Evidence-Based Treatment Interventions for Substance Use Disorders or Misuse Among Older Adults in the United States: A Scoping Review

OBJECTIVES: Substance use disorders (SUD) are rising among U.S. older adults, yet few studies have synthesized evidence on effective treatments for this population. This scoping review mapped and evaluated U.S.-based empirical literature on evidence-based treatments or evidence-based practices (EBPs) for older adults (age ≥ 60) with SUD. EBPs identified were Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), Medications for SUD, particularly medications for opioid use disorder (MOUD), and Screening, Brief Intervention, and Referral to Treatment (SBIRT). METHODS: Following PRISMA-ScR guidelines, systematic searches were conducted in PubMed, PsycINFO, JSTOR, and Google Scholar. Screening and data extraction were performed using Rayyan software. RESULTS: 18 studies met the inclusion criteria: three for CBT, nine for MI, three for medications for SUD, and three for SBIRT. CONCLUSIONS: Our review shows the promise of CBT, MI, MOUD, and SBIRT for older adults with SUD or substance misuse problems, but additional research is needed to establish their effectiveness. Developing specialized, evidence-based interventions remains a critical priority for addressing SUDs among aging populations. CLINICAL IMPLICATIONS: Evidence-informed behavioral interventions (e.g. CBT and MI), pharmacotherapy, and SBIRT may be effective for older adults with SUD; however, more research is needed to establish evidence base.