Usually, a team approach is best. Your healthcare provider will help organize others to make sure that you have a professional available who knows about your needs. The team may include a nurse, social worker, psychotherapist, or counselor. In fact, older adults tend to do even better than younger people in drug and alcohol treatment programs.  

Support groups such as Alcoholics Anonymous, Rational Recovery, or Narcotics Anonymous have excellent track records. Ask your healthcare team to suggest groups that would fit your needs. You should feel free to find the group that you feel most comfortable with to treat your addiction.  Finding a support group that you feel comfortable with is more important than which type of addiction the group focuses on. 

Non-Drug Therapies

The following are among the effective treatments that are part of a team approach:

• Talk therapy (psychotherapy) with a trained supportive counselor
• Group therapy with a trained therapist
• Keeping a diary to record your patterns of use of the problem substance
• Residential care in a rehabilitation facility
• 12-step programs and other long-term programs (such as Alcoholics Anonymous)

Tobacco Abuse (Cigarette, Cigar or Pipe Smoking)

If you are addicted to smoking, you have probably tried to quit many times. But another serious try is always worth it, even if you are among the very old. Quitting at any age slows the decline in lung function.

Let your healthcare provider know that you want to stop smoking. Together, you will take the following steps:

• Choose a date that suits you
• Get any needed medications
• Arrange a follow-up visit
• Educate yourself about smoking and the benefits of quitting
• Get involved in a support group or buddy system to help keep you motivated

Drug Treatment

Your treatment must meet your needs and lifestyle, and any special requirements you might have. Treatment options using medications may include: 

• Specialized drugs to reduce cravings and withdrawal symptoms
• Slow tapering of the problem substance with drug substitutions as support
• Hospitalization until you are stabilized and detoxification is achieved (in cases of severe alcohol or substance abuse)
• Nutritional counseling, multivitamins, and supplemental B vitamins (in cases of severe problem drinking)
• Antidepressants during withdrawal or detoxification, if necessary

Medications to Reduce Cravings

Some drugs can help reduce cravings for the addicted substance. Some drugs, such as naltrexone, may help you stay away from alcohol. Methadone,buprenorphine and other drugs have proved to be effective in older people who are trying to stay away from narcotics like oxycodone or morphine. Other types of medications may help, depending upon your particular circumstances. You may need a consultation with a professional who is trained in treating substance use like an addiction medicine specialist.

Medications to Reduce Tobacco Use

Many people have had success in quitting smoking by using certain drugs in combination with programs that help you change your behavior. All forms of nicotine replacement therapy ( such as skin patches or chewing gum) increase the success rate of quitting smoking by up to 50%–70%. The nicotine patch and gum reduce withdrawal symptoms by delivering nicotine to the brain more slowly than smoking does. The use of both patches and gum is more effective than use of either alone.

Bupropion and varenicline are effective medications for reducing tobacco dependence. However, there is some evidence that use of varenicline may be associated with a higher rate of injury from road accidents and falls.

Battery-powered electronic cigarettes (e-cigarettes) may contain ingredients that are toxic to humans. There are currently no e-cigarettes that are approved by the U.S. Food and Drug Administration (FDA) for help in quitting smoking.

Monitoring 

Since recovery from alcohol and substance abuse is considered an ongoing process, your healthcare provider will want to make follow-up appointments to make sure that you are successfully avoiding your problem substance. For example, you may be at risk of “falling off the wagon” (using substances again) if there are new stresses in your life. Therefore, it is a smart precaution to see your healthcare provider or social worker every three to six months after you have kicked your habit. 

Last Updated July 2020