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Substance Use in Older Adults

Edited by Art Walaszek, M.D.

  • 2024
  • 356 Pages
  • ISBN 978-1-61537-507-3
  • Item #37507

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By 2050, 85.7 million people in the United States are projected to be 65 or older. Older adults are especially prone to the effects of substances, and a 2021 survey showed that 4 million older adults were dealing with a substance use disorder. As the country's population ages, clinicians will inevitably have to care for a greater number of older adults with substance use disorders, but the literature on the topic—and the evidence base for treatment—is limited.

In Substance Use in Older Adults, more than 20 contributors translate their real-world experience in geriatric psychiatry into an accessible, evidence-based guide to screening for and assessing substance use in older adults. Early chapters discuss not only etiology and epidemiology but also comorbidities and management and subsequent sections address the problematic use of specific substances, including

  • Alcohol
  • Tobacco
  • Opioids
  • Sedatives
  • Stimulants
  • Cannabinoids

Readers will find guidance on safe prescribing practices for older patients, as well as an examination of the cultural and ethical issues that may arise when working with this patient population.

Rife with case examples that illustrate key points in clinical practice, Substance Use in Older Adults also features numerous tables that can be referenced time and again with information on comorbidities, screening frameworks, and interventions for specific substances; stigma-reducing language; the pharmacological implications of physiological changes in older adults; and more.

Clinicians from psychiatric professionals to primary care providers will benefit from exhaustive listings of additional resources. This guide also includes resources for patients, families, and caregivers that will help to strengthen the partnership between clinician and patient.


  • Chapter 1. Introduction to Substance Use Among Older Adults
  • Chapter 2. Comprehensive Assessment of Older Adults with Substance Use
  • Chapter 3. Management of Substance Use Disorder in Late Life
  • Chapter 4. Alcohol Use and Use Disorder Among Older Adults
  • Chapter 5. Tobacco Use Among Older Adults
  • Chapter 6. Opioid Use and Use Disorder Among Older Adults
  • Chapter 7. Sedative, Hypnotic, and Anxiolytic Use and Use Disorder Among Older Adults
  • Chapter 8. Stimulant Use Disorder in Older Adults
  • Chapter 9. Cannabinoid Use and Cannabis Use Disorder Among Older Adults
  • Chapter 10. Safe Prescribing practices for Older Adults
  • Chapter 11. Cultural, Structural, and Ethical Issues in the Care of Older Adults with Substance Use Disorders


    Rajdip Barman, M.D.
    Laurel Bessey, M.D.
    Jonathan Buchholz, M.D.
    Seetha Chandrasekhara, M.D.
    Michael Fingerhood, M.D.
    Samuel Gazecki, B.A.
    Ganesh Gopalakrishna, M.D., M.H.A.
    Pallavi Joshi, D.O., M.A.
    Susan Lehmann, M.D.
    Noelle Martinez, M.D., M.P.H.
    Jen McDonald, M.D.
    Dolapo Oseni, M.D.
    Nisha Patel, D.O.
    Badr Ratnakaran, M.B.B.S.
    Karen Reimers, M.D.
    Robert Rymowicz, D.O.
    Andrew J. Saxon, M.D.
    Sandra Swantek, M.D.
    Art Walaszek, M.D.
    Margaret Z. Wang, M.D.
    Sue-Jean Sylvia Yu, M.D.

About the Authors

Art Walaszek, M.D., is a Professor at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin.

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