Course Summary

Older adults who use alcohol or drugs may also have a co-occurring health problem or mental disorder. These patients often have common characteristics that may include being unmarried, early onset of substance use as a younger adult, less than average education and income, existence of a chronic mental illness, and poor social and spiritual support. Retirement with a sudden change in job status, loss of co-workers, and declining health are all factors that are typical of older adults who are diagnosed with substance misuse and a co-occurring physical or mental disorder. The Substance Abuse and Mental Health Services Administration (SAMHSA) has reported that older adults often lack the social support needed to recognize and to manage a co-occurring health or mental disorder, and they require assistance to be properly screened, diagnosed, and offered options for recovery and a plan of care to achieve optimal health.

Course Format


Course Syllabus

  • Introduction
  • Factors Contributing to Substance Misuse
    • Retirement
    • Bereavement and Grief
    • Comorbid Health Issues
  • Confusional and Aggressive Behavior
    • Confusional Behavior
    • Aggression
  • Screening for a Co-occurring Disorder
    • Patient History
  • Screening Tests
    • Drug Abuse Screening Test (DAST)
    • Alcohol Use Disorder
  • Comorbidities and Risk of a Substance Use Disorder
    • Collateral Information
    • Fear of Confrontation
  • Ageism, Stigma and Denial
    • Stigma and Barriers to Treatment
  • Case Study: Older Female With a Co-Occurring Disorder
    • Discussion
  • Summary


Noah H. Carpenter, MD

Dr. Noah Carpenter is a Thoracic and Peripheral Vascular Surgeon. He completed his Bachelor of Science in chemistry and medical school and training at the University of Manitoba. Dr. Carpenter completed surgical residency and fellowship at the University of Edmonton and Affiliated Hospitals in Edmonton, Alberta, and an additional Adult Cardiovascular and Thoracic Surgery fellowship at the University of Edinburgh, Scotland. He has specialized in microsurgical techniques, vascular endoscopy, laser and laparoscopic surgery in Brandon, Manitoba and Vancouver, British Columbia, Canada and in Colorado, Texas, and California. Dr. Carpenter has an Honorary Doctorate of Law from the University of Calgary, and was appointed a Citizen Ambassador to China, and has served as a member of the Indigenous Physicians Association of Canada, the Canadian College of Health Service Executives, the Science Institute of the Northwest Territories, Canada Science Council, and the International Society of Endovascular Surgeons, among others. He has been an inspiration to youth, motivating them to understand the importance of achieving higher education.

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