Substance Abuse among Older Adults. Treatment Improvement Protocol (TIP) Series 26.

As alcohol and other drug disorders become acknowledged as major problems, the need increases for current information on the scope of the problem and appropriate treatment. This TIP serves to educate treatment providers with information about older adults who, in general, are more likely to hide their substance abuse, less likely to seek professional help, and mistake symptoms of substance abuse for another ailment. It brings together literature on substance abuse and gerontology to recommend best practices for identifying, screening, assessing, and treating alcohol, prescription drugs, and other medication abuse among people age 60 and older. Brief intervention is recommended as the first step of treatment, followed by motivational interviewing, and intervention. Brief interventions may include motivation for change strategies, patient education, assessment and direct feedback, contracting and goal setting, and behavioral modification techniques. Treatment programs take a holistic approach since a number of interrelated emotional, social, medical, and spiritual problems characterize older adults' experiences with substance abuse. It also includes information on cognitive-behavioral, group, individual, and family therapy approaches to treatment. Appendixes include: "Legal and Ethical Issues,""Tools,""Bibliography,""Resource Panel," and "Field Reviewers." (Contains 19 figures and approximately 400 resources.) (JDM)