Substance use disorders in older people

Substance use disorders in older people are a growing public health problem and are often overlooked. Although alcohol is a very commonly used substance, older people also smoke cigarettes, use prescribed medications, buy over-the-counter medication and are increasingly using illicit drugs. These substances impact on mental health, even if the effects may seem less obvious than in younger people.

Older people access many different care pathways, including liaison psychiatry and old age psychiatry services. 'Dual diagnosis’ (comorbid substance use disorders and psychiatric illness), rather than substance use disorder alone, is the commonest presentation within old age psychiatry services.

While the evidence base for the treatment of substance use disorders in older people is limited, evidence suggests that older people engage better in treatment when compared with younger people.

This module will cover the following areas:

• terminology, classification and diagnosis
• epidemiology, assessment and psychological treatment of alcohol use disorder (including a video case presentation)
• comorbid psychiatric illness and substance use disorders or ‘dual diagnosis’
• benzodiazepine misuse
• use of other substances e.g. prescribed medications, over-the-counter drugs, opiates and nicotine
• treatment of substance use disorders.