The Growing Problem of Illicit Substance Abuse in the Elderly: A Review



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Objective: To explore and integrate the extant data on the subject of illicit substance use and abuse in the elderly and to determine shortcomings in the current understanding of the problem and potential topics of future research.

Data Sources: Ovid MEDLINE was searched (1960–2011) using the keywords substance use disorders and geriatrics; PsycINFO was searched (1967–2011) using the keywords drug abuse and geriatrics.

Data Extraction: The searches of Ovid MEDLINE and PsycINFO returned 35 and 85 results, respectively. Other relevant articles were identified by checking reference lists of the identified studies. A total of 26 articles with a focus on use of illicit substances, excluding alcohol, over-the-counter drugs, and prescription drugs, in the elderly were determined to be applicable to the review.

Data Synthesis: Limited data were available to combine between studies, but certain conclusions could be generalized among separate sources.

Results: Geriatric substance abuse is a topic of growing interest, importance, and research; however, most of the existing literature has focused on licit substances. Illicit substance abuse has been incorrectly assumed to end as patients age, whereas in reality, elderly drug users are increasingly common and have a unique profile quite different from that of their younger counterparts.

Conclusions: Geriatric substance abuse is a common problem and includes both licit and illicit substances. There are not yet reliable screening instruments or treatment methods for identification and treatment of illicit substance abuse in the elderly. A high index of suspicion and consideration of illicit substance use as a real possibility are vital for early recognition and diagnosis of such abuse in the elderly.

Primary Care Companion CNS Disord 2012;14(4):doi:10.4088/PCC.11r01320

Submitted: November 11, 2011; accepted February 21, 2012.

Published online: July 12, 2012.

Corresponding author: Matthew H. Taylor, MD, Department of Neurology and Psychiatry, Saint Louis University School of Medicine, 1402 South Grand Blvd, Mailbox 545, St Louis, MO 63110 (

Primary Care Companion CNS Disord 2012;14(4):doi:10.4088/PCC.11r01320