This text-based Treatment Improvement Protocol (TIP) 26 provides a wide range of guidance in the latest evidence-based screening and assessment approaches, interventions, and services for substance misuse, including substance use disorders (SUDs), in older adults. It is intended for behavioral health service providers, healthcare professionals, and older adults, as well as those people who are significant in their lives.

Older adults are a special group because they are particularly vulnerable to the negative effects of substances and therefore substance misuse. Further, providers, professionals, and family and caregivers tend to overlook substance misuse in older people, meaning they are less likely than younger adults to be correctly diagnosed and offered treatments, services, or referrals. This oversight makes SUDs particularly dangerous for this population in terms of possible effects on mortality and comorbid conditions (including physical, cognitive, and mental disorders). This TIP is designed to help providers and others better understand how to identify, manage, and prevent substance misuse in older adults.

This publication describes the unique ways in which SUD signs and symptoms manifest in older adults; drug and alcohol use disorder (AUD) screening tools, assessments, and treatments specifically tailored for older clients’ needs; the interaction between SUDs and dementia and other cognitive disorders; and strategies to help providers improve their older clients’ social functioning and overall wellness—both of which are critical to
successful recovery.

A consensus panel developed the TIP’s content based on a review of the most up-to-date literature and on their extensive experience in the field of geriatric alcohol and drug addiction treatment. Other professionals also generously contributed their time and commitment to this publication. This publication is an update of the original TIP. The content addresses many of the same key topics and messages, as well as new ones. Revisions reflect the most recent scientific knowledge, clinical advances, and guidance pertaining to preventing and treating substance misuse among older adults.

Course updated in 2020.

This course is available in text format only.

Format: Reading-based, asynchronous, distance, non-interactive

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Page last modified or reviewed by athealth.com on Apr 19, 2026.

Consensus Panel
Each Treatment Improvement Protocol (TIP) consensus panel is a group of primarily nonfederal addiction-focused clinical, research, administrative, and recovery support experts with deep knowledge of the TIP’s topic. With the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Knowledge Application Program (KAP) team, they develop each TIP via a consensus-driven, collaborative process that blends evidence-based, best, and promising practices with the panel’s expertise and combined wealth of
experience.
Note: The information below indicates each participant’s position and affiliation when the panel was convened and may not be current.
Consensus Panel Chair
Frederic C. Blow, Ph.D. Director, Addiction Center and Substance Abuse
Section. Professor, Department of Psychiatry University of Michigan, Ann Arbor, MI. Senior Research Investigator, Center for Clinical Management Research Department of Veterans Affairs,  Ann Arbor, MI
Consensus Panelists
Kimberly Burton, Director, Older Adult Programs Chair, Maryland Coalition on Mental Health and Aging. Mental Health Association of Maryland, Lutherville, MD

Sarah L. Canham, Ph.D., M.A., Aging, Alcohol, and Addictions Interest Group
Convener. Gerontologists Giving Back Founder and Co-Coordinator Gerontological Society of America, Washington, DC. Senior Lecturer and University Research Associate, Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada

Alexis Kuerbis, Ph.D., LCSW. Assistant Professor, Silberman School of Social Work Member, Advisory Committee on LGBT Social Science & Public Policy Center Member, Health and Mental Health Field of Practice Committee Member, Clinical Practice with Individuals, Families, and Groups Committee, Hunter College City University of New York, New York, NY

Sharon A. Matthew, LPC, ACRPS, CCS, CSAT, CMAT. Clinical Director, Addiction Rehab for Older Adults Program, Caron Treatment Centers, Wernersville, PA

David W. Oslin, M.D. Professor, Geriatric and Addiction Psychiatry Treatment Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Chief of Behavioral Health, Philadelphia VA Medical Center, Philadelphia, PA

Derek D. Satre, Ph.D. Associate Professor of Psychiatry, In Residence - Step 4 School of Medicine. Medical Staff Psychologist, Langley Porter Hospital and Clinics University of California, San Francisco, San Francisco, CA

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