Originating in the 1960's, ageism is a term that refers to the negative stereotypes society places on older adults that justify their problems as ramifications of their old age, instead of as actual medical, social, or psychological problems. An example of this is the tendency for older adults to be categorized as senile, when instead the adult actually has some type of treatable comorbid condition.

These stereotypes are internalized by older adults very often, and many times the adult will not ask for mental health and substance use treatment. Ageism has negative effects in that it causes health care providers to simply attribute old age to symptoms instead of looking deeper for the real problem. Older adults are frequently misdiagnosed because of this. Another reason older adults are misdiagnosed is because their health care providers will mistakenly think that even if the older adult is treated for substance use issues, then his/or her quality of life will still be low.

This low level of expectation is called "therapeutic nihilism". Another reason older adults are not treated is because of the lack of awareness of the people around them. Society has placed a stigma on substance use in the older generation because of religion, gender, or culture. Thus, many older adults deny a problem with substance use to avoid this stigma.