The Drug Abuse Screening Test (DAST) is a modified Michigan Alcohol Screening Test (MAST) that can be applied to all substances. Make sure your primary doctor has a list of all the medications you take, even over-the-counter ones.

• As the end of the declaration of the public health emergency nears – on May 11, 2023 – many people continue to grapple with worsened mental health and well-being and face barriers to care.
• It was approved for use in a sample of older veterans (mostly male; mean age 63 years).420 All questions are yes/no.
• Don’t shy away from asking if a family member or friend is feeling depressed or suicidal.
• The pandemic has continued to negatively impact LBGT+ people’s mental health in disproportionate ways.
• Mutual-help programs offer older adults a network of peers with whom they can relate.
• As shown in Figure 3, the gap in the share of adolescent females and males reporting feelings of hopelessness and sadness – symptoms indicative of depressive disorder – widened from 2019 (47% vs. 27%, respectively) to 2021 (57% vs. 29%, respectively).

Deaths From Substance Abuse Rose Sharply Among Older Americans in 2020

Older adults are also more likely to take multiple medications, which means they may face dangerous and potentially fatal drug-drug interactions. Furthermore, identifying substance misuse in older adults is not simple. The signs and symptoms of substance misuse can be easily mistaken for normal aging or physical or mental disorders common in older populations. Full assessments often involve several substance abuse in older adults members of the care team, depending on the setting and available resources of your program. Which care team members contribute to the full assessment depends on the qualifications and level of expertise needed to address the client’s problems. For instance, the assessment may start with a certified drug and alcohol counselor or other licensed provider taking a complete psychosocial history.

Assessment Resources

In the pandemic’s first year, death rates linked to alcohol and drugs climbed among seniors as lockdowns and isolation spread. Some people may try complementary health approaches, like yoga, to improve well-being and cope with stress. However, there is little evidence to suggest that these approaches, on their own, can successfully treat depression. While they can be used in combination with other treatments prescribed by a person’s doctor, they should not replace medical treatment.

Negative Results

The American Geriatrics Society’s 2019 Beers Criteria® address medications that are potentially inappropriately prescribed for older adults.319 See the Chapter 6 text box on the 2019 Beers Criteria®. You can help older clients feel less shame and stigma by talking about substance misuse in the same way you would a mental disorder, like depression or anxiety. Be sure to also ask about their overall health, functioning, and well-being. This shows clients that you are concerned and feel empathy for them rather than making them feel like their substance use is a consequence of weak willpower or a personal flaw. The third section describes how to use brief assessments—an important follow-up to screening—for clients who screen at risk for substance misuse and co-occurring mental or neurocognitive disorders. Brief assessment helps make or rule out diagnoses and aids you and your clients in making appropriate shared treatment decisions.

Items for Older Adults on Suicide Prevention and Postvention

Explain what will take place during and after the screening and assessment so that the individual knows what to expect. Living in the home with someone who misuses substances or has a mental disorder. The SMAST-G is the first brief alcohol misuse screener developed for older adults. If a client marks two or more items on the SMAST-G with a “yes” response, that suggests potential alcohol misuse.332 The SMAST-G is available in the Chapter 3 Appendix.

Family, friends, and doctors often don’t know when older people have a problem with alcohol and drugs. Once you retire, problem drinking or drug use doesn’t interfere with your job. Sometimes, people notice but ignore it, thinking it’s best for older people to keep doing what makes them happy. More middle-aged and older adults are misusing alcohol, opioids, heroin, and marijuana. The National Institute on Drug Abuse reported in 2019 that rates of substance use had climbed in adults between 50 and 64 years old and in those 65 years and older in the previous decade.

• After 988 implementation, national answer rates increased alongside increases in call volume.
• Young adults, Black adults, men, and uninsured people were less likely to receive services compared to their peers.
• This updated TIP is designed to help providers and others better understand how to identify, manage, and prevent substance misuse in older adults.
• You can help clients discover their own reasons for wanting to change by talking about these mixed feelings and pointing out problem areas.
• This report provides evidence-based practices for screening and assessment of adults in the justice system with mental illness, substance use disorders, or both.
• Also essential are the client’s agreement, engagement level, and preferences.

Different years of NSDUH, TEDS, and DAWN data were used in this analysis because they are the latest years of data available. All NSDUH estimates in this report are annual averages based on combined 2007 to 2014 NSDUH data. Combining multiple years of NSDUH data allows substance use among older adults to be examined in greater detail by improving the precision of estimates for making statistical comparisons. TEDS data provide information on admissions to substance abuse treatment in 2012, and DAWN data provide information on drug-related ED visits in 2011.

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