SUD 101: Substance Use Disorders in Older Adults-Course Content

Video Transcription

Video Summary

This video is an educational session on substance use disorders in older adults, presented by PCSS MOUD and SAMHSA-funded partners. The speakers review the rising prevalence of substance use in aging populations, emphasizing that older adults use many of the same substances as younger people, especially alcohol, tobacco, opioids, cannabis, stimulants, and sedatives. They highlight concerning trends, including increasing opioid overdose deaths among adults over 50, with disproportionate impact on Black non-Hispanic men.<br /><br />The presentation explains why substance use disorders are often missed in older adults: symptoms may be mistaken for normal aging, family and clinicians may deny the possibility of misuse, and older adults may present with fewer obvious DSM-related social consequences. It also describes risk factors such as polypharmacy, multiple prescribers, chronic pain, psychiatric illness, social isolation, and age-related changes in medication metabolism.<br /><br />A major portion of the session covers screening and treatment. For alcohol use, tools such as the Michigan Alcoholism Screening Test, AUDIT-C, and CAGE are discussed. For tobacco, nicotine dependence measures are reviewed; for opioids, tools like STOPP and other misuse assessments are mentioned. Treatment recommendations include “start low, go slow,” careful monitoring of liver, kidney, cognitive, and cardiovascular status, and attention to drug interactions.<br /><br />Evidence-based treatments are reviewed across substances: nicotine replacement, varenicline, and bupropion for tobacco; naltrexone, acamprosate, and disulfiram for alcohol; and methadone, buprenorphine, and naltrexone for opioid use disorder. The speakers stress that psychosocial interventions, age-specific treatment settings, brief interventions, motivational interviewing, and social support are essential parts of care.

Asset Subtitle

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Keywords

opioids

chronic pain

pain management

opioid risks

fentanyl

overdose

methadone

tolerance

physical dependence

universal precautions

naloxone

non-opioid therapies

older adults

substance use disorders

alcohol use

opioid overdose

screening tools

AUDIT-C

polypharmacy

nicotine dependence

buprenorphine

motivational interviewing

age-specific treatment