Briggs et al. (2011) note that "as with all substance-abusing clients, successful treatment planning is wholly dependent on accurate screening, assessment, and diagnosis. The complications of the aging client require a skilled and knowledgeable practitioner" (p. 118). Since many older adults do not visit a mental health professional as a part of their wellness plan, the burden is often on medical professionals to see the warning signs of substance use and abuse in older patients and refer them to treatment. While media attention and public health initiatives largely focus on substance misuse in younger members of society, research suggests that substance abuse in older populations is under-recognized, under-diagnosed, and under-treated. …show more content…
There are several problems with current standards that need to be addressed to accurately diagnose alcohol abuse and dependence in older adults. Many diagnostic criteria for substance dependence may not apply to the older population or may mimic signs of physical or psychological impairment that is common in older adults (Morgan et al., 2011). There are some specific conditions that might complicate the diagnosis of older adults.
For example, “with dementia affecting 5.2 million (or one in six) older adults over 65, an older individual might continue to forget having already taken an addictive prescription medication, and accidentally build dependence” (Hawn, 2014, p. 17). Social seclusion is another indication of substance abuse that might present a problem when diagnosing older adults; “the ageist myth that people become less social as they age might influence medical professionals to ignore decreased social activity as a normal side-effect of aging as opposed to drug abuse caused by social isolation” (Hawn, 2014, p. 17), and then goes on to say that “their substance abuse problems will probably not be diagnosed or will be misdiagnosed as a physical health issue, and they are often ignored by family, friends, and health care providers once diagnosed because of the associated stigma and shame” (p. …show more content…
20). Treatment Options The deficiency of research concerning older adults and substance abuse translates to a lack of treatment options for older adults with substance abuse disorders. The intricacies of the misuse of alcohol, prescription drugs, over-the-counter medications, and illegal drugs demand complex methods for older adults (Lee Heather Sophia, Mericle Amy A., Ayalon Liat, & Areán Patricia A., 2008). Older adults with substance abuse issues are less likely to seek treatment because of stigma (Hawn, 2014). Appropriate treatments require empathy and concern when a problem is recognized because many older adults will be fearful to admit they have a problem out of shame or out of fear (Simoni-Wastila & Yang, 2006). Research suggests that outcomes are better if the treatment is an age-specific treatment that is caring, adaptive, creative, and that addresses needs related to the aging process (Simoni-Wastila & Yang, 2006). Several treatment approaches have been examined for alcohol abuse for this population, including cognitive-behavioral treatment, motivational interviewing, and pharmacotherapy (Briggs et al., 2011).
Studies have shown positive results for all these approaches; pharmacotherapy should be used cautiously, however, since older adults are more likely to have health problems and suffer more severe side effects. Briggs et al. also noted positive outcomes when a variety of therapeutic approaches is used, including individual, group, and family counseling (2011). Additionally, attendance and participation in 12-step fellowship programs may help alleviate feelings of seclusion and isolation. It may be helpful to choose meetings that are oriented toward elderly populations or are attended by a large number of older adults. This may increase the likelihood of positive social engagement and peer support, which has been shown to help prevent relapses (Briggs et al.,
2011). Conclusion Alcohol and drug use among older adults is an especially important clinical problem due to the rapid aging of the U.S. population. With increased life expectancy and the aging of the baby boomers, the number of older adults is also increasing. With this comes an increase in older adults with substance abuse issues that must be addressed. There is a grave need for research focused on older adults with alcohol and drug abuse problems. Widely used diagnostic criteria and screening measures for substance abuse may not be valid for older adults. Traditional approaches to substance abuse prevention, screening, and treatment should be revised and their relevance to older adults evaluated. Proper diagnosis is needed before treatment can occur, and a correct diagnosis is dependent upon professionals who must be knowledgeable of the ways that substance abuse presents itself in older adults. Regrettably, professionals working with the older population often overlook substance abuse among their clients because they simply don't know the signs. “Because many older adults confront multiple challenges, including social isolation, loss and grief, economic difficulties, and physical illnesses, it is easy to assume symptoms are a result of these difficulties and not recognize characteristics of misuse and abuse” (Blow & Barry, 2014, p. 63). There needs to be a concerted effort to properly educate those who work with older adults about how substance abuse may present in this population, because there is evidence to suggest that older adults do as well as young people when it comes to recovering from substance abuse and that they may even do somewhat better than their younger counterparts (Blow & Barry, 2014).
Alcoholism is as prevalent in my family, as blood is in our veins. When previously asked to observe 12-step groups, I ritualistically flocked to Alcoholics Anonymous, without consideration of the possibility that other groups had any potential to make an impact on me. I always pride myself in my ability to identify as an individual that is not ensnared in alcoholism, but unfortunately am an individual that was highly tormented by alcoholism. Through observation of the group and how it processed, as well as identifying how I felt as a new attendee, I was able to understand why self-help, support groups are so vital for individuals in recovery. I finally realized, I too am in recovery.
When we picture the United States Military we regard men and women in uniform fighting for our country. However, what we do not picture is the hidden problems. Stress of the job, members returning home from war, and combat create an increased stress level that can result in abusing substances and cause behavioral problems. The military has recognized that this has become a problem and is now taking steps to ensure their members safety.
It was the late 19th century when a lot of conflict for families from the Industrial Revolution and illegal drugs had easy access to anyone in the United Sates. These illegal drugs like morphine, cocaine, and alcohol were available through manufacture, delivery, and selling. It was proved that the over use of alcohol and violence in families’ homes were linked together around the 1850’s and that women and children were being abused by the father and husband from the letters and journals that were wrote. These were times when women were stay at home mothers and it was the man’s responsibility to be the provider for the wife and children. Because of the abuse in the household it led up to the temperance movement. The purpose
Gardner will focus on assessing, diagnosing, and treating depression, anxiety and substance abuse of adults eighteen years and older. She understands that there are many factors that can affect depression, anxiety and substance abuse, including family, environment, and medical conditions. Ms. Gardner will ensure that each client understands both risk and benefits of the services being rendered to them upon the obtaining of their written consent. She will refer clients when appropriate, to intense treatment facilities and/or to hospitals for further treatment when it is outside of her scope of practice. The organization will utilize new equipment and a trained staff that will be able to optimize the care of each client. Staff consists of three employees: a licensed clinical social worker, mental health tech and an administrative
There is no doubt that there is a prevalence of substance abuse throughout several age groups. To a certain extent, a society is faced with the reality of controlling substance abuse. Or allow it run rampant throughout the community. Often times, we hear and read about the level of substance abuse among teen, young adults and mid-aged adults. Alcohol, medications, illegal drugs, and over-the-counter medicines can be both abused and misused. It is a widespread belief that age plays a role in the level of influence that drugs and alcohol diminishes. As a person becomes older, drugs and alcohol is not as influential in their loves. This widespread belief has truth. However, it is important to understand that substance abuse is still prevalent in the elderly community.
The U.S. Department of Health and Human Services (2013) Report revealed that the World Health Organization describes the inequities and disparities within a community as social determinants. These social determinants include age, sex, birth place, where one lives, works, plays, race, ethnicity, sexual orientation, disability, and has a healthcare system. McKibbin and Deacon (2011) revealed it is estimated that 20% of older adults suffer from a mental health disorder. Patients with a chronic illness such as coronary artery disease, congestive heart failure, hypertension, geriatric depression, chronic pain issues, cancer, and diabetes account for trillions of dollars spent on medical care in the United States. As the population ages the costs will expand, the shortage of physicians and nurses will continue to decrease and the scope of this problem will increase thus the need for new innovative ideas and plans to care for the geriatric population including those in the rural regions. One potential solution for geriatric depression ...
Nobody denies that every client and situation is unique, but there is a general layout out of a treatment plan that can be used thought out the facility to ensure success for the client. The first step in the treatment plan is to screen clients to determine if he/she meets the criteria of the facilities drug, or alcohol program. The facility will use the standard CAGE, of the Substance Abuse Subtitle Screening Inventory questioner as a screening tool. These two screening tools are consist of few questions and require only short answers to determine (American Society of Addiction Medicine, 2012). These tools are easy to use and can be done by any qualified staff according to the ASAM. If more through information is needed then the client will go under an assessment.
Cooley, S., Deitch, I., Harper, M., Hinrichsen, G., Lopez, M., & Molinari, V. (1998). What practioners should know about working with older adults. American Psychological Association, Retrieved from http://www.nova.edu/gec/forms/practitioners_older_adults.pdf
If the older patient’s complaints during a routine office visit are being ignored because of their chronological age, successful aging and quality of life will certainly be impacted by lack the of treatment for potential mental conditions. The fact that this ignorance can directly lead to suicide among this particular cohort more than any other group is frightening. Considering that social isolation is a primary reason for the onset of depression among older adults, the importance of physician and other health care provider identification of depression through screening and preventive measures are imperative. According to Blakemore (2009), 40 percent of older people who visit their general physician, half of older adult inpatients in general hospitals and 60 percent of long-term care residents have mental health problems and are often denied access to the same mental health services as younger adults including psychological therapist and drug interventions (p. 6). These numbers are astounding among a group of individuals whose physical health could be directly impacted by improved mental health care. Again, the ageism that influences screening and prevention among older adults is directly impacting the quality of life and chance at active aging among the older population.
All randomized controlled trials that included older adults diagnosed as suffering from depression (ICD or DSM criteria) were included. All types of psychotherapeutic treatments were included, categorized into cognitive behavioral therapies (CBT), psychodynamic therapy, interpersonal therapy and supportive therapies.
Ageism, a term used to assign negative labels to the elderly population has caused many of these older adults to internalize such stereotypes and thus, they have been less likely to seek out mental health and substance abuse care. Substance abuse, predominantly of alcohol, prescription drugs and over-the-counter medications is a growing health problem among adults age 60 and older and is a major concern that the country is facing. Even though the number of older adults suffering from these substance disorders is increasing, the situation tends to be overlooked or misdiagnosed by health care professionals and thus, inadequate treatment has not been provided to this population. One contributing factor to why substance abuse among older adults remains underdiagnosed is because indications of substance abuse in older individuals sometimes imitate symptoms of other medical and psychological disorders common among this population such as depression, dementia, and diabetes (Center for Substance Abuse Treatment, 2012).
The elderly represents a large amount of the population in our society and continues to grow each day. As the population grows, it is important to meet the demands and resolve the challenges that we encounter in regards to the overall quality of health and well-being of the elderly. Mental health of the elderly is a major issue but majority of the time goes unnoticed and untreated by caregivers and loved ones. About 20 percent of adults 55 and older are suffering from some type of mental health disorder, and one in three elderly adults do not receive any type of treatment (The State of Mental Health, 2008). Those suffering from mental illness are hesitant to seek out help or any type of treatment because of the stigma, services and cost for care that then comes with mental health disorders. Mental health issues that affect elderly include dementia, delirium, and psychosis. Some of the most common conditions include anxiety, mood disorders such as depression and bipolar disorder and cognitive impairment such as Alzheimer’s disease. Mental health is essential to the
Substance abuse complicates almost every aspect of care for the person with a mental disorder. When drugs enter the brain, they can interrupt the work and actually change how the brain performs its jobs; these changes are what lead to compulsive drug use. Drug abuse plays a major role when concerning mental health. It is very difficult for these individuals to engage in treatment. Diagnosis for a treatment is difficult because it takes time to disengage the interacting effects of substance abuse and the mental illness. It may also be difficult for substance abusers to be accommodated at home and it may not be tolerated in the community of residents of rehabilitation programs. The author states, that they end up losing their support systems and suffer frequent relapses and hospitalizations (Agnes B. Hatfield, 1993).
Substance abuse is a challenging battle that cannot be won over night it takes a lot of hard work and dedication from every one. Local government agencies, national, and global evolvement needs to be present to overcome substance abuse. It is important to try and overcome substance abuse due to the negative impact that it is having on society, financially and
Alcohol and drug abuse is one of biggest problems in United States today. It is not only a personal problem that dramatically affects individuals' lives, but is a major social problem that affects society as whole. "Drug and alcohol abuse", these phrases we hear daily on the radio, television or in discussions of social problem. But what do they mean or what do we think and understand by it? Most of us don't really view drug or alcohol use as a problem, if that includes your grandmother taking two aspirins when she has a headache or your friends having few beers or drinks on Saturday night. What we really mean is that some drugs or alcohol are being used by some people or in some situations constitute problem with which our society must deal. It becomes a real problem when using or I should say abusing drugs cause accidents, antisocial behavior, broken relationships, family instability, crime and violence, poverty, unsafe streets and highways, worker absenteeism and nonproductivity, and the most tragic one death. The situation in which the drug or alcohol uses accurse often makes all the difference. The clearest example is the drinking of alcohol, when individual begins to drink during the job, at school, or in the morning, we have evidence that indicates a potential drinking problem. If a person takes narcotic drug because he just wrecked his knee while his physician prescribed playing football and the drug, most of us would be not concerned. If, on the other hand, he took the same drug on his own just because he likes the way it makes him feel, then we should begin to worry about him developing dependence. Even use of illegal drugs are sometimes acceptable, but it also depends on situation, for example in some countries smoking marijuana is legal just like drinking alcohol in United States. Some subcultures even in United States that accept the use of illegal drugs may distinguish between acceptable and unacceptable situation, some college age groups might accept marijuana smoking at a party on weekends, but not just before going to a calculus class. Most of people would accept a fact that a bartender or a waiter who is working at a night club is having a beer or a drink on his break or that a landscape worker is having a cold beer with his lunch on a hot summer day. I'm not saying that it is "OK" but we wouldn't complain a...