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The Michigan Alcohol Screening Test-Geriatric Version (MAST-G)101 is an instrument designed to identify drinking problems and was developed specifically for the elderly by modifying the Michigan Alcohol Screening Test. This screening tool contains 24 questions with yes/no responses; 5 or more positive responses indicate problematic use. The MAST is highly sensitive and specific and generally has strong psychometric properties.102 It is also administered in a short form, the SMAST-G, which has 10 questions, with 2 positive responses indicating a problem with alcohol.
Treatment options remain generally limited, as few programs or health care settings offer tailored interventions for older adults. Health care professionals need to continue to do as thorough of assessments as possible and enlist the help of formal measures, Web-based assessment, and build in the questions outlined earlier as routine. As the baby boom generation ages, the health care system will be challenged to provide culturally competent services to this group, as they are a unique generation of older adults. Knowledge about older-adult substance use and the issues that contribute to late onset or maintained addiction in late life will need to be continually updated as we learn how and why this generation of adults uses substances. Furthermore, the advancement and development of interventions that may be more useful for, effective for, and desired by this incoming generation of older adults than previous generation, such as mobile interventions, will be crucial to alleviating the projected pressures on the health care system.
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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. It’s been called the “invisible epidemic.” But knowing what to look out for can help you protect yourself or a loved one. Combined 2007 to 2014 NSDUH data indicate that, on an average day, 6.0 million older adults used alcohol (Figure 1).5 Older adults who used alcohol in the past https://ecosoberhouse.com/article/abuse-in-older-adults-a-growing-threat/ month drank an average of 1.8 drinks per day on the days they drank. NSDUH data indicate that older adults who used alcohol in the past month drank on an average of 11.1 days per month. This trend concerns family members of older Americans, as well as healthcare providers and social workers who work with this vulnerable population. It’s essential to understand why seniors are increasingly suffering from addiction so we can better prevent it in older adults.
This type of disorder is particularly concerning when it affects seniors, as they can be especially vulnerable to the consequences of drug addiction. Isaak learned addiction psychology at Aspen University and got a Master’s Degree in Arts in Psychology and Addiction Counseling. After graduation, he became a substance abuse counselor, providing individual, group, and family counseling for those who strive to achieve and maintain sobriety and recovery goals. Physicians rely on the criteria outlined by the DSM to diagnose substance abuse disorder in the general population. That is perhaps the main reason for misdiagnosis and lack of treatment of seniors – these criteria are less relevant to them. Moreover, they can unknowingly become addicted to these medications, making it another cause of substance abuse in the elderly.
Who Is Most at Risk?
It’s essential for family members and physicians alike to educate seniors on proper medication usage and side effects so they can avoid any potential misuse down the line. Mental health conditions such as depression or anxiety can affect how a person perceives and responds to stimuli, making them more vulnerable to risky behaviors like substance misuse. Seniors with co-occurring psychiatric disorders may be more likely to try drugs or alcohol as a means of self-medicating to cope with their symptoms.
Because of the diagnostic challenges outlined earlier, the MAST-G focuses more on potential stressors and behaviors relevant to alcohol use in late life, as opposed to questions toward family, vocational, and legal consequences of use. This tool has many of the advantages of the CAGE, such as ease of administration and low cost. Although useful as an indicator of lifetime problem use, it lacks information about frequency, quantity, and current problems important for intervention. The questions can be adapted to a specific substance, such as a prescription medication, and they can be asked either in the context of an interview or self-administered.