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Alcohol and drug misuse are associated with a wide array of negative physical and mental health outcomes that are exacerbated with advancing age, such as functional and cognitive decline, compromised immune function, and depression; however, relatively little work has examined the correlates and consequences of substance use among older adults. Accordingly, substance misuse in later life, which encompasses misuse of alcohol and illicit, prescription, and over-the-counter drugs, has been called an “invisible epidemic” (Widlitz and Marin 2002). Epidemiological work, which has focused on younger populations, demonstrates that beginning in the middle to late 20s, overall rates of alcohol and illicit drug use begin to decline, with the majority of older adults reporting no substance use. Nevertheless, changes in demographic and cohort trends suggest that substance misuse in later life is a pressing public health matter and that older adults represent a group in growing need of specialized substance treatment programs and services (Gfroerer et al. 2003).
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