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Guidelines and Classification: A Spectrum of Use | Epidemiology of Late-Life Substance Use | Correlates and Consequences of Substance Use Problems | Screening and Diagnosis of Substance Use Problems | Treatments for Substance Use Problems | Medical and Psychiatric Comorbidity | Future Directions | References

Excerpt

Alcohol and drug misuse are associated with a wide array of negative physical and mental health outcomes that are exacerbated with advancing age, such as functional and cognitive decline, compromised immune function, and depression. However, relatively little work has examined the correlates and consequences of substance use among older adults. Accordingly, substance misuse in later life has been called an “invisible epidemic” (Widlitz and Marin 2002). Epidemiological work determined that beginning when people are in their mid- to late 20s, overall rates of alcohol and illicit drug use begin to decline, and most older adults report no substance use. Nevertheless, changes in demographic and cohort trends suggest that substance misuse in later life is a pressing public health matter and that older adults represent a group in growing need of specialized substance treatment programs and services (Gfroerer et al. 2003). Most notable among demographic changes is the aging of the “baby boom” generation, a cohort that poses unique challenges; in addition to reporting higher rates of illicit drug and alcohol use and addiction than earlier aging cohorts, the baby boom cohort is significantly larger than previous cohorts (Koenig et al. 1994).

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