Table 6.

Directions for future clinical practice and research in late‐life substance use disorders

1.	Clinicians and lay persons should be educated about the importance of substance use disorders in older adults, including their medical sequelae such as falls, cognitive decline, and worsening of co‐occurring physical and mental disorders.
2.	Screening for substance use disorders should be integrated in both primary care and specialty mental health services for older adults.
3.	The most important risk factors for substance use disorders in older adults – particularly social isolation, loneliness, bereavement, and felt loss of purpose and meaning in life – should be better known, evaluated and addressed.
4.	Self‐help groups should be adapted for older adults, e.g., by slowing the pace to accommodate cognitive impairment, and/or by addressing issues related to social support.
5.	The silos of mental health and substance abuse services should be broken down.
6.	Possible adaptations of diagnostic criteria/guidelines for substance use disorders should be considered to improve their performance in older adults.
7.	Further research should be conducted into the effectiveness of standardized brief interventions, such as motivational interviewing, in older adults.
8.	Further research should be carried out into the effectiveness and safety of using medications such as buprenorphine and naltrexone in older adults with substance use disorders.
9.	Factors in midlife which predispose to the development of substance use disorders in late life should be explored.
10.	Differences in substance use disorders by ethnicity, gender and geography should be investigated, and risks associated with disruptions in the lives of older adults that might lead to these disorders should be explored.