This paper reviews the literature and presents some new data on alcohol and drug problems in older individuals. Drug abusers include users of opiates (5% of opiate addicts are over age 45), inadvertent drug misusers (over or under use of prescription medications), and deliberate abusers of nonopiates (especially anti-anxiety drugs, hypnotics, analgesics, laxatives, and bromides). Two to 10% of the elderly are alcoholic, and these are usually individuals beginning alcohol abuse after age 40. The importance of these findings regarding treatment and etiology are discussed.