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Recognizing Addiction in Older Patients 

Recognizing Addiction in Older Patients
Recognizing Addiction in Older Patients

Anna Levesque

and Edward V. Nunes

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date: 13 June 2021

Alcohol and substance-use disorders in older adults can present in primary care practice in subtle or confusing ways. Screening and diagnostic tools validated in younger populations may limit their recognition. The main objective of this chapter is to differentiate signs and symptoms of alcohol or substance use disorder from other medical and psychiatric comorbidities. We review normal metabolic changes associated with aging as well as clinical features of harmful drinking. The risks of combining alcohol with psychoactive prescription medications are also considered. The relevance of DSM-5 diagnostic criteria to older patients is explored, and we review the evidence for the importance of systematic screening using validated instruments in an older population. Therapeutic vs. aberrant uses of psychoactive prescription medications in the geriatric population are discussed. Finally, we review patterns of illicit substance use in older adults.

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