Introduction
Alcohol and substance-use disorders in late life have been under-studied. Alcohol and prescription drugs are frequently abused by older Americans, yet addictive disorders are often difficult to identify in this population because of screening instruments adapted to younger adults, stigma and shame that limit help-seeking in older adults, and co-occurring medical and psychiatric conditions that mimic or mask both acute effects and withdrawal syndromes associated with alcohol or substance-use disorders. We will review the evidence for the effectiveness of motivational brief interventions in this population, the need to modify certain pharmacotherapies, including standard detoxification regimens, as well as how to develop age-specific treatment services which tailor the content and pace of presentation toward older adults. Older patients can demonstrate equally or more successful outcomes than younger individuals. This text is intended as a practical handbook to enhance clinical skills in identifying and treating addiction in older adults.