Abstract
Substance use disorders (SUDs) pose unique risks to older individuals due to the effects of aging on metabolism and the brain. Alcohol use disorder is the most common SUD in late life. Signs and symptoms of SUDs are important to recognize as they present in physical, psychiatric, and social dimensions, and sometimes can be masked by other comorbid conditions. Comorbid anxiety, depression, and sleep disorders are commonly associated with SUDs and should be treated promptly, using both therapeutic approaches and standard antidepressants or other targeted medications while avoiding use of benzodiazepines. Treatment should address acute withdrawal states as well as maintenance approaches using medications as well as psychotherapy and support groups such as Alcoholics Anonymous (AA) and or Narcotics Anonymous (NA).