The inadequate and abusive usage of psychoactive substances is something real that affects Brazil’s elderly population, and it is a huge challenge for the public health system and its professionals. Aware of the social impact involving the use of illegal drugs, in 2002, the Ministry of Health instituted a network of psychosocial assistance as a strategy to deal with the problem. This study carried out an analysis of the profile of use of legal and illegal drugs by the elderly who are assisted by the network of psychosocial assistance in the Federal District. A quantitative and analytical study with secondary data collection, using patient records held in the CAPS-AD in the Federal District. The inclusion criteria were people of 60 and over who were users of alcohol and other drugs and who sought assistance at CAPS-AD between 2000 and 2017. A total of 408 medical records were analyzed concerning social demographic variations, types of rehabilitation services sought, types of substances consumed, associations between drugs consumed, time of consumption, and adherence to the treatment. Most of the elderly users were male (85.3%), on average 64 ± 4.42 years old. Regarding the drugs consumed, the highest quantity was for illegal substances (76%), compared to the legal ones (23%). No significant difference was found between males (OR = 1.1) and females (OR = 0.74) regarding the use or abuse of multiple drugs. The elderly used both legal and illegal drugs for a long period of time, with low adherence to the treatment, and alcohol consumption among the elderly prevailed above the other psychoactive substances.