Letter to the Editor Open Access
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jul 19, 2025; 15(7): 104254
Published online Jul 19, 2025. doi: 10.5498/wjp.v15.i7.104254
Empowering older adults: Enhancing addiction literacy to address unique vulnerabilities
Kae Leopoldo, João Mauricio Castaldelli-Maia, Department of Psychiatry, Medical School, University of Sao Paulo, São Paulo 01246903, Brazil
Kae Leopoldo, Department of Experimental Psychology, Psychology Institute, University of Sao Paulo, São Paulo 01246903, Brazil
João Mauricio Castaldelli-Maia, Instituto Perdizes (IPER), Hospital das Clinicas, Medical School, University of Sao Paulo, São Paulo, 05021001, Brazil
ORCID number: Kae Leopoldo (0000-0002-5541-8397); João Mauricio Castaldelli-Maia (0000-0001-9621-2291).
Author contributions: Leopoldo K and Castaldelli-Maia JM contributed to conceptualization, writing, reviewing and editing; Leopoldo K and Castaldelli-Maia JM have read and approved the final version of the manuscript.
Supported by FAPESP and Conselho Nacional de Desenvolvimento Científico e Tecnológico, No. 2024/13209-0.
Conflict-of-interest statement: There is no conflict of interest associated with the senior author and coauthors who contributed to this manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: João Mauricio Castaldelli-Maia, MD, PhD, Assistant Professor, Instituto Perdizes (IPER), Hospital das Clinicas, Medical School, University of Sao Paulo, R. Cotoxó, 1142 - Pompeia, São Paulo, 05021001, Brazil. jmcmaia2@gmail.com
Received: December 16, 2024
Revised: March 27, 2025
Accepted: April 10, 2025
Published online: July 19, 2025
Processing time: 207 Days and 11.5 Hours

Abstract

Addiction literacy equips older adults with the knowledge to navigate substance use risks amid unique challenges like polypharmacy and social isolation. With rising trends in cannabis use among this group, targeted education can promote safe practices and reduce preventable harms. By fostering open conversations and integrating addiction literacy into healthcare, providers can support informed decision-making.

Key Words: Health literacy; Addiction literacy; Ageing; Older adults; Drug use; Polypharmacy

Core Tip: Addiction literacy equips older adults with the knowledge to navigate substance use risks amid unique challenges like polypharmacy and social isolation. With rising trends in cannabis use among this group, targeted education can promote safe practices and reduce preventable harms. By fostering open conversations and integrating addiction literacy into healthcare, providers can support informed decision-making.



TO THE EDITOR

Addiction literacy, a subdomain of health literacy, refers to the knowledge and skills necessary to understand, prevent, and manage substance use disorders and their associated risks[1,2]. As many countries experience a rapid demographic shift toward an ageing population, enhancing addiction literacy among older adults has never been more crucial.

In that sense, the study by Fang et al[3] captured our attention as it provides critical insights into the interplay between health literacy, social isolation, and psychological distress among older adults. Analyzing the dual challenge of frailty and social isolation, the authors emphasize the need to address both factors in order to mitigate adverse health outcomes. Among its key findings, the study indicates that social isolation is negatively associated with health literacy, which in turn is linked to psychological distress in this vulnerable group. Notably, health literacy was identified as a mediating factor between social isolation and psychological distress, underscoring its role in promoting mental well-being.

In this context, addiction literacy becomes especially important, as psychological distress is often, and wrongly, addressed through the use of alcohol, marijuana, and prescription drugs without proper medical supervision[4,5]. Such practices not only fail to resolve underlying issues but may also create and exacerbate health risks, particularly among older adults already dealing with frailty, polypharmacy and other risk factors. Building addiction literacy can empower this population to seek appropriate support and make informed decisions about substance use, contributing to overall health and well-being.

The concurrent use of prescription medications alongside substances like alcohol or cannabis increases the risk of adverse drug interactions, cognitive impairment, and accidents[6,7]. Alarmingly, recent trends show a significant rise in cannabis use among older adults, with studies highlighting an increase of marijuana use in those over 60 years in many regions of the world[8]. While often used for therapeutic purposes, such as pain management or insomnia, cannabis use in this group may exacerbate health risks, especially when combined with other medications.

Older adults may lack awareness of these risks due to inadequate addiction literacy, widespread misinformation and target campaigns that are often absent. This gap in addiction literacy may leave older adults ill-equipped to navigate the complexities of modern substance use trends and associated health risks.

To address this gap, targeted interventions are essential. Health education campaigns tailored for older populations can be delivered through community centers, primary care settings, and digital platforms. These campaigns should focus on: (1) Risk awareness: Educating about the potential interactions between commonly prescribed medications and substances such as alcohol, cannabis, or opioids; (2) Safe use practices: Providing guidance on the appropriate use of therapeutic substances like medical marijuana and encouraging discussions with healthcare providers. Notably, we highlight that, in most cases, “no use” is the safest practice; and (3) Destigmatization: Creating a non-judgmental environment for older adults to discuss substance use concerns and seek help.

Healthcare providers play a pivotal role in improving addiction literacy. Training clinicians to screen substance use with their older patients can be an important step in promoting informed decision-making. Integrating addiction literacy into routine health check-ups, along with the provision of easy-to-understand educational materials, can also have a meaningful impact.

Moreover, policymakers must invest in research to better understand substance use patterns and related health outcomes among older adults. Such evidence, as presented by Fang et al[3], can inform the design of interventions that are culturally appropriate and address the main factors that curb health and quality of life.

As we continue to grapple with the challenges of an ageing population, prioritizing addiction literacy among older adults is an important public health necessity. By equipping this vulnerable demographic with the knowledge and tools to make informed-and healthy-choices, we can enhance quality of life in this population and reduce the burden of preventable health complications.

Footnotes

Provenance and peer review: Invited article; Externally peer reviewed.

Peer-review model: Single blind

Specialty type: Psychiatry

Country of origin: Brazil

Peer-review report’s classification

Scientific Quality: Grade A, Grade A, Grade B

Novelty: Grade A, Grade A, Grade B

Creativity or Innovation: Grade A, Grade A, Grade B

Scientific Significance: Grade A, Grade A, Grade B

P-Reviewer: Lei HK; Liu Y S-Editor: Qu XL L-Editor: Webster JR P-Editor: Zhang L

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