Substance Abuse in the Elderly (Part 2)As mentioned in last week’s Weekly Message, substance abuse in our elderly is at epidemic proportions. Understanding and identifying the problem is paramount towards the treatment of our elder substance abusers, however, utilizing the proper treatment modality is Part II for successful outcomes in substance abuse cases.
Treatments must be age-specific and “tailored to the specific physical, emotional, and psychological needs of older adults.” There are several factors which differentiate younger treatment patients from elder treatment patients. For example, “withdrawal is typically more difficult and dangerous for older adults” and “initial treatment of older addicted adults often requires more intensive medical support than is necessary in younger patients.” (Source: www.drug-addiction.com/senior_treatment.htm). Problems, such as denial, concurrent mental health issues (i.e., depression, dementia, etc.), isolation, and others, complicate the successful completion of treatment for substance abuse.
Before a treatment program can be successful, or even properly selected, the family and the elder must be educated on the particular issues involved; such as what is causing the substance abuse, what are the potential treatment programs and methodologies, and what is the success rate for each program. Family input is essential in this stage because behaviors, current medication use, changes in moods or habits, etc., all play significant parts in the treatment process.
With regard to treatment programs, many factors must be considered: Will this be an inpatient rehabilitation stay (more appropriate for frail elders, suicidal individuals, or those with ongoing mental health issues), residential rehabilitation, outpatient rehabilitation, holistic approach or specific abuse treatment, etc.? Treatment options include (source: National Institute of Health www.ncbi.nlm.nih.gov/books/NBK25639):
• Cognitive-behavioral approaches
• Group-based approaches
• Individual counseling
• Medical/psychiatric approaches
• Marital and family involvement/family therapy
• Case management/community-linked services and outreach
There are numerous professionals who can assist with treatment options for an elder substance abuser, but the first step is to visit the elder’s internist or family doctor. Additional professionals that may be instrumental in coming to the aid of an elder substance abuser are (source: www.ncbi.nlm.nih.gov/books/NBK25639):
• A geriatrician
• A geriatric psychiatrist
• A geropsychologist
• A gerontological counselor
• A nutritionist
• An activities director or recreational therapist
• A chaplain or other member of the clergy
• Occupational therapists
• Social workers
• Peer counselors
Treating our elders is a significant challenge on many fronts. Yet, with continuing research and improved treatment options, much success can be had.
Our elders represent our history. And as we all know, without history we have no future. Please have your caregivers and your staff begin to notice any abnormal behaviors, medication misuse, moods swings, changes in eating and sleeping habits, etc.
Your observations may just save a life!