Dual diagnosis among older adults: a new array of policy and planning problems.

Case finding and successfully engaging and treating older adults with substance abuse disorders continue to be enigmatic processes. Because of the adverse consequences on health of substance abuse among the elderly, substance abuse has serious implications not only for the well-being of the elderly but also for the future costs and resources of the mental health and health care systems for older adults. However, older adults with concurrent mental and substance abuse disorders are appearing in the public gerontological mental health system. This system is both unprepared and ill-equipped to manage and treat these often difficult clients. Further complicating the situation is the seeming lack of knowledge about "dual diagnosis" among the elderly. Policy and planning issues necessary to address this newly discovered array of problems are discussed.