A case of late‐onset dependence on cocaine and crack

Kouimtsidis, Christos; Padhi, Ashwini

doi:10.1111/j.1360-0443.2007.01757.x

Cited by 4 publications

(3 citation statements)

References 4 publications

(4 reference statements)

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“…In 2014, an estimated 372 000 people in the United States over 50 had used cocaine or ‘crack’ in the past month, a number that increased to 562 000 in 2015 (SAMSHA ). These data are supported by case reports, with older cocaine users presenting in drug treatment (Kouimtsidis & Padhi ), emergency (Yarnell ) and urgent care (Yarnell ) settings. Presentation in generalist medical settings underlines the greater likelihood of adverse health implications of cocaine use in aging relative to younger users.…”

Section: Introductionsupporting

confidence: 62%

Social motivational processing and interpersonal function in aging cocaine smokers

et al. 2018

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Illicit drug use among aging cohorts is increasing, yet little is known about functional impairments in older drug users. Given the importance of social integration for aging and documented social decrements in cocaine users, we examined social function and its neurocognitive substrates in aging cocaine users relative to carefully matched non-cocaine users. Regular (≥twice/week), long-term (≥15 years) cocaine smokers 50-60 years old (COCs; n = 22; four women) and controls (CTRLs; n = 19; four women) underwent standardized probes of social reward and threat processing during functional magnetic resonance imaging and a behavioral facial affect recognition task. Self-report and peer-report of daily interpersonal function were also collected. COCs, and CTRLs reporting current marijuana or alcohol use, were tested after four drug-free inpatient days. COCs had pronounced problems in daily social function relative to CTRLs indicated by both their own and their peers' reports. Compared with CTRLs, COCs had stronger amygdala responses to social threat versus control stimuli, with no other differences in social processing or cognition. Aging cocaine users appear to have marked, generalized difficulties in 'real-world' interpersonal function but largely intact social processing on laboratory-based measures when compared with appropriately matched controls and tested under well-controlled conditions. Daily social difficulties may be related to transient factors such as acute/residual drug effects or cocainerelated changes in health behaviors (e.g. disrupted sleep and poor diet). These data suggest that interpersonal function may be a valid intervention target for aging cocaine users and warrants further study in older drug users.

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Section: Introductionsupporting

confidence: 62%

Social motivational processing and interpersonal function in aging cocaine smokers

et al. 2018

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“…Some previous studies (Cumella & Kally, ,b; Krug et al, ) have also shown that these impulsive behaviours are more common among TAO patients than LAO eating disorder patients. Furthermore, psychoactive substance use disorders and impulsivity seem to decline substantially with age (Dom, D'Haene, Hulstijn, & Sabbe, ; Kouimtsidis & Padhi, ).…”

Section: Discussionmentioning

confidence: 99%

Late Onset Eating Disorders in Spain: Clinical Characteristics and Therapeutic Implications

et al. 2013

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“…The demand on health and social care of people aged 65+ years needing support for problematic substance use is well documented [6,11,12]. For example, problematic use of alcohol and other drugs (AoD) including polypharmacy (over-the-counter and prescribed medication) is associated with increased use of emergency services and hospital admission [7,[13][14][15]. Older people with co-occurring conditions have been shown to experience delayed transfers after hospital admissions, premature transfer to long-term care and present more frequently with adult abuse [16][17][18].…”

Section: Problematic Substance Use In Later Lifementioning

confidence: 99%

Community Based Interventions for Problematic Substance Use in Later Life: A Systematic Review of Evaluated Studies and Their Outcomes

Hafford‐Letchfield

McQuarrie

Clancy

et al. 2020

IJERPH

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Problematic substance use (PSU) in later life is a growing global problem of significant concern in tandem with a rapidly ageing global population. Prevention and interventions specifically designed for older people are not common, and those designed for mixed-age groups may fail to address the unique and sometimes complex needs of ageing communities. We report findings from a systematic review of the empirical evidence from studies which formally evaluated interventions used with older people and reported their outcomes. Nineteen studies were included, of which thirteen focused solely on alcohol-related problems. Eight interventions utilised different types of screening, brief advice and education. The remaining drew on behavioural, narrative and integrated or multi-disciplinary approaches, which aimed to meet older people’s needs holistically. Quality assessment of study design helped to review evaluation practice. Findings point to recommendations for sustainable and well-designed intervention strategies for PSU in later life, which purposefully align with other areas of health and well-being and are delivered in locations where older people normally seek, or receive, help. There is further scope for engagement with older people’s own perspectives on their needs and help-seeking behaviours. Economic evaluation of the outcome of interventions would also be useful to establish the value of investing in targeted services to this underserved population.

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A case of late‐onset dependence on cocaine and crack

Abstract: Although dependence on cocaine among the elderly is considered very rare, clinical management can be challenging and is likely to require the involvement of several specialist and general health services.

Cited by 4 publications

References 4 publications

Social motivational processing and interpersonal function in aging cocaine smokers

Social motivational processing and interpersonal function in aging cocaine smokers

Late Onset Eating Disorders in Spain: Clinical Characteristics and Therapeutic Implications

Community Based Interventions for Problematic Substance Use in Later Life: A Systematic Review of Evaluated Studies and Their Outcomes

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