When discussing substance use prevention, we generally focus on the first stages of life because science has proven that multi-component programs delivered at the right time have an undeniable positive impact. However, prevention is not exclusive to children and youth; its primary objective is to help all people avoid or delay the initiation of psychoactive substances or avert substance use disorders1. Therefore, effective prevention programs can help people of all ages realize their talents and potential to contribute to their communities.
According to experts, we must start paying more attention to older adults because substance misuse, which is increasing at an alarming rate, is difficult to recognize and can affect the aging process. Furthermore, older adults have a bigger risk of falls and reduced independence, they experience stressful changes such as their retirement, or the loss of a spouse, and are more likely to suffer depression and anxiety which makes them more vulnerable to the harmful effects of substances2,3.
Fortunately, the potential consequences of substance use disorders in older people are preventable. Some programs include health education programs, prescription drug monitoring programs, and online training programs in managing chronic pain4. Nevertheless, there is an information gap and a significant need to develop age-specific programs5. The International Standards encourages not to limit prevention programs to hospital-related environments but to use a more holistic approach that focuses on reducing risk factors and increasing protective factors6.
Risk factors are biological, psychological, cultural, or societal characteristics associated with a higher likelihood of an adverse outcome in stressful situations. In contrast, protective factors are characteristics that prevent negative consequences and help people adapt and reduce a risk’s impact7. Even though the risk and protective factors were conceptualized for children and youth, the same principles apply to the aging population. Therefore, the science of prevention focuses on developing different skills a person may need to adapt and adjust when transitioning to a different phase of life; therefore, the most effective prevention increases protective factors and reduces risk factors.
An initiative that promotes evidence-based drug use prevention and supports families and communities worldwide is Listen First8. One of its main goals is to raise awareness among families and caregivers about the importance of actively listening to children, monitoring their daily routines, participating in their activities, and being patient with them to help them grow healthy and safe. But, as we pointed previously, being heard, spending time with family, having routines, receiving praises, doing exercise, and receiving love and affection are universal needs we have as human beings.
Focusing on these needs to prevent substance misuse and promote health makes sense because processes like growing up and aging involve adaptation and learning. Therefore, addressing factors influencing them, such as the environment, lifestyle, behavior, and relations, can make these processes more manageable and less stressful.
For instance, the science of the affection sheet states that “physical affection such as hugs and smiles releases oxytocin, also known as the love hormone.”
Oxytocin can stimulate growth in children but is also associated with better health in older adults because it strengthens the immune system and even helps wounds heal faster9.
The impact of loving and being loved, shown through smiles and hugs, is unmeasurable. Spending quality time with the people we care about is another expression of love, and it builds stronger, connected families. It seems that the social isolation due to the pandemic took that away from many older adults. Thus, including them in family group activities such as cooking, painting, or playing music together promotes bonding, trust, love for one another and gives them a sense of belonging and increases well-being10,11.
It is essential to emphasize that expressions of love are grand gestures and everyday things like sharing meals, going to the store, or playing together. Therefore, routines also help families relieve stress, connect, and feel valued. These routines help older adults manage everyday tasks and, if they have a specific role, they create a sense of control and independence that increases well-being12,13. To fulfill universal human needs, we need to listen first to help children and youth grow and listen again to help older adults age.
UNODC encourages communities to use the Listen First materials available at www.unodc.org/listenfirst. These materials were designed for young people but can be transitioned to meet the needs of an aging population. And the new materials to be released in November 2021 will focus on the Science of Skills including decision-making, communication, stress-management, planning, and organizing, and self-management. People of all ages can benefit from focusing on growing these skills no matter their age. It is time to complete the circle – Listen First and then Listen Again.
1Alpert, P. T. (2017). Self-perception of social isolation and loneliness in older adults. Home Health Care Management & Practice, 29(4), 249-252. https://doi.org/10.1177/1084822317728265
2Bayar, R., & Türkoğlu, H. (2021). The relationship between living environment and daily life routines of older adults. A/Z ITU J. Fac. Archit, 18, 29-43.
3Gonçalves, A. R., Barcelos, J. L. M., Duarte, A. P., Lucchetti, G., Gonçalves, D. R., Silva e Dutra, F. C. M., & Gonçalves, J. R. L. (2021). Perceptions, feelings, and the routine of older adults during the isolation period caused by the COVID-19 pandemic: a qualitative study in four countries. Aging & Mental Health, 1-8. https://doi.org/10.1080/13607863.2021.1891198
4Han, B. H., & Moore, A. A. (2018). Prevention and screening of unhealthy substance use by older adults. Clinics in geriatric medicine, 34(1), 117-129. doi: 10.1016/j.cger.2017.08.005
5Lehmann, S. W., & Fingerhood, M. (2018). Substance-use disorders in later life. New England Journal of Medicine, 379(24), 2351-2360. doi: 10.1056/NEJMra1805981
6Minkove, J. (2019). Substance Use Disorders in Older Adults: A Growing Threat. Hopkins Brain Wise. https://www.hopkinsmedicine.org/news/articles/substance-use-disorders-in-older-adults-a-growing-threat
7Pinquart, M., & Sörensen, S. (2000). Influences of socioeconomic status, social network, and competence on subjective well-being in later life: A meta-analysis. Psychology and Aging, 15(2), 187–224. https://doi.org/10.1037/0882-7974.15.2.187
8Rogers-Jarrell, T., Eswaran, A., & Meisner, B. A. (2021). Extend an Embrace: The Availability of Hugs Is an Associate of Higher Self-Rated Health in Later Life. Research on Aging, 43(5-6), 227-236. doi: 10.1177/0164027520958698
9Substance Abuse and Mental Health Services Administration. (2019). Risk and Protective factors. https://bit.ly/3AF6QRO
10Seim, L., Vijapura, P., Pagali, S., & Burton, M. C. (2020). Common substance use disorders in older adults. Hospital Practice, 48(sup1), 48-55. doi: 10.1080/21548331.2020.1733287
11United Nations Office on Drugs and Crime (n/d). Science & Publications. Listen First. https://www.unodc.org/unodc/en/listen-first/about.html
12United Nations Office on Drugs and Crime (2020). Listen First. https://www.unodc.org/unodc/en/listen-first/about.html
13United Nations Office on Drugs and Crime & World Health Organization (2018). International Standards on Drug Use Prevention: second updated edition. Vienna: UNODC and WHO. http://www.add-resources.org/unodc-international-standards-on-drug-use-prevention.5896450-315775.html
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