SUBSTANCE ABUSE

Substance Abuse

Substance Abuse

Elderly Substance Abuse

Alcohol and drug dependence constitute a public health problem of moderate proportions in the elderly. However, doctors have been slow to recognize these problems, partly due to the erroneous view that these disorders are rarely observed from age 40. It was thought that alcoholics and drug addicts could die prematurely or recover spontaneously, and the traditional start of the addition was rare. Substance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. Trained in this opinion, the doctors did not expect to find these abnormalities in older people. Further complicating this problem is the fact that the symptoms of substance abuse in the elderly can mimic symptoms of other medical and behavioral disturbances, leading to diagnostic errors.

Another complex phenomenon are few reports on these issues reported to clinicians. Contribute to this: the memory impairment, including recent drinks, the resignation of the elderly and their families to reveal such problems due to the shame of, or the belief that alcohol or drugs are the ultimate good are left, the lack of observation by third parties (employers, fairness or spouse) who find themselves often young abusers of substances, the therapeutic pessimism and lack of appropriate methods of documentation in medical reports. These factors, coupled with differences in demographic and referral patterns and distribution of programs for patients in health care, probably explain the diversity reported in the prevalence of substance abuse in the elderly, and the fact that these problems tend to remain hidden from the scrutiny of the physician and society in general.

A model "substance abuse" generally to include alcohol, licit and illicit psychoactive drugs, is supported by recent research suggesting common biocomportamentales basis for these disorders. The concept of "drug behavior" highlights the consumption patterns that can be applied to any substance, and implies that the characteristics of the consumer and the social context in which it is consumed are often as important as the pharmacological properties of drugs in the development of clinical disorders.

Epidemiology

Risk Factors

Risk factors for disorders due to substance use in the elderly are listed in Table .

Table: Risk factors in substance abuse in elderly

Factors Predisposing

Family history (alcohol)

Prior substance abuse

Previous pattern of substance use (individual effects and secondary)

Personality traits (sedative hypnotics, anxiolytics)

Factors that may increase the exposure and the level of substance use

Sex (male: alcohol, illegal drugs, women: sedative hypnotics, anxiolytics)

Chronic diseases associated with pain (opioid analgesics), insomino (hypnotic drugs) or anxiety (anxiolytics)

Requirements for prolonged periods (sedative hypnotics, anxiolytics)

Overuse of the caregiver of medication "as needed" institutionalized elderly)

Stress, loss, social isolation

Negative affective states (depression, sadness, discouragement, anger) (alcohol)

Compañeeros family life and drink (alcohol)

Discreccional management of time and money (alcohol)

Factors that may increase the effects and abuse potential of substances

Sensitivity to age-related drugs (pharmacokinetic and pharmacodynamic factors)

Chronic medical illnesses

Other medications (alcohol, drugs, drug interactions)

The predisposing factors are similar for all ...