Substance Use and Older People

Substance use and addiction is an increasing problem amongst older people. The identification of this problem is often more difficult in older patients and is frequently missed, particularly in the primary care context and in emergency departments, but also in a range of medical and psychiatric specialties. Substance Use and Older People shows how to recognise and treat substance problems in older patients. However, it goes well beyond assessment and diagnosis by incorporating up–to–date evidence on the management of those older people who are presenting with chronic complex disorders, which result from the problematic use of alcohol, inappropriate prescribed or over the counter medications, tobacco, or other drugs. It also examines a variety of biological and psychosocial approaches to the understanding of these issues in the older population and offers recommendations for policy. Substance Use and Older People is a valuable resource for geriatricians, old age psychiatrists, addiction psychiatrists, primary care physicians, and gerontologists as well as policy makers, researchers, and educators. It is also relevant for residents and fellows training in geriatrics or geri–psychiatry, general practitioners and nursing home physicians.

Contributors Foreword Introduction Section 1 Legal and ethical aspects of care for older people with substance misuse 1 Negotiating Capacity and Consent in Substance Misuse Dr Kritika Samsi 2 Elder Abuse Jill Manthorpe 3 The US Perspective On The Legal And Ethical Aspects Of Care For Older People With Substance Misuse Cynthia M. A. Geppert, Peter J. Taylor 4 The European Perspective Abdi Sanati, Mohammed Abou–Saleh 5 Clinical Medicine and Substance Misuse among Older Adults: Research, Assessments, and Treatment Amit Arora, Andrew O’Neil, Peter Crome, Finbarr Martin Section 2 Epidemiology and Demography 6 Current Cigarette Smoking among Adults aged 45 years or older in the United States, 2002–2011 Shanta R. Dube, Li–Tzy Wu 7 Epidemiology and Demography of Alcohol and the Older Person Stephan Arndt, Susan K. Schultz 8 Epidemiology and Demography of Illicit Drug Use and Drug Use Disorders among Older Adults Aged 50 and Older Shawna L. Carroll Chapman, Li–Tzy Wu 9 Epidemiology and Demography of Nonmedical Prescription Drug Use among Older Adults Jane Carlisle Maxwell Section 3 Longitudinal Studies of Ageing and Substance Abuse 10 Ageing and the Development of Alcohol Use and Misuse Marja Aartsen 11 Progression from Substance Use to Development of Substance Use Disorders in the Older Person Carla L Storr, Kerry M Green 12 Psychopharmacology and the Consequences of Alcohol and Drug Interactions in Older People Vijay A. Ramchandani, Patricia W. Slattum, Ashwin A Patkar, Li–Tzy Wu, Jonathan C. Lee, Maitreyee Mohanty, Marion Coe, Ting–Kai Li Section 4 Comprehensive Geriatric Assessment and Special Needs of Older People 13 Comprehensive geriatric assessment and special needs of older people Dan Wilson, Stephen Jackson, Ilana Crome, Rahul (Tony) Rao, Peter Crome Section 5 Screening and Intervention in Health Care Settings 14 Screening and Brief Intervention for Older Adults in the Psychiatric Setting M. Shafi Siddiqui, Michael Fleming 15 Tobacco Use Cessation among Older Adults Daniel Pilowsky, Li–Tzy Wu Section 6 Utilization of Substance Abuse Treatment Services among Older Adults 16 Epidemiology of Utilization of Substance Abuse Treatment Services among Adults aged 50 and older Shawna L. Carroll, Li–Tzy Wu 17 Substance Misuse and Older people: Implications for Primary Care Steve Iliffe, Devoshree Chatterjee 18 Addiction Liaison Services for Older Adults Roger Bloor, Derrett Watts 19 Current Healthcare Models and Clinical Practices Rahul (Tony) Rao, Ilana Crome, Peter Crome, Finbarr C Martin Section 7 Age–specific Treatment Interventions and Outcomes 20 Pharmacological and Integrated Treatments in Older adults with Substance Use Disorders Paolo Mannelli, Li–Tzy Wu, Kathleen T. Brady 21 The Assessment and Prevention of Potentially Inappropriate Prescribing for Elderly Patients. Denis O’Mahony 22 Age–Sensitive Psychosocial Treatment for Older Adults with Substance Abuse Kathleen Schutte, Sonne Lemke, Rudolf Moos, Penny Brennan 23 Integrated Treatment Models for Co–morbid Disorders Rahul (Tony) Rao Section 8 Policy: Proposals for Development 24 Proposals for Policy Development: Drugs. Susanne MacGregor 25 Proposals for Alcohol–Related Policy Development for Older People in the United States Ralph Hingson, Ting–Kai Li 26 Proposals for Policy Development–Tobacco Michael Givel 27 Recommendations Ilana Crome, Peter Crome, Rahul (Tony) Rao, Li–Tzy Wu

Ilana Crome, Emeritus Professor of Addiction Psychiatry, Keele University, Keele, UK; Honorary Consultant Psychiatrist, South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Stafford, UK; Honorary Professor, Queen Mary University of London, London, UK; Senior Research Fellow, Imperial College, London, UK Li–Tzy Wu, Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USA Rahul (Tony) Rao, Visiting Researcher, Department of Old Age Psychiatry, Institute of Psychiatry, London, UK and Lead for Dual Diagnosis, Mental Health of Older Adults and Dementia Clinical Academic Group, South London and Maudsley NHS Foundation Trust, UK Peter Crome, Honorary Professor, Department of Primary Care and Population Health, University College London, London, UK; Emeritus Professor of Geriatric Medicine, Keele University, Keele, UK