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Trauma may not be readily observable in older adults. Patients may not acknowledge or may minimize the importance of their experiences, and health care providers may not recognize or provide timely and appropriate mental health treatment (

). Data from a study examining the influence of chronic 

 (PTSD) on biological aging processes in older adult men and women with PTSD in New York City found that 43% were currently receiving some kind of medication or psychotherapy.

 Of those, less than 25% were receiving an adequate dose and duration of a first-line pharmacotherapy option, and not one individual was currently participating in an evidence-based psychotherapy for PTSD, which is disappointing given the larger treatment effect sizes observed with such psychotherapy compared with pharmacotherapy.

 (For more information on the prevalence of PTSD and similar issues, please see the previous review article, “

These low rates are consistent with national findings from the US Department of Veterans Affairs Health Care System. Although most older veterans with newly diagnosed PTSD received at least 1 follow-up mental health visit, increased age was associated with decreased odds of receiving combined psychotherapy and 

, decreased number of psychotherapy visits, and increased waiting times.

There are many reasons for mental health providers to be enthusiastic about promoting healing from trauma and PTSD in their older adult patients and a number of options exist (

). Even though most randomized controlled trials of psychotherapy do not include sufficient numbers of older adults to make definitive age comparisons, existing data suggest that psychotherapy is feasible and efficacious for older individuals.

 However, it may require adjustments for this age group, including increasing the number of sessions, or modifications such as adding additional content or components.

For example, although there are case studies

 that show acceptability and preliminary efficacy for an evidence-based psychotherapy for PTSD—prolonged exposure (PE)

—results of the first randomized controlled trial of PE that specifically focused on older adults indicated that effects may not be as strong as those reported in studies for younger adults.

 who received PE and those who received the comparison condition (relaxation therapy) experienced significant declines in PTSD symptoms after intervention, many symptom gains were lost by the time of the 6-month follow-up. In addition, depression symptoms did not significantly change over time, nor were they moderated by treatment condition. It is possible that while exposure can reduce PTSD symptoms in older adults during active engagement, it does not work as well during the maintenance phase. This may be due to several factors, including the difficulty in recalling older memories and potentially weakened trauma processing. Some older adults may need additional frequency and intensity of PE sessions to gain full therapeutic effect. In addition, 

 delivered via internet or mobile devices may be used to increase the reach of PE and other evidence-based psychotherapies, as well as to help older adults engage more actively in treatment or enhance care after formal intervention has ended.

These findings are consistent with those from a study of another evidence-based psychotherapy, cognitive processing therapy (CPT).

 A multivariate model predicting post-CPT symptom severity indicated lower PTSD symptoms for veterans of wars in Iraq and Afghanistan than for Vietnam veterans.

 Thus, treatment for older veterans with moderate-to-severe PTSD may also need to address such issues as aging and retirement and incorporate motivational techniques. A current psychotherapy trial in Israel testing the use of life review

 compared with a supportive control condition for PTSD, depression, and/or prolonged grief in 

 Life review takes a narrative approach and includes the developmental life-span orientation as well as exposure therapy.

The gold-standard pharmaceutical treatments for PTSD

 in the general adult population are selective serotonin reuptake inhibitors (SSRIs), particularly sertraline, paroxetine, and fluoxetine, and a selective serotonin and norepinephrine reuptake inhibitor (SNRI), venlafaxine; all of these are commonly used for depression.

However, few pharmacotherapy studies focus on or include patients who are 65 years and older. Simply generalizing findings from randomized controlled trials of younger adults with PTSD to the clinical treatment of older adults may be problematic. It is possible that age-related changes in the brain (eg, declining locus coeruleus functioning with consequent alterations in noradrenergic tone

) may specifically affect treatment responses to SSRIs and SNRIs in older adults. Moreover, intervention studies exclusively enrolling younger adults typically do not contain outcome measures relevant to older adults, such as assessments of cognitive and physical functioning. It may be the case that, similar to the aforementioned psychotherapy trials for PTSD, pharmacotherapy in older adults will require aging-informed adjustment in order to achieve optimal responses. For example, good clinical medication management for PTSD in older adults must also consider potential frailty, complex comorbidities, multimorbidity, and polypharmacy.

Differences in clinical phenomenology, brain mechanisms, and treatment responsivity based on age have been well documented in the case of major depressive disorder in older adults, which is quite relevant to individuals with PTSD given its frequent cooccurrence.

 The average response to antidepressant medication tends to be higher in younger than older adults.

 Reasons for attenuated responses and more chronic clinical courses include age-related biological processes, such as cerebrovascular infarcts; development of frailty; inflammation and neurochemical changes like diminished dopamine signaling; and oxidative stress and mitochondrial aging.

 One forward-thinking strategy is to identify and deploy precision treatments rather than apply an empirical treatment (eg, antidepressant medication) that may not address the specific disease process occurring in a given patient.

 In addition, optimal management of late-life depression should begin earlier in adulthood, incorporating preventive strategies as well as a focus on such lifestyle strategies as 

Thus, while pharmacotherapy research into PTSD in older adults is lagging far behind the psychotherapy literature, lessons learned from treatment of depression in older adults may be informative. In addition, innovative pharmacotherapy augmentation or second-tier interventions for increasing the mental health treatment response in older patients with PTSD include the use of d-cycloserine and 3,4-methylenedioxymethamphetamine

 as well as an α-2 adrenergic receptor antagonist, yohimbine.

One important caveat to the issues presented earlier in this article is that most of the empirical literature focuses on older adults with trauma occurring earlier in life (eg, combat, sexual assault). Attention must also be paid to older adults who are currently experiencing trauma. At least 11% of community-residing older adults in the United States have experienced some form of mistreatment—emotional, physical, sexual, financial, and neglectful events—in the past year.

 Older adults who are experiencing current polyvictimization are also in need of identification, assessment, and intervention. Methods to promote help-seeking and healing in survivors of elder abuse are available and should be integrated across a range of health care and law enforcement systems.

Trauma-related psychiatric disorders such as PTSD and grief often go undetected and untreated in older adults. There are evidence-based psychotherapies and pharmacotherapies that could provide great benefit in symptom reduction and increased life functioning, although augmentation or modification may be necessary for older adults. In order to assist older survivors in receiving timely and appropriate mental health treatment, targeted outreach, psychoeducation, and assessment in health care settings is warranted.

is a professor of psychiatry, Yale School of Medicine, New Haven, CT.

is the John and Myrna Daniels Professor of Psychiatry in Honor of Dr Herbert Pardes, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, and co-director, Research Area on Brain Aging and Mental Health, New York State Psychiatric Institute, New York, NY.

is the executive director, Trauma and Resilience Center, vice chair for Veterans Affairs, and professor in the Louis Faillace Department of Psychiatry at McGovern Medical School, University of Texas Health Science Center at Houston.

The authors report no conflicts of interest concerning the subject matter of this article

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Trauma-related psychiatric disorders such as PTSD and grief often go undetected and untreated in older adults. Here's how to help. 

PTSD in Late Life: An Update on Clinical Issues 

 was characterized as a pandemic, it was clear that older adults in general, and those with 

 (ADRD) in particular, would be severely impacted both directly by the virus and indirectly by the social consequences and responses.

 Now, approaching 2 years since SARS-CoV-2 emerged, we are starting to measure the impact of COVID-19 on older patients with cognitive impairment and ADRD. Further, we can begin to review neurobiological issues associated with COVID-19 in older adults, and consider how COVID-19 may contribute to cognitive impairment and future cases of dementia.

The demographics of COVID-19 cases have shifted over time, with older adults being most impacted early in the pandemic, and later waves involving younger individuals.

 Similarly, risk varied by setting, with an early wave of COVID-19 cases in congregate settings including nursing homes, retirement homes, and hospitals. These frequent and widespread outbreaks were associated with significant morbidity and mortality. Despite campaigns to vaccinate nursing home residents, they still account for a large proportion of the total deaths due to COVID-19.

The severity of COVID-19 spans the spectrum from asymptomatic carrier state to severe illness and death, with age being the strongest demographic risk factor for a more severe illness: Age has an exponential relationship with infection fatality rate, reaching 15% at age 85.

 Older adults with cognitive impairment are doubly at risk, with age and cognitive impairment independently contributing to illness severity.

 Cognitive impairment has been associated with double the risk of COVID-19 mortality in nursing homes.

 Even when controlling for residence in a nursing home, those with dementia had twice the risk of acquiring COVID-19.

We had anticipated that rates of behavioral and psychologic symptoms associated with dementia (BPSD) would increase as a result of indirect factors such as disruption to care, social isolation, and disruption to routine.

 Unfortunately, this has been borne out, with studies reporting increases in BPSD including anxiety, depression, insomnia, wandering, and agitation.

Alongside the risk of mortality, the pandemic is also affecting mental health negatively, both via the direct effect of the virus and indirectly via the massive disruption to society in response to the pandemic. Early and ongoing mental health consequences of the pandemic include increased rates of symptoms of depression, anxiety, substance use, and suicidal ideation. However, paradoxically, younger individuals may be more impacted than older ones.

 Similarly, while the pandemic may have increased BPSD in some individuals with dementia, this has not been universally true. For example, in New Brunswick, Canada, despite a marked reduction in family visits and periods of lockdown (mitigated by virtual visits and volunteer services), there was no change in rates of agitation, and a reduction in rates of depression among nursing home residents, with more than half of them having dementia.

The availability of safe and effective COVID-19 vaccines is thought to be a key element to ending the pandemic. Early on, in the context of limited supply, governments prioritized vaccination for high-risk groups such as the elderly and those living in long-term care (LTC) facilities. Thus, most individuals with dementia were prioritized for vaccination. For example, in Ontario, Canada, despite only 0.5% of the population living in LTC facilities, vaccination initially was reserved for LTC residents and health professionals when vaccines first became available in December 2019.

 By March 2020, more than 92% of LTC residents had received at least 1 dose of a COVID-19 vaccine, which was estimated to have reduced mortality by 96%.

 The recent approval by the US Food and Drug Administration of booster shots for older persons (ie, a third dose) may offer them further protection and also deepen current inequities when vaccination remains unavailable due to supply constraints in some jurisdictions.

COVID-19 is transmitted person to person via inhalation of respiratory droplets and their deposition on mucous membranes, and to a lesser extent by contaminated hands contacting mucous membranes.

 The virus enters cells via the angiotensin-converting enzyme 2 receptor, present not only in the respiratory and gastrointestinal tract but also in other organs, including the brain and blood vessels.

 Thus, COVID-19 can potentially lead to neuropathology via systemic and inflammatory indirect effects and by its direct action on the nervous system.

Although most cases of COVID-19 are classified as mild, severe cases occur in individuals of all ages, most commonly in older adults. Common acute symptoms include cough, fever, fatigue, headache, myalgias, and diarrhea.

 Symptoms can progress and involve hypoxemia and acute respiratory distress syndrome.

 In addition, injury to all organ systems due to severe inflammation, thromboembolic events, and neurologic complications can occur.

The neurologic consequences of severe COVID-19 are common and involve both the central nervous system (CNS) and peripheral nervous system (PNS) (

 Dizziness and headache are the most common CNS manifestations, which can also include cerebrovascular disease (eg, ischemic stroke, hemorrhage), ataxia, and seizure. Delirium is a common presentation of older adults with COVID-19; it has a very poor prognosis and is associated with permanent cognitive impairment.

 Anosmia and ageusia are the most common PNS manifestations.

Neurologic manifestations can occur within the first days of illness and persist months after hospital discharge.

 Isolating the virus in cerebrospinal fluid is rare.

 Cognitive impairment is a commonly reported symptom in survivors of severe COVID-19 at 60 days post discharge.

 Although research is needed to confirm the neuropsychiatric sequelae of COVID-19, a broad spectrum of neuropsychiatric symptoms have been reported, including headaches, sleep disorders, encephalopathy, myalgia, and ageusia.

 The term long COVID refers to the persistence of symptoms after the resolution of the acute infection, and a broad range of symptoms have been reported, including neuropsychiatric symptoms such as cognitive impairment, insomnia, impaired concentration, posttraumatic symptoms, and headache.

 Long COVID is not always associated with the severity of acute COVID-19 or risk factors for severe COVID-19, and it may involve multiple organ damage by other direct mechanisms.

 Long COVID is thought to be relatively common, but estimates of its prevalence vary widely depending on definition and time since infection. It may also depend on the SARS-CoV-2 genetic variant.

There is evidence for both structural and functional brain changes following COVID-19, and these changes may be associated with the neurologic symptoms of long COVID. Various studies have reported heterogenous findings. A recent systematic review summarizing the neuroimaging findings associated with COVID-19 in older adults reported widespread neuropathological issues typically associated with cerebrovascular damage, most consistently in white matter, brainstem, and frontotemporal cortical areas.

 A case-control study of patients who recovered from COVID-19 found hypometabolism in frontotemporal regions, which was associated with neurological symptoms.

 A study of United Kingdom Biobank participants by Douaud et al found changes in 394 individuals who had brain imaging before and after a COVID-19 infection, compared with 388 matched controls without a history of COVID-19. Among those who had survived COVID-19, Douaud et al identified reductions in grey matter in the left parahippocampal gyrus, left lateral orbitofrontal cortex, and left insula.

Although it is staggering that approximately 1 in 500 Americans has died of COVID-19, mortality is the tip of the iceberg. The Centers for Disease Control and Prevention estimates that as of May 29, 2021, there had been more than 100 million individuals with symptomatic COVID-19 in the United States, 10 million of them 65 years or older.

 The sequelae from severe COVID-19 are risk factors for dementia, and they may increase the growing number of individuals living with dementia. Understanding the specific contribution of a past COVID-19 infection on future risks of dementia will require longitudinal studies. These risks may be substantial given the cerebrovascular changes associated with past infection. During the next few years, post-COVID-19 issues may occur mostly in older adults. However, COVID-19 may also increase the risk of future cognitive impairment and dementia in younger individuals, because early life experiences and exposures contribute to the risk of dementia, as is the case in other risk factors for dementia such as low level of education or depression early in life. The magnitude of the current and future human, financial, and societal cost of COVID-19 is unknown, but certainly worrisome.

On the other hand, we expect that the pandemic will lead to numerous changes that benefit older adults. Specifically, the spotlight on nursing homes has revealed systemic flaws and inequities in many countries that now will be hard to ignore. The pivot to virtual care has spurred some innovation that may facilitate access to care going forward.

In our own experience, working at the Centre for Addiction in Mental Health in Toronto, we have had to pivot to providing care to older individuals despite multiple waves of COVID-19 cases in the community. Some of the changes in our practice and our environment will have long-lasting benefits. The heterogeneity of real-world experience, compared with averages often reported in research, is humbling. Some of our older patients have shown remarkable resilience through the pandemic and have adjusted their lifestyle to thrive during this time. Others have had their usual coping mechanisms totally disrupted and are suffering, needing additional mental health and social resources. In our geriatric mental health inpatient unit, technology (eg, internet-connected tablets) has been helpful to connect patients to family, activities, and entertainment. We have also noticed an improved access to specialist consultations with virtual care and additional physician-to-physician consultation options. In our outpatient setting, virtual care options introduced to reduce risk of COVID-19 have also reduced barriers for certain patients who prefer it or may have mobility issues.

The impact of the pandemic on older adults and those with dementia has been immense. Vaccination can dramatically reduce severe outcomes from COVID-19 in older adults. The indirect impact of the pandemic on individuals with dementia, such as isolation and disruption of care, can be pronounced, but they can also be mitigated. COVID-19 causes neurological damage that is not restricted to severe cases or older adults. A significant proportion of individuals infected by COVID-19 will experience long-term negative impact, including an increased risk of dementia. Research to better understand the neurobiology and the long-term neuropsychiatric impacts of COVID-19 is critical, as it will shift the understanding of the risk-benefit of population-level interventions to prevent COVID-19. The pandemic is not over. Efforts to protect everyone, including older adults, from COVID-19 are essential.

 is an assistant professor of psychiatry at the University of Toronto and a clinician scientist at the Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, in Toronto, Canada. 

 is an associate professor of psychiatry at the University of Toronto and chief of geriatric psychiatry at the Centre for Addiction and Mental Health. 

 is the Labatt Family Chair of the Department of Psychiatry in the Faculty of Medicine at the University of Toronto and a clinician scientist in the Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health.

Anticipating and mitigating the impact of the COVID-19 pandemic on Alzheimer’s disease and related dementias

2. Boehmer TK, DeVies J, Caruso E, et al. 

Changing age distribution of the COVID-19 pandemic – United States, May-August 2020

3. Panagiotou OA, Kosar CM, White EM, et al. 

Risk factors associated with all-cause 30-day mortality in nursing home residents with COVID-19

Nursing home care in crisis in the wake of COVID-19

5. Levin AT, Hanage WP, Owusu-Boaitey N, et al. 

Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications

6. Tahira AC, Verjovski-Almeida S, Ferreira ST. 

Dementia is an age-independent risk factor for severity and death in COVID-19 inpatients

COVID-19 and dementia: analyses of risk, disparity, and outcomes from electronic health records in the US

Effectively caring for individuals with behavioral and psychological symptoms of dementia during the COVID-19 pandemic

9. Dellazizzo L, Léveillé N, Landry C, Dumais A. 

Systematic review on the mental health and treatment impacts of COVID-19 on neurocognitive disorders

10. Czeisler MÉ, Lane RI, Wiley JF, et al. 

Follow-up survey of US adult reports of mental health, substance use, and suicidal ideation during the COVID-19 pandemic, September 2020

11. McArthur C, Saari M, Heckman GA, et al. 

Evaluating the effect of COVID-19 pandemic lockdown on long-term care residents’ mental health: a data-driven approach in New Brunswick

12. Brown KA, Stall NM, Vanniyasingam T, et al. Early impact of Ontario’s COVID-19 vaccine rollout on long-term care home residents and health care workers. Science Table: COVID-19 Advisory for Ontario. March 8, 2021. Accessed October 5, 2021. 

https://covid19-sciencetable.ca/wp-content/uploads/2021/03/Science-Brief_LTC-and-Vaccine_20210308_version-1.1_published-1.pdf

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Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. a first step in understanding SARS pathogenesis

Long Covid – mechanisms, risk factors, and management

Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China

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The impact of delirium on outcomes for older adults hospitalised with COVID-19

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Sixty-day outcomes among patients hospitalized with COVID-19

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Heterogeneity in regional damage detected by neuroimaging and neuropathological studies in older adults with COVID-19: a cognitive-neuroscience systematic review to inform the long-term impact of the virus on neurocognitive trajectories

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F-FDG brain PET hypometabolism in patients with long COVID

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How does COVID-19 contribute to cognitive impairment in older adults and future cases of dementia?

COVID-19, Cognition, and Dementias: What Role Has the Pandemic Played?

From a psychiatric perspective, the older population is inherently isolated under normal circumstances. Many seniors live alone and in locations with limited social contacts and support networks, and rely on their local YMCA, church, or neighbors for socialization. When the COVID-19 pandemic hit, however, nearly all of those opportunities were eliminated. The pandemic has resulted in complete and utter isolation for many older adults, which can contribute to long-term mental illness, anxiety, and depression, and overwhelming feelings of 

Though the impacts of the COVID-19 pandemic were enormously significant for all, none were more affected than those in long-term care facilities. For these residents, the behavioral health challenges presented by the COVID-19 pandemic have been even greater because the population is more inherently isolated and immobile. Even prior to the COVID-19 pandemic, between 22% and 42% of residents in long-term care facilities experienced loneliness, and 1 study showed that more than half of US nursing home residents without cognitive impairment reported feeling lonely.

 During the pandemic, long-term care residents were essentially “frozen” within their facilities, with no physical contact or meaningful interaction with families and friends.

Since the COVID-19 pandemic was declared a national emergency in the US in March 2020, increases in 

 and the negative effect of older patients with substance use disorders (SUDs) has also become a more serious public concern.

 Emerging evidence suggests that the pandemic has unfortunately exacerbated substance use and mental health symptoms in the most vulnerable populations—including older adults, as studies show that the mental and psychological problems of patients with SUDs might relapse or be exacerbated by social isolation and lockdown during a pandemic.

According to data from the Centers for Disease Control and Prevention (CDC), deaths from synthetic opioids increased by 52% between August 2019 and August 2020, and synthetic opioids were found in the bloodstream of 62% of overdose victims in 2020—compared with 41% in 2017.

Increased social isolation, government shutdowns, job losses, and furloughs have also contributed to an increase in fatal 

, which were already marching upwards before the pandemic. According to data from the Centers for Disease Control and Prevention (CDC), deaths from synthetic opioids increased by 52% between August 2019 and August 2020

, and synthetic opioids were found in the bloodstream of 62% of overdose victims in 2020—compared with 41% in 2017.

 Substance abuse within the older population has justifiably become a worldwide concern during the COVID-19 pandemic, and clinicians face the daunting challenge of treating and preventing relapses amongst the US older population.

Though caring for patients in a fully remote capacity certainly presents unique challenges, the COVID-19 pandemic has taught both clinicians and patients that behavioral telemedicine is an effective alternative to face-to-face interactions. Amongst long-term care residents, we have seen the rise of 

 generally, and behavioral medicine specifically, for several reasons.

: Throughout the pandemic, long-term care facilities have put in place restrictive policies that prevent families and friends—as well as physicians—from visiting patients onsite. These safeguards have also prohibited patients from visiting labs for testing related to addiction or treatment. As the delta variant continues to spread amidst the upcoming cold and flu season, I expect several facilities to reenter or continue their lockdown protocols.

Long-term care facilities have faced critical staffing shortages throughout the pandemic, and we have witnessed an exodus of clinicians across specialties. While many psychiatrists have retired—more than 60% of practicing psychiatrists are over the age of 55, one of the highest proportions among all specialties

, and the rest may not have been equipped to adequately leverage telemedicine to meet patients’ needs.

There is also a notable lack of physicians practicing in the geriatric space: Only 3% of licensed psychologists identify professional geropsychology as their primary or secondary specialty.

 allows providers broader access to these scarce resources. Though general clinicians can certainly care for older patients, for many, it is not their specialty or focus, and to become a geropsychologist requires additional training. This provider shortage has arisen at an unfortunate time, as there are now more people requiring psychiatric care than ever before. Due to the pandemic, Americans’ assessment of their own mental health is “worse than it has been at any point in the last 2 decades.”

For decades, payors did not reimburse for telemedicine, and certainly not for behavioral telemedicine services. Those health plans that did reimburse typically did not do so at sustainable rates. Further, the Centers for Medicare & Medicaid Services (CMS) also introduced telehealth flexibilities, and doctors are calling for a permanent solution and more flexibility for mental health telehealth services.

 Though the pandemic has challenged the status quo, the long-term future of payor and CMS reimbursement for telemedicine remains to be seen.

 has waned slightly since the peak of the COVID-19 pandemic, clinicians are maintaining a hybrid model—and from an industry perspective, I expect a long-term benefit of the pandemic is that psychiatrists now understand how to use telemedicine and have taken advantage of it when they otherwise would not have.

The Application of Telemedicine for Addiction Treatment

Telemedicine is a reasonably new phenomenon within the addiction space; unfortunately, challenges related to regulations and reimbursement have stagnated telemedicine adoption for years. 

 is unique from other treatment scenarios; addiction patients typically require drug screens in a timely, reliable, reproducible, and trustworthy manner. As psychiatrists, we cannot provide medications safely for addictions without this initial drug screening in nearly all settings. Traditionally, a urine drug screen was performed in the office at the time of prescribing. The regulations requiring this have not changed, and efforts are being made to streamline this process for treatment via telemedicine. Processes such as overnighting swabs for new patients and partnering with local and regional labs are all necessary to safely treat patients in a timely manner.

It is widely known that patients seeking treatment for substance abuse have a 48- to 72-hour window to enter treatment before they may relapse, but efforts to capture the needed information within those 48 to 72 hours to include drug screening has been challenging. Treating patients for substance abuse and dependency without drug screening is neither safe nor the standard of care.

Though the COVID-19 pandemic has undoubtedly presented challenges for addiction treatment, a silver lining has been the rise of telemedicine.

First, the COVID-19 pandemic served as an impetus for the invention of oral swabs, which can be used via camera and validated in that way.

Historically, there have been several laws, including the Ryan Haight Act, that prevented the prescription of controlled substances via telemedicine. For example, despite 

 being used to treat addiction, it is classified as a controlled substance and so was initially impacted by state restrictions. During the pandemic, however, the federal government declared a public health emergency and several states passed laws allowing for addiction treatment via telemedicine. Under the emergency designation, practitioners approved to prescribe certain controlled substances, such as buprenorphine, are no longer prohibited from doing so without first conducting an examination of the patient in person.

Effectiveness of Telemedicine in Addiction Treatment

For patients requiring addiction treatment—including older adults living in long-term care facilities—telemedicine presents several benefits.

Isolated older adults may be especially vulnerable to addiction issues with the onset of the pandemic. Here’s how telemedicine can help. 

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PTSD in Late Life: An Update on Clinical Issues

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