Substance Abuse _ Older Adults

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					Substance Abuse Among Older
           Adults
 Presentation prepared for the Illinois Department
                of Human Services,
  Division of Alcoholism and Substance Abuse by
           Rick Alonzo, Ph.D., CADC.
    Specialist over HIV Aging and Disabilities
                     Programs
   DHS / DASA Funded Pilot
In 1999 DASA and IDOA mapped out
 a plan to work jointly
DASA funded (for $190,650 GRF)
  Human Service Center of Peoria -
   White Oaks
  Central Illinois Agency on Aging
DHS / DASA Funded Pilot Paid for

 Training Video / Manual
 Training for Aging Network
  workers in SFY01
 In SFY02 DASA offered
  training to DASA Licensed
  and funded AOD Providers
  DHS / DASA Funded Pilot

Since March of 2000 to June of
 2004, this project has admitted
 165 - 60 + individuals into the
    DAYBREAK Program
    DHS / DASA Funded Pilot
But not all of those this project has served
 have been admitted.
In the DASA system we also have early
 intervention services that we pay for. This
 way we provide substance abuse related
 interventions before they become problems
    DHS / DASA Funded Pilot
Since implementation of the project, there
 have been at least 242 that are seen on an
 ongoing basis.
Approximately 5,600 individuals have been
 oriented about DAYBREAK and about
 AOD and Seniors
    DHS / DASA Funded Pilot
• The program was designed according to
  recommendations made in the CSAT TIPS
  # 26 available by going to

http://kap.samhsa.gov/products/manuals/index.htm
   Barriers in Identification and
             Treatment
Ageism. Our society tends to assign negative
 stereotypes to older adult behavior, ignoring
 specific medical, social or psychological causes.
 “They only have a little time, let them enjoy”
Health care providers tend to overlook alcohol
 abuse and medication mismanagement (AA&MM)
 among older adults
The symptoms are mistaken for those of
 depression, dementia or other problems common
 to older adults
   Barriers in Identification and
          Treatment(cont‟d)
Older adults are more likely to hide their
 AA&MM and less likely to seek help
Relatives are ashamed and choose not to address it
 (“there is an elephant in my living room, but it‟s
 not in my corner”)
Stigma - “alcoholics” and “dope fiends” „look
 different‟ from the older adult who has begun
 drinking more than they should or mismanages
 their medication
   Barriers in Identification and
          Treatment(cont‟d)
While „early onset‟ of AOD problems is easier to
 identify in older adults, „late onset‟ is more
 difficult to identify because of stigma
Late onset: an older adult begins AA&MM due to
 loss, loneliness
Medicare / Insurance: Medicare doesn‟t cover
 many programs and imposes a complex system of
 rules on programs it does cover.
   Barriers in Identification and
          Treatment(cont‟d)
AOD Treatment: Older Adults are often
 overwhelmed by the AOD intake /
 treatment process - also they have difficulty
 identifying with „hard core‟ addicts and
 alcoholics
Co-Morbidity: Medical and psychiatric co-
 morbidities complicate diagnosis
   Barriers in Identification and
          Treatment(cont‟d)
Special Populations
  Women: have less insurance coverage and
   supplemental income
  Women are prescribed more and consume more
   psychoactive drugs than men and are more
   likely to be long-term users
  Racial and ethnic minorities may face workers
   who lack knowledge of their language and
   culture
  Conversation vs. Interrogation
Many Older Adults are aware of the stigma
 associated with substance abuse
Utilizing conversation will provide better results
 rather than a question and answer session
Preface what is said with a link to medical
 condition
Why? Older Adults are more willing to accept a
 medical diagnosis as an explanation for their
 problems.
 4 Components of Active Listening
Observing and reading nonverbal behavior
 – posture
Listening to and truly understanding verbal
 communication
Listening to the “whole person” within the
 context of the social settings of her / his life
Listen for the “sour notes”: things they say
 that a little off and need to be challenged
  Specialized AOD Services for
          Older Adults
Outreach services
In-home visits
Off - site exceptions (to provide services in
 senior homes, etc.)
Harm reduction model
Brief Intervention Model
 What Works in AOD Treatment
       of Older Adults
Persistence
Consumer Friendly Services
Cultural Competence
Multi Service Programming
Health Promotion
Comprehensive Assessment and consumer
 direction
 What Works in AOD Treatment
       of Older Adults
Peer Support, Staffing and Evaluation
Collaboration at all levels
Appropriate linkages (partnerships)
Cross-Training
University Links (for research)
        The Problem

According to CSAT, as many
  as 17% of older adults are
    affected by alcohol and
   prescription drug misuse
               The Problem
According to USDHHS / SAMHSA / CSAT in
    FFY 2002 our State served a total of 1,505
           persons age 56 to 65 and over
 According to the IDOA State Plan, the Aging
  Network serves approximately 500,000 Older
                 Adults every year.
Using the National average, at least 85,000 Older
 Adults in the IDOA system may be impacted with
                 ADOA problems
       The Problem

If this data is accurate, our
 substance abuse system is
  serving only 2% of those
    who really need these
           services
      The Problem


WHY AREN’T WE SERVING
 MORE OLDER ADULTS IN
  OUR AODA SYSTEM?

				
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