Volume 4, Number 2 - October 2008
In This Issue: Substance Abuse and Aging
Rates of substance abuse among older adults are increasing. This edition of Aging Times explores why social workers must be prepared to address this issue and what tools are available to both students and faculty.
Aging and Substance Use, Misuse, and Abuse
Kathleen J. Farkas, Case Western Reserve University
With rates of substance-dependency among older adults increasing, Professor Farkas describes the need for social workers to be knowledgeable of the substance abuse issues elders face.
Substance Use and Abuse Among Older Adults: Reflections from an MSW Student
Sarah Axner, MSW Student, Case Western Reserve University
One student worries that oversights in social work education may leave the next generation ill-prepared to meet the changing needs of an aging population.
Resources on Older Adults & Substance Abuse
The MAC Project
SAMHSA Web Resources and Publications (MS Word)
Gero-Ed Center Updates
Don’t Miss the Gero-Ed Track at the 2008 APM!
The 2008 CSWE Annual Program Meeting is only three weeks away, and the Gero-Ed Center is looking forward to seeing you at the Gero-Ed Track. Don’t miss this year’s special events!
State of the Science Report Released: Professional Partners Supporting Family Caregiving
This report, which identifies ways both social workers and nurses can better support family caregivers, is now available on the Gero-Ed Center Web site.
Faculty Development Institute at APM: Teaching Evidence-Based Aging Content in Mental Health, Substance Use, and Health
Register now for the MAC Project FDI at CSWE’s Annual Program Meeting to learn more about using research-based gerontological content in MSW advanced courses in mental health, substance use, health, and aging.
Gero-Ed Center Paper Session at APM on the Master’s Advanced Curriculum Project
Attend this paper session to learn more about results and progress of the MAC Project’s first year Gero Innovations Grant awardees.
Aging and Substance Use, Misuse, and Abuse
By Kathleen J. Farkas
Today approximately 1.7 million adults over age 50 are substance dependent. This group is expected to increase to 4.4 million by 2020 (Korper & Rasken, 2003). Why? What is happening to create such a surge in alcohol and other drug abuse among older adults?
Lifetime patterns of drug use provide one reason. Today’s middle-aged adults are accustomed to using prescription and over-the-counter pharmaceuticals to treat illness and discomfort. Alcohol use has also been part of life for the baby boomer generation, and there is reason to expect alcohol use will continue as these cohorts age. Baby boomers have also used illegal substances, especially marijuana, at higher rates than previous cohorts, so there are expected changes in the prevalence and incidence rates of illicit substance use.
The size of future older cohorts will increase the need for substance abuse assessment and treatment services even if age-related prevalence rates of abuse and dependence remain constant. Bartels (2006) describes these age cohort changes as a “demographic tsunami” that requires additional attention to issues of substance use and commonly occurring mental disorders. These projections have implications for social work practice and education as well as for alcohol and other drug service delivery systems.
For most social workers, aging and substance abuse has not been a familiar intersection. Older adults are not the primary group seeking treatment for alcohol and other drug abuse (AODA) issues; there are few treatment programs and AODA practitioners reaching out to older persons. Among gerontological social workers, the topic of substance use, abuse, and dependence is easily masked by other later life medical, social, and psychological problems. Gerontological social workers may be well-versed in medication management, but not prepared to assess for intentional prescription drug misuse, alcohol or illicit drug abuse, or to make a referral to AODA treatment. Once an older person is enrolled in treatment, the AODA treatment staff may not have adequate skills to develop age-appropriate engagement strategies or interventions.
In social work education, there is a growing need to recognize the overlaps between AODA and aging practice to prepare students to address the substance use and abuse needs of older populations. Social work programs often mirror the separate silos of the practice community and neglect opportunities for cross training. AODA educators have specific knowledge of the literature on alcohol and other drug abuse. However, the majority of AODA research and teaching is with younger populations. Without specific content on older adults, most AODA specialization social work students will lack exposure to information about older adults. The same can be said for students in aging practice. Without specific content in AODA, they will lack tools for effective practice with substance-using older clients.
Fortunately, there is a growing body of research and empirically supported interventions on substance use, misuse and abuse among older adults. Through the generous support of the John A Hartford Foundation and CSWE’s Gero-Ed Center, this information will soon be available to all social work programs. The Substance Use and Aging Resource Review for Teaching (Farkas & Drabble, in press) discusses the empirical literature and describes curricula and teaching resources such as DVDs and web sites. The goal is to provide social work faculty with current and empirically based information on substance use, misuse, abuse, and dependence among older adults. The content can be added to AODA classes within social work programs to provide current and empirically based information and resources on substance use, misuse, abuse, and dependence among older adults.
Kathy Farkas holds a Ph.D. from Case Western Reserve University, an A.M. from the University of Chicago, and a B.A. from Case Western Reserve University. She is an Associate Professor at the Mandel School of Applied Social Sciences at Case Western Reserve University. Her research and practice interests are in substance abuse assessment, diagnosis and treatment.
References
Bartels, S. (2006). The aging tsumani and geriatric mental health and substance use disorders. Journal of Dual Diagnosis, vol. 2(3) p.5.
Farkas, K. & Drabble, L. (In Press). Advanced MSW curriculum in substance use and aging. Available October 30, 2008: http://www.Gero-EdCenter.org/mac
Korper, S.P. & Raskin, I.R. (2003). The impact of substance use and abuse by the elderly: The next 20 to 30 years. In Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Substance Use by Older Adults: Estimates of Future Impact on the Treatment System.
Substance Use and Abuse Among Older Adults:
Reflections from an MSW student
By Sarah Axner
Through my personal and professional experience, especially in my field placement, I have learned that a surprising number of baby boomers are negatively affected by substance use. The behaviors I have seen first-hand range from smoking marijuana for recreation, to refusing to seek treatment for alcoholism, to obtaining sleep aid prescriptions for insomnia from two different doctors.
I became alarmed when I learned that the number of adults over the age of 50 who will require treatment for a substance abuse problem will be approximately 4.4 million in 2020 (Gfroerer et al., 2002; see also Simoni-Wastila & Keri Yang, 2006). I questioned if the individuals whom I know will be able to manage their abuse and dependency, or if they will need treatment in their older years. I wondered if appropriate screening assessments will be available to appropriately evaluate their situations.
I discovered very few substance abuse intervention strategies are currently in place for older adults. I also found out that although there are many assessment tools to screen for substance use, only a small number of these are appropriate for screening in the older adult population. In addition, few treatment programs exist that are specifically designed for older adults (Schultz, Arndt, & Liesveld, 2003).
Substance abuse assessment and treatment are not often addressed in gerontological practice courses, and aging is not a typical component of alcohol and other drug treatment curriculum. These oversights may leave the next generation of social workers ill prepared to meet the needs of older adults.
However, I remain optimistic. Awareness of the many changes that must be implemented for older adults in the next two decades is increasing. There is also a better understanding that treatment centers will be required to “address the special needs of the older population of substance abusers” (Gfroerer et al., 2002, p. 128). In addition, many social workers are now aware that “improved tools that measure substance use and abuse” (p. 134) must be developed for older adults in community and institutional settings.
Continued reflection of my personal experiences, research, and knowledge acquired while engaging in field practicum will help me to achieve my goal to become more competent in gerontological issues regarding substance abuse and dependency. To prepare myself for the realities of future practice in social work, I plan to participate in and contribute to specialized treatment programs, interventions, and assessments for older adults so that I may better accommodate their distinctive needs regarding substance use, abuse, and dependency.
Sarah Axner is currently a second year graduate student at Case Western Reserve University’s Mandel School of Applied Social Sciences. She is in the direct practice concentration specializing in the field of aging. She is completing her advanced field placement at The Benjamin Rose Adult Day Program and Partial Hospitalization Program in Cleveland, OH.
References
Gfroerer, J., Penne, M., Pemberton, M., Folsom, R. (2002). Substance abuse treatment need among older adults in 2020: the impact of the aging baby-boom cohort. Drug and Alcohol Dependence, 69, 127-135.
Schultz, S. K., Arndt, S., Liesveld, J. (2003). Locations of facilities with special programs for older substance abuse clients in the US. International Journal of Geriatric Psychiatry, 18, 839-843.
Simoni-Wastila, L., Keri Yang, H. (2006). Psychoactive drug abuse in older adults. The American Journal of Pharmacotherapy, 4(4), 380-394.
Don’t Miss the Gero-Ed Track at the 2008 APM!
The CSWE Gero-Ed Center invites you to attend the Gero-Ed Track (Thursday, October 30–Sunday, November 2) at the 2008 APM in Philadelphia, PA. In addition to the more than 70 paper, poster, workshop, and roundtable sessions, the Gero-Ed Center has several special events that must not be missed!
The keynote speaker for our Gero-Ed Track Kick-Off (Friday, October 31, 10:30 am–12:00 pm, Grand Ballroom D) is Robert Hudson (PDF), professor and chair, department of social welfare policy, Boston University School of Social Work and editor of the Public Policy & Aging Report. Hudson’s keynote address will focus on the policy challenges and practice implications of health care for older adults. The CSWE Gero-Ed Center is delighted to have such a highly regarded social work policy analyst kick-off the Gero-Ed Track!
Building on the healthcare theme introduced during the Gero-Ed Track Kick-Off, the Gero-Ed Center/AGE-SW Hot Topic Panel on Healthcare (Sunday, November 1, 10:30 am–12:00 pm, Grand Ballroom D) will further discuss health care issues facing older adults. Panelists for this sessions will be: Joan Weiss of the U.S. Health Resources and Services Administration, Michelle Putnam of Simmons College, Grace Christ of Columbia University, and Patricia Volland of the New York Academy of Medicine.
We are also holding our 3rd Annual Anita Rosen Gerontology Awards for Outstanding Student Poster (Friday, October 31, 1:30 pm–3:00 pm, right front corner of the Exhibit Hall). Please tour this year’s student posters to support future gerontological social workers and view their wonderful work!
Don’t miss the Gero-Ed Center/Association for Gerontology Education in Social Work (AGE-SW) Reception! The Reception (Friday, October 31, 6:00 pm–7:00 pm, Grand Ballroom D), which is also supported by the Institute for Geriatric Social Work at Boston University, is a place to network with your colleagues and meet the winners of the Rosen Awards and the Gero-Ed Center Best Practice Awards. Put this on your “must-attend” list!
The popular 3rd Annual Gero-Ed Center Film Festival will again feature films on aging issues that are appropriate for the classroom. Films will be shown throughout the conference, and a schedule of films will be available in the 2008 APM totebag.
With so many exciting events at the APM, it can be hard to keep track of everything you want to attend. Luckily, you can create your own customized calendar online using the CSWE’s Personal Scheduler. Go ahead and block off the Gero-Ed Track events today!
State of the Science Report Released: Professional Partners Supporting Family Caregiving
Today, families and other unpaid caregivers (such as friends and neighbors) are the primary providers of long-term care in the United States. Family members are often unprepared to take on the monumental task of caregiving.
In a first-of-its-kind collaboration, national organizations representing nurses, social workers, family caregivers and people age 50 and older produced a report calling for a re-definition of good patient care to include those family members and friends who provide ongoing, often daily, care. The report, “State of the Science: Professional Partners Supporting Family Caregiving,” is a joint endeavor of the AARP Foundation, the American Journal of Nursing, the Council on Social Work Education and its Journal of Social Work Education, the Family Caregiver Alliance, and Rutgers Center for State Health Policy with funding from the John A. Hartford Foundation and the Jacob and Valeria Langeloth Foundation.
To access the report, please visit the Family Caregiving Section of the Gero-Ed Center Web site where the full text version of JSWE is posted. The report is also available through the American Journal of Nursing Web site. If you a member of the Council on Social Work on Education, please watch your mail for this special issue of JSWE
Faculty Development Institute: Teaching Evidence-Based Aging Content in Mental Health, Substance Use, and Health
The CSWE Gero-Ed Center’s Master’s Advanced Curriculum (MAC) Project, funded by the John A. Hartford Foundation, will launch the Web-based gerontological Resource Reviews for faculty teaching in the areas of mental health, substance use, and health. These Resource Reviews, which include case studies, lecture notes, and PowerPoint presentations, will be presented and discussed during the MAC Project’s Faculty Development Institute (FDI) at CSWE’s Annual Program Meeting (APM).
During the FDI session, the Resource Review authors will demonstrate how to include research-based aging content in MSW advanced courses in the three specialty areas. Kevin Hennessy, the science to service coordinator at the U.S Substance Abuse and Mental Health Services Administration will also discuss how social work faculty can use and submit their own research to the National Registry of Evidence-Based Programs and Practices.
Gero-Ed Center Paper Session at APM on the Master’s Advanced Curriculum Project
Be sure to attend the Master’s Advanced Curriculum (MAC) Project paper session from 1:30 pm–3:00 pm in Room 413 on Friday, October 31 at the 2008 CSWE Annual Program Meeting.
Leaders from the MAC Project’s Gero Innovations Grant (GIG) are the presenters for this event. The purpose of the GIG is to increase gerontological competencies in the advanced practice areas of substance use, mental health, and health, by developing, implementing, and evaluating gerontological innovations into curriculum and related field opportunities.
During this session, the GIG project directors will present an in-depth look at some of their gerontological innovations in each of the three specialty areas. The titles and authors of the three papers are:
A. Piloting a Gero-Infused Curriculum in Advanced-Level MSW Courses—Judy Fenster, Adelphi University. (Focus on substance use)
B. Using Web-Based Technology to Expose Advanced-Year Students to Geriatric Mental Health—Caroline Rosenthal Gelman, New York University. (Focus on mental health)
C. Gero Innovations in the Advanced MSW Curriculum: Outcomes and Lessons Learned—Jay Poole, University of North Carolina, Greensboro. (Focus on health)