Community Based Interventions for Problematic Substance Use in Later Life: A Systematic Review of Evaluated Studies and Their Outcomes

Abstract

Problematic substance use (PSU) in later life is a growing global problem of significant concern in tandem with a rapidly ageing global population. Prevention and interventions specifically designed for older people are not common, and those designed for mixed-age groups may fail to address the unique and sometimes complex needs of ageing communities. We report findings from a systematic review of the empirical evidence from studies which formally evaluated interventions used with older people and reported their outcomes. Nineteen studies were included, of which thirteen focused solely on alcohol-related problems. Eight interventions utilised different types of screening, brief advice and education. The remaining drew on behavioural, narrative and integrated or multi-disciplinary approaches, which aimed to meet older people’s needs holistically. Quality assessment of study design helped to review evaluation practice. Findings point to recommendations for sustainable and well-designed intervention strategies for PSU in later life, which purposefully align with other areas of health and well-being and are delivered in locations where older people normally seek, or receive, help. There is further scope for engagement with older people’s own perspectives on their needs and help-seeking behaviours. Economic evaluation of the outcome of interventions would also be useful to establish the value of investing in targeted services to this underserved population.

Affected family members social support experiences when assisting an individual with substance use disorder

“…Community‐based programs or spirituality/religion‐based programs ideally cover prevention, harm reduction, treatment, and aftercare for the AFM and ISUD. Literatures support the positive impact of community‐based treatment (Hafford‐Letchfield et al, 2020; Jiwa et al, 2008) and spirituality and faith (Grim & Grim, 2019; Walton‐Moss et al, 2013). Grim and Grim (2019) reported that interestingly, many behavioral health substance abuse treatment services in the US include a spirituality‐based element as embodied in the 12‐step programs and fellowships, the majority of which emphasize reliance on God or a Higher Power to stay sober.…”

Based on the relationship between anxiety of existential meaninglessness, hope level, and fear of progression, explored the effect of preoperative nursing with Orem theory in the senile cataract population

“…Conversely, higher education levels and lower monthly incomes were correlated with less severe anxiety among these patients, likely influenced by their awareness of the disease and their financial situation (Gase et al, 2017;Knifton and Inglis, 2020). Additionally, the frequency of alcohol consumption was observed to have varying impacts on physical and psychological well-being (Hafford-Letchfield et al, 2020). An increased frequency of interventions leads to significantly greater physical stress and fatigue, subsequently elevating the sense of anxiety related to feelings of meaninglessness among elderly patients with senile cataracts (Song et al, 2022).…”

Mental health and well-being for the prevention of substance use disorders

“…The remaining drew on behavioral, narrative, and integrated or multidisciplinary approaches, which aimed to meet older people's needs holistically. [ 89 , 90 , 91 ] Interventions need to align with other areas of health and well-being and should be delivered in locations where older people normally seek or receive help.…”