohol and substance use disorders in the elderly can be confusing, given the metabolic changes and concurrent conditions associated with aging, together with interactions between alcohol and prescribed psychoactive drugs. Further, screening instruments have not been validated for this population. Brief interventions may be effective but should take into account contextual needs such as medical conditions, cognitive decline, and mobility limitations. Treatment strategies, including detoxification regimens, need to be modified for older patients and - in the case of opioid dependence - must address the management of chronic pain in this population. Ironically, benzodiazepines are the most frequently prescribed psychoactive medication in the elderly, despite older individuals' greater sensitivity to side effects and toxicity. Older women are at particularly heightened vulnerability for iatrogenic dependence on sedatives and hypnotics. More clinical research data are needed to inform screening and referral strategies, behavioral therapies, and pharmacological treatment. At the same time, emerging technologies such as communication tools and monitoring devices offer important opportunities to advance addiction treatment and recovery management in older adults. Although research to date has been limited in this population, recent data suggest that treatment outcomes are equal or better to those seen in younger cohorts.

Bibliographic Information

Publisher:: Oxford University Press

Print Publication Date:: Aug 2016

Print ISBN-13:: 9780199392063

Published online:: Sep 2016

DOI:: 10.1093/med/9780199392063.001.0001

Authors

Maria Sullivan, editor Associate Professor of Clinical Psychiatry, Columbia College of Physicians and Surgeons/New York State Psychiatric Institute, New York, NY

Frances Levin, editor Kennedy-Leavy Professor of Clinical Psychiatry, Columbia University, New York

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Front Matter
- Contributors
Chapter 1 IntroductionMaria A. Sullivan and Frances R. Levin
Chapter 2 Recognizing Addiction in Older PatientsAnna Levesque and Edward V. Nunes
Chapter 3 Brief Interventions for Substance-Use Disorder in Older PatientsRoland C. Merchant and Francesca L. Beaudoin
Chapter 4 Alcohol and Older AdultsAnna Terajewicz LaRose and John Renner
Chapter 5 Abuse of Opioids and Prescription MedicationsIsis Burgos-Chapman, Louis A. Trevisan, and Kevin Sevarino
Chapter 6 Cannabis, Nicotine, and Stimulant Abuse in Older AdultsChristina A. Brezing and Frances R. Levin
Chapter 7 Benzodiazepines and Other Sedative-Hypnotics in the Older AdultArthur Robin Williams and Olivera J. Bogunovic
Chapter 8 Assessment in the Older PatientRahul Rao and Ilana Crome
Chapter 9 Sex Differences in Late-Life Substance-Use DisordersElizabeth Evans and Maria A. Sullivan
Chapter 10 Treatment Options for Older Adults with Substance-Use DisordersStacy A. Cohen, Margaret M. Haglund, and Larissa J. Mooney
Chapter 11 Technology-Based Interventions for Late-Life AddictionEsra Alagoz, Kim Johnson, Andrew Quanbeck, and David Gustafson, Jr.
Chapter 12 ConclusionMaria A. Sullivan
End Matter
- Index

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date: 02 March 2021

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Edited by Maria Sullivan and Frances Levin

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Edited by Maria Sullivan and Frances Levin

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