With the "Baby Boom" cohort reaching the age of 65 years, the older adult population is growing and will continue to grow at a rapid rate. There is a substantial and growing number of older adults who misuse alcohol, psychoactive prescription drugs, and/or other substances. The emerging literature on the cohort of aging adults indicates that they are continuing to use alcohol and psychoactive prescription medications at a higher rate than previous generations. The development and refinement of techniques to address these problems and provide early intervention services is going to be crucial to meeting the needs of this growing population. This chapter provides background on the extent of the problem, guidelines for alcohol and psychoactive medication use, and methods for screening and providing early interventions to improve the lives of older adults who misuse alcohol and/or psychoactive medications and drugs.