Addiction Across the Lifespan 2: Geriatric Populations (2025-2026 Recording)-Addiction Across the Lifespan 2: Geriatric Populations Recording

Video Transcription

Video Summary

The presentation focused on substance use disorders in older adults, emphasizing why this population needs special attention as the U.S. ages. Speakers reviewed epidemiology showing rising alcohol-, opioid-, cannabis-, benzodiazepine-, and stimulant-related harms, including increasing treatment admissions, hospitalizations, and overdose deaths in people 65 and older. They highlighted how stigma, ageism, caregiver dynamics, and reduced screening lead to missed diagnoses.<br /><br />The talk covered screening and diagnosis, recommending routine nonjudgmental screening and noting that tools such as the MAST-G, S-MAST-G, and AUDIT-C may be especially useful in elders, often with lower cutoffs. Because older adults often have cognitive, sensory, and medical comorbidities, DSM-5 criteria can be harder to apply, and symptoms may be mistaken for dementia, depression, anxiety, or delirium.<br /><br />Treatment discussion emphasized that older adults often need slower, more cautious medication use due to physiologic changes, polypharmacy, and comorbid illness. Behavioral interventions such as CBT and motivational interviewing can be effective, especially when adapted for age and functioning. For alcohol use disorder, naltrexone and acamprosate remain key options, while withdrawal management often requires inpatient monitoring. For opioid use disorder, buprenorphine was presented as a particularly important option, with methadone and naltrexone also considered depending on medical status and setting.<br /><br />Several patient cases illustrated how pain, isolation, caregiving stress, cognitive changes, and multiple medications complicate diagnosis and management. The session ended with a reminder that substance use in older adults is common, underrecognized, and best managed through careful assessment, close coordination with primary care and caregivers, and individualized, harm-reducing care.

Keywords

substance use disorders

older adults

alcohol use disorder

opioid use disorder

cannabis-related harms

benzodiazepine misuse

stimulant overdose

screening and diagnosis

stigma and ageism

DSM-5 criteria

polypharmacy

motivational interviewing

naltrexone and acamprosate

buprenorphine