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Community Interventions for Older Adults with Comorbid Substance Abuse: The Geriatric Addictions Program (GAP)

ABSTRACT Objective: The purpose of this paper was to provide an initial evaluation of an innovative, model community-based intervention program, the Geriatric Addictions Program (GAP), designed to assist older adults who have substance abuse and co-occurring mental health problems in accessing services and changing health behaviors. Methods: On entry into the program, an interview using standardized substance abuse and mental health instruments was conducted. A chart review was conducted following discharge to determine disposition. The first 120 clients to the GAP were stratified by clinical referrals (N = 60), non-clinical referrals (N = 60) and by gender. In addition, each client was randomly assigned either: Group (1) a traditional referral approach with an assessment and linkage model, or Group (2) a multi-dimensional approach incorporating geriatric care management assessment, motivational counseling, and the combination of aging service and chemical dependency linkages. Results: Approximately 90% of the clients were referred to the GAP for alcohol problems; 15% had a comorbid or primary prescription drug problem. Comorbid mental health problems were common. Functional levels were relatively low at admission. Although both groups linked to substance abuse treatment at greater rates than seen in younger adults in other studies, those in Group II with the multidimensional approach had greater rates of linkage to both outpatient and inpatient treatment. Discussion: Programs like the GAP model of intervention, by addressing co-occurring physical and psychological problems of older adults with substance abuse, may provide the greatest potential for improved outcomes and stable recovery in later life.