Currently Australia has a well developed aged care service system. Comprehensive 'mainstream' aged care services are generally effective in delivering appropriate levels of care and support to the majority of the aged population. Despite the richness of services available, there are still groups of people in the community who are not gaining access to these services or not utilising the full potential of these services to meet their needs. There are also some people for whom the services available lack the specialised skills or resources required to adequately address their needs. Relatively little is known about the incidence of alcoholism and substance misuse in older people, including misuse of over-the-counter medication. Although there is a general perception that this kind of abuse is uncommon in older generations, it is more likely that the incidence is hidden. While it has been well documented that alcohol use and misuse generally declines with age, the use of prescription and over-the-counter drugs increases in later life. The frequency and effects of substance abuse, particularly of illicit drugs among older people has not been thoroughly investigated. Changes in attitude in subsequent generations mean that alcohol consumption amongst older people, and possibly use of illicit drugs, is likely to increase as these groups age. We have already begun to see evidence of this change with survivors of heavy drug use from the 'flower' generation (the 1960s and 1970s) beginning to enter aged care services and presenting with a number of drug related ailments.