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SUMMARY
A review of the epidemiology of substance abuse and corollary treatment capabilities for older adults is summarized. This review demonstrates that there is a growing number of older adults with substance abuse problems, and that a majority of such adults are under-diagnosed and have little access to treatment.
Research at Odyssey House, a non-profit, substance abuse and mental health treatment agency based in New York City, where older adults have been treated since 1997 within a discrete residential unit, is reviewed. Findings identify two distinct subgroups among the older adults being treated at Odyssey House: lifelong users (become dependent on drugs during adolescence) and late-in-life users (become dependent on drugs after age 45). Treatment implications are discussed in terms of the provision of special groups, such as trauma and bereavement groups for late-in-life users; and poly-substance abuse and relapse prevention groups for the lifelong users.
The Enhanced Therapeutic Community is presented as the primary social group and treatment modality for the effective care of older adults with chemical dependence problems. The community intervention is based on the values and principles of mutual aid and self-help for individuals who are willing and able to share their common experiences while supporting and comforting each other. The Enhanced Therapeutic Community is consistent and contemporary with our social work values and methods of social work with groups today, and is an effective method for the treatment of older adults with substance abuse problems. Two case study vignettes, which mirror the research and group process, are presented.
