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Substance use disorders in later life

Rates of substance misuse are rising among older people in the USA, with alcohol misuse being the most prevalent.1

Because of retirement from work and public life, many social indicators of impaired function such as difficulty at work, driving errors or legal charges are not as obvious.

Signs of problematic substance use in older adults include:

  • Psychiatric: insomnia, mood swings, irritability, anxiety, depression.
  • Physical symptoms: nausea, vomiting, poor coordination, tremors.
  • Physical signs: injuries, falls, self-neglect, poor hygiene, malnutrition.
  • Cognitive: confusion, disorientation, memory impairment, drowsiness.
  • Social change: withdrawal from social activities, family discord, premature requests for prescription refills.

The AUDIT-C is a screening tool2 for alcohol where a score of 5 out of 12 or more warrants a full audit screen (the article suggests a lower score on the full audit so perhaps a 3 or 4 on the AUDIT-C).


  1. Audit-C tool