Re: College issues guidance to identify substance misuse among older people
This newly issued guidance by the Royal College of Psychiatrists is to be welcomed as it is comprehensive and brings attention to a neglected issue for an increasing number of our population.
In addition to the issues covered in the report it is worth highlighting the ageing drug treatment population as these services have an increasing number of older people who use opiates. However there is also a rapidly growing number of people in the United Kingdom who have a problems with cannabis, albeit from a low baseline (Hamilton et al 2014). This trend is mirrored in the United States (Burns et al 2013). Little is known about effective evidence based treatment options for this latter group.
Evidence is also sparse about the specific effect of comorbidities for older people who have a problematic relationship with substances (Rao 2011). As the report makes clear ageing brings with it an increased risk of developing other health related problems which in turn increases the likelihood of exposure to prescribed medication. Understanding the potential for drug-drug interactions between prescribed medication and drugs including alcohol and tobacco is an area that requires further attention for this population. Understanding which drugs interact and whether these effects are beneficial or hazardous is an important area for further investigation (Hamilton et al 2013) .
The report offers hope by making clear that older people not only want to change but are able to change, perhaps it is time to reflect on our attitude to older people and substance use.
References:
Burns,R.M. Caulkins,J.P. Everingham,S.S. Kilmer,B. (2013) Statistics on cannabis users skew perceptions of cannabis use. Frontiers in Psychiatry,4,138,1-10.
Hamilton,I. Pringle,R. (2013) Drug interactions and dual diagnosis. Advances in Dual Diagnosis, Volume 6, Issue 3,145-150.
Hamilton,I. Lloyd,C. Monaghan,M. Paton,K. (2014) The emerging cannabis treatment population. Drugs and Alcohol Today, 14,3,150-153.
Rao, R. (2011). Older people and dual diagnosis–out of sight, but not out of mind. Advances in Dual Diagnosis, 4(1).
Rapid Response:
Re: College issues guidance to identify substance misuse among older people
This newly issued guidance by the Royal College of Psychiatrists is to be welcomed as it is comprehensive and brings attention to a neglected issue for an increasing number of our population.
In addition to the issues covered in the report it is worth highlighting the ageing drug treatment population as these services have an increasing number of older people who use opiates. However there is also a rapidly growing number of people in the United Kingdom who have a problems with cannabis, albeit from a low baseline (Hamilton et al 2014). This trend is mirrored in the United States (Burns et al 2013). Little is known about effective evidence based treatment options for this latter group.
Evidence is also sparse about the specific effect of comorbidities for older people who have a problematic relationship with substances (Rao 2011). As the report makes clear ageing brings with it an increased risk of developing other health related problems which in turn increases the likelihood of exposure to prescribed medication. Understanding the potential for drug-drug interactions between prescribed medication and drugs including alcohol and tobacco is an area that requires further attention for this population. Understanding which drugs interact and whether these effects are beneficial or hazardous is an important area for further investigation (Hamilton et al 2013) .
The report offers hope by making clear that older people not only want to change but are able to change, perhaps it is time to reflect on our attitude to older people and substance use.
References:
Burns,R.M. Caulkins,J.P. Everingham,S.S. Kilmer,B. (2013) Statistics on cannabis users skew perceptions of cannabis use. Frontiers in Psychiatry,4,138,1-10.
Hamilton,I. Pringle,R. (2013) Drug interactions and dual diagnosis. Advances in Dual Diagnosis, Volume 6, Issue 3,145-150.
Hamilton,I. Lloyd,C. Monaghan,M. Paton,K. (2014) The emerging cannabis treatment population. Drugs and Alcohol Today, 14,3,150-153.
Rao, R. (2011). Older people and dual diagnosis–out of sight, but not out of mind. Advances in Dual Diagnosis, 4(1).
Competing interests: No competing interests