DRUG AND ALCOHOL REFERRALS - ARE ELDERLY SUBSTANCE-ABUSE DIAGNOSES AND REFERRALS BEING MISSED

Objective-To examine the diagnosis of problem substance use in hospita l inpatients aged 65 years and over and their referral to drug and alc ohol services by medical staff. Design-Questionnaire to registrars or house officers caring for patients 65 years of age and over with probl em substance use. Setting-5 hospitals in New South Wales, Australia. S ubjects-Medical staff caring for 263 inpatients. Results-Medical staff did not recognise substance misuse in older hospital patients and did not seem to be aware of current recommendations of the National Healt h and Medical Research Council recommendations for safe use of alcohol and benzodiazepines. Three out of 88 problem users of benzodiazepines , 29 out of 76 smokers, and 33 out of 99 problem drinkers were identif ied by medical staff. Of those identified with problems, 2 benzodiazep ine users, 6 smokers, and 19 drinkers were considered for referral to drug and alcohol services. Conclusions-Greater awareness of recommenda tions for dealing with problem use of benzodiazepines and alcohol need s to be promoted among medical staff, along with an increased emphasis in medical education on substance use as a potentially important prob lem for older people. Drug and alcohol services also need to promote a broader role, particularly in regard to early intervention in a hospi tal setting for older patients.