Recognition and treatment of substance abuse in the elderly.

Elderly people do use substances to alter mood and states of awareness. Detection is difficult because presenting symptoms are often those that are commonly associated with aging itself. All patients who present with symptoms of self-neglect, falls, cognitive and affective impairment, and social withdrawal should be screened for substance abuse. The CAGE and MAST, although not perfect, can be used. When abuse is found, the elderly should be treated as aggressively as their younger counterparts, with slow, careful detoxification and the use of some form of group therapy, such as AA.