Week 1 Adult Health - Substance Abuse in the Elderly

What types of drugs are commonly used by elderly folk?

Alcohol abuse Prescription medication Marijuana Nicotine

Why does substance abuse in the elderly often go untreated?

Embarrassment Shame Isolation Psychosocial and functional decline (confused for "just getting older"_ It goes unrecognized by the public Easy for them to hide their substance abuse because they are not involved much in activities such as going to work, driving, meeting people frequently Some doctors do not recognize it as substance abuse and may assume that the elderly person is acting as such because they are confused

True or False Substance abuse is not very common in the elderly

FALSE. •Alcohol is the most commonly abused substance, and accounts for Approx 18% of older adults who are hospitalized for general medical and surgical procedures, as well as those who are institutionalized •Up to 50% of nursing home patients have a history of alcohol abuse and hospital admissions rated for alcohol-related problems may be equal to the admission rates for MI's

True or false Early onset alcoholism is characterized as drinking large amounts of alcohol early in the morning

FALSE. •Early onset alcoholism is characterized as having a problem with alcohol that began between 30 and 40 •Accounts for 2/3 elderly alcoholics •Late onset (use began after age 60) drinking may be related to situational events (death of spouse, illness)

True or false Elicit (illegal) drugs are the most commonly abused drug by older adults.

FALSE. •Heavy drinking (alcohol abuse most prevalent) •Prescription medications (benzodiazepines followed by opioids) • Marijuana •Nicotine •However, Illicit drug use such as cocaine and heroin are on the rise with the baby boomer generation

True or false The elderly have a poor success rate for overcoming substance abuse when they seek treatment because they have waited too long to get help.

False •Treatment outcomes for older people have been shown to be *equal to or better then those for younger people*

Which screening tool is recommended to use in the geriatric age group?

Short Michigan Alcoholism Screening Test-Geriatric Version it is more age appropriate than other test instruments

What are some strategies that can be used on the elderly that are struggling with substance abuse?

Strategies include: •Cognitive-behavioral approaches, individual and group counseling medical and psychiatric approaches, referral to Alcoholics Anonymous, family therapy, case management, community and home care services, and formalized substance abuse treatment. The Hartford Institute of Geriatric Nursing recommends that the Short Michigan Alcoholism Screening Test-Geriatric Version be used because it is more age appropriate then other instruments

True or False? Substance abuse in the elderly often goes untreated

TRUE.

True or false? As Baby boomers become older adults, there will be an increase in illegal drug use

TRUE. More exposure during youth and a culture of lenience.

True or False? Seniors that drink alcohol socially, should decrease the amount of alcohol that they consume

TRUE. •Alcohol drinking increases the risk of adverse effects in the elderly due to: • Interactions with medications • Reduced Liver and Kidney Function slow metabolism (Higher Blood alcohol) • Reduction in gastric enzymes, increased body fat, decreased lean muscle, and total body water content (Altered absorption and distribution) Alcohol will stay in their body longer and interact with other drugs causing problems

True or false? Embarrassment and Denial are reasons that most older adults refrain from seeking treatment for their substance abuse.

TRUE. •Alcohol users often reject or deny the diagnosis •Take offense if you suggest that they may have a problem •Family members may be ashamed of the problems and choose not to address it •Health care providers my feel helpless over alcoholism or uncomfortable with direct questioning

True or false Alcohol can help an older person fall asleep.

TRUE. •Alcohol may help one fall asleep, but use interferes with sleep quality, quantity and causes disturbances in restorative sleep It could help someone fall asleep but you have trouble staying asleep •Drugs and alcohol are thought to account for 10-15% cases on insomnia •Increased risk of medication interactions with alcohol that are used for the treatment of insomnia

What trend will occur among the elderly as it pertains to substance abuse?

•Estimates are that the number of adults over 50 with a substance abuse problem will double by 2020. •The use of illicit drugs such as cocaine, heroin, and marijuana is becoming more prevalent, and baby boomer marijuana users will triple in the next three decades