Abstract
This chapter highlights the importance of alcohol use disorders (AUDs), inappropriate medication use (IMU) and use of illicit drugs in older people. Such problems are associated with considerable morbidity and will become more important with the ageing ‘baby-boomer’ generation in coming years. AUDs are under-detected, misdiagnosed and often completely missed in older populations. However, despite ageist and pessimistic assumptions, AUDs in older people are as amenable to treatment as in younger people. IMU in older people includes abuse of prescribed medications such as benzodiazepines and opiates, unnecessary treatment of medical and psychiatric conditions and toxic drug reactions related to inappropriate polypharmacy. Screening and treatment programmes for IMU could lead to considerable improvements in individual and population health. Misuse of illicit drugs, e.g. marijuana, cocaine, opioids and stimulants, by older people is not yet a major problem, but will probably become more prevalent and be a more important clinical issue for future generations of older people.
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