This review is devoted to alcoholism but also to other substance-dependences (tobacco, medication, illicit drugs) and behavioral addictions (gambling) in the aged. Compared to younger subjects, addictions in older people are marked by the high frequency of somatic comorbidities, physiological changes related to age, increased severity due to atypical presentations. Moreover, usual screening tests and diagnostic questionnaires are often not suited for the aged. Psychopathology of addictions in the aged points out vulnerabilities not resolved with the advance in age, in connection with separation, narcissism, oral regression, alexithymia and other pathological dimensions of personality. The weight of the environment, dominated by a certain agism, remains a brake to the global care that must be based, as in younger adults, on motivational approach and specific treatments with special pharmacological vigilance.