Old Age Psychiatry and SUD addresses substance use disorders in older adults, where physiology, polypharmacy, cognition, sleep, pain, grief, and isolation intertwine. This page turns complexity into clear, humane steps. Start with a function-first assessment: medication review for sedatives/anticholinergics, pain management that avoids destabilizing opioids, screening for alcohol, prescription misuse, and nicotine, and a cognitive and falls check. Map routines (sleep, light exposure, meals, movement) and social participation to understand why change is hard. If you’re aligning practice at a geriatric addiction psychiatry conference (/program/scientific-topics/old-age-psychiatry-and-sud), you’ll find safer induction guides (lower doses, slower titration), hepatic/renal adjustments, and deprescribing checklists that simplify regimens without withdrawal. Because grief and role loss often drive use, we integrate problem-solving therapy, behavioral activation, and peer groups that rebuild purpose. Coordination with primary care, cardiology, and pain clinics prevents ping-ponging and catches interactions early.

Care must fit home life. We design appointments that include caregivers—with consent—and create step-by-step plans patients can follow on low-energy days: short activity bouts, hydration prompts, morning light, and simple medication boxes. We embed tobacco treatment (varenicline/combination NRT) and address alcohol with naltrexone or acamprosate when appropriate, alongside brief skills for cravings and sleep. Housing, transport, and benefits navigation stabilize the basics; fall-proofing and hearing/vision fixes unlock engagement. For cognitive impairment, we outline safe cues, pill organizers, and caregiver training that respects autonomy; for pain, we stress multimodal strategies that reduce sedative load. Equity features—interpreters, large-print materials, phone visits—turn interest into continuity for rural and low-income elders. Dashboards track function, falls, ER visits, sleep, and quality of life; transitions (hospitalizations, bereavements) trigger proactive outreach. Treatment success is measured in safer routines, steadier mood, and time regained with family and community.