Tipping points surrounding motivation to change substance use patterns among seniors in the general population or with incarceration experience: are they all the same?

Background: Substance use can have different meanings among seniors depending on the perceptions and can explain their motivations related to their choice to continue or change. While incarceration can influence motivations, it remains important to examine potential differences between seniors subgroups, such as older offenders and seniors from the general population. This presentation aims to compare the perceptions of two different subgroups of seniors.

Method: This thematic comparison analysis was performed from two qualitative studies on seniors who had problematic substances use. The first study aims to examine the addiction trajectories of eleven seniors who sought help from a public addiction center. The second aims to examine the perceived influence of substance use on the transition process from 22 older offenders. In both studies, the main themes explored the perceptions and the role of substance use in the seniors' life course.

Results: Many reasons regarding the decision to change using are mainly associated with consciousness rising in both groups. This increased awareness is accompanied by a fear of the physical consequences of substance use. While there is a consciousness of improving their health, older offenders also specify a willingness to put aside their criminality. According to participants, a therapeutic alliance between the participant and the counselor is of particular importance in following the progress of both groups.

Conclusion: Similarly, to seniors who receive services for their addiction, older offenders become aware of their consumption and the consequences it could have on their lives. The results support the importance of taking advantage of 'teachable moments'. These are unpredictable moments during which counselors should seize the window of opportunity to encourage change in substance use behavior among seniors.