February 11, 2021

Treatment Improvement Protocol (TIP) 26: Treating Substance Use Disorder in Older Adults

The updated Treatment Improvement Protocol (TIP) 26: Treating Substance Use Disorder in Older Adults, was released by the Substance Abuse and Mental Health Services Administration (SAMHSA) in September 2020. This comprehensive publication is designed for providers with the identification, prevention, and treatment of substance misuse in older adults. Developed by a consensus panel of experts, and reviewed by stakeholders, TIP 26 includes information on how substance use disorder manifests in this population and provides appropriate tools, assessments, and treatments. Frederic C. Blow, Ph.D., Director of the U-M Addiction Center and Substance Abuse Program, served as Consensus Panel Chair for the development of TIP 26. 

Despite consistent evidence that treatment can be just as effective in improving their quality of life and health as it is for younger age groups, older adults are often an “invisible population” when it comes to the identification and treatment for substance misuse. Substance misuse in older adults often remains hidden due to ageist thoughts and attitudes from providers, families, and caregivers. Some may have a “why bother” mentality and incorrectly assume that treatment later in life is just not worth it. Additionally, it is not uncommon for providers to feel uncomfortable talking to older adults about substance misuse or to feel as though they do not have time for screening/assessment. Providers may not fully understand how to differentiate between the symptoms of substance use and other age-related illnesses (ie dementia, mobility issues, etc). 

Because there are so many factors that may lead to older adults’ substance misuse being unseen and untreated, all providers, from PCPs to in-home to direct care workers, have a role to play. The TIP addresses this through nine chapters that cover a variety of topics, five of which are specifically for providers. Chapters emphasize the importance of recognizing the diversity of older clients through age-sensitive and age-specific treatment practices. In addition to presenting screening and assessment resources specific to different cases of substance misuse, the TIP also includes valuable information about social support and overall wellness. 

TIP 26 is available for free download at SAMHSA.gov. Made for providers, stakeholders, individuals, and families, it features the latest evidence-based information on how to identify, manage, and prevent substance misuse in older adults.