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Substance Use Disorders in Older Adults

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Geriatric Psychiatry Study Guide

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Abstract

Substance abuse is a major class of psychiatric illnesses in all patients but poses specifically greater challenges in geriatric psychiatry. Older patients, especially those with long history of substance use, are at particular risk for chronic systemic medical and psychiatric complications of substance abuse, attributable to the “wear and tear” on body systems from years of abnormal neurophysiology. Psychiatric comorbidity or even “tri-morbidity” (e.g., substance abuse + depressive disorder + personality disorder) presents particular challenges in the geriatric population, as the cumulative effects of multi-morbid psychiatric illness may both obscure the often surreptitious role of substance abuse (masking its clear diagnosis) and complicate other psychiatric treatment. In addition, recovery programming needed to gain control over substance abuse may not be readily available to older patients. Management of substance abuse in geriatric patients therefore calls on sophisticated clinical skills and acumen.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Ana Hategan

  2. Department of Psychiatry, Baylor Scott and White Health Central Texas Division, Dallas, TX, USA

    James A. Bourgeois

  3. Department of Psychiatry, Texas A&M University Health Science Center, College of Medicine, Temple, TX, Canada

    James A. Bourgeois

  4. St. Joseph’s Healthcare Hamilton, McMaster University, Hamilton, ON, USA

    Tracy Cheng

  5. Mercy San Juan Medical Center, Farmington, NM, USA

    Julie Young

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  1. Ana Hategan
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  4. Julie Young
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Hategan, A., Bourgeois, J.A., Cheng, T., Young, J. (2018). Substance Use Disorders in Older Adults. In: Geriatric Psychiatry Study Guide. Springer, Cham. https://doi.org/10.1007/978-3-319-77128-1_7

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