Alcohol and drug dependence among the elderly: epidemiology, diagnosis, and treatment.

Alcohol and drug dependence among the elderly is common and yet frequently underdiagnosed. The practice of self-administration of prescribed medications, particularly sedative/hypnotics, benzodiazepines, and nonprescription, over-the-counter (OTC) medications is prevalent, with untoward consequences in the geriatric population. Dementia, depression, and anxiety syndromes are some of the consequences of alcohol and drug dependence, and may mimic other causes of these disorders. The clinician's index of suspicion must be high enough to make the proper diagnosis of these alcohol- and drug-induced syndromes. Unnecessary evaluations, improper diagnosis, and ineffective and costly treatments may be avoided if alcohol and drug dependence is identified and treated. Effective treatment for alcohol and drug dependence does exist for the elderly and may be instituted in a cost-effective manner.