Atlanta VA Medical Center, Mental Health Service Line (116), 1670 Clairmont Road, Atlanta, GA, 30033, USA.
Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.
Curr Psychiatry Rep. 2016 Sep;18(9):87. doi: 10.1007/s11920-016-0718-x.
The purpose of this article is to provide an overview of alcohol use disorder (AUD) and opioid use disorder (OUD) in older adults for general psychiatrists. The rapid growth of the geriatric population in the USA has wide-ranging implications as the baby boomer generation ages. Various types of substance use disorders (SUDs) are common in older adults, and they often take a greater toll on affected older adults than on younger adults. Due to multiple reasons, SUDs in older adults are often under-reported, under-detected, and under-treated. Older adults often use substances, which leads to various clinical problems. Space limitations prevents a comprehensive review; therefore, we primarily focus on alcohol use disorder and the problem of opioid use disorder, with more emphasis given to the latter, because the opioid use epidemic in the USA has gained much attention. We reviewed the literature on the topics, integrated across geriatric psychiatry, addiction psychiatry, research, and national trends. We discuss unique vulnerabilities of older adults to SUDs with regard to management of SUDs in older adults, medication-assisted treatment (MAT), and psychosocial treatments. We encourage general psychiatrists to raise their awareness of SUDs in older adults and to provide brief intervention or referral for further assessment.
本文旨在为一般精神科医生概述老年人的酒精使用障碍（AUD）和阿片类药物使用障碍（OUD）。随着婴儿潮一代的老龄化，美国老年人口的快速增长具有广泛的影响。各种类型的物质使用障碍（SUD）在老年人中很常见，它们通常比年轻人对受影响的老年人造成更大的伤害。由于多种原因，老年人的 SUD 往往报告不足、发现不足和治疗不足。老年人经常使用物质，这会导致各种临床问题。篇幅限制使得无法进行全面审查；因此，我们主要关注酒精使用障碍和阿片类药物使用障碍问题，后者更受重视，因为美国的阿片类药物流行引起了广泛关注。我们综述了老年精神病学、成瘾精神病学、研究和国家趋势等领域的相关文献。我们讨论了老年人在 SUD 管理、药物辅助治疗（MAT）和心理社会治疗方面对 SUD 的独特脆弱性。我们鼓励一般精神科医生提高对老年人 SUD 的认识，并提供简短干预或转介以进行进一步评估。
