Literature on elderly women and substance abuse is sparse. What data exist support the following conclusions: (1) older women are at risk for self-medicating with prescription drugs and alcohol and have more risk for drug-drug and drug-alcohol interactions, (2) women are more likely to be prescribed psychotropics, (3) older women are at greater risk for prescription drug abuse by a physician or physicians than other age groups, (4) alcohol and drug abuse are likely to increase as younger women drinkers and drug users age, and this younger cohort will use more illicit drugs, and (5) the incidence of substance abuse remains underreported and underdiagnosed.