Illicit Drug Use in Older Adults

Ghantous, Ziad; Ahmad, Victoria; Khoury, Rita

doi:10.1016/j.cger.2021.07.002

Cited by 11 publications

(6 citation statements)

References 73 publications

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“…Likewise, studies conducted in Yemen found that older women were more likely to use khat than younger ones ( 81 ). This finding might be justified by the fact that older women are vulnerable to psychiatric symptoms such as stress, anxiety, depression, loneliness, grief, and social isolation ( 82 ). Women may take khat as a copying strategy to reduce stress.…”

Section: Discussionmentioning

confidence: 99%

Individual and community-level factors associated with khat (Catha edulis) use among women of reproductive age in Halaba zone, South Ethiopia: a multilevel mixed effect analysis

Wogayehu,

Demissie,

Wolka

et al. 2024

Front. Psychiatry

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IntroductionThere is a paucity of data on factors associated with khat chewing among women of reproductive age using multilevel analysis. Furthermore, the effects of some potential factors like stressful life events, knowledge about and attitude toward the effects of khat have been given little attention and are not well understood. Therefore, this study aimed to examine the prevalence and multilevel factors associated with khat use among women of reproductive age in Halaba zone, South Ethiopia.MethodsA community-based cross sectional study was conducted in Halaba zone from February to July, 2023. Systematic random sampling technique was used to include 1573 study participants. The dependent variable was current khat use, which is operationalized as using khat within 30 days preceding the study. An interviewer administered questionnaire was used for the data collection.ResultsThe prevalence of current khat use among women of reproductive age was 65.9% [95%CI (63.5-68.2%)]. Factors significantly associated with khat use were; ages of women 35 and above years [Adjusted Odds Ratio (AOR) = 6.35, 95% CI: (3.62, 11.13)], ever married [AOR = 2.41, 95% CI: (1.10, 5.31)], secondary and above education [AOR = 0.28, 95% CI: (0.15, 0.49)], belong to richer household [AOR = 1.75, 95% CI: (1.12, 2.75)], mass media use [AOR = 3.12, 95% CI: (1.85, 4.81)], low knowledge about khat effects [AOR = 3.12, 95% CI: (1.85, 5.24)], positive attitude towards khat use [AOR = 11.55, 95% CI: (6.76, 19.71)], and strong social support [AOR = 0.43, 95% CI: (0.28, 0.64)] and non-user friend [AOR = 0.31, 95% CI: (0.20, 0.48)]. From the community level variables: rural residence [AOR = 5.06, 95% CI: (1.82, 14.09)] was significantly associated with khat use.ConclusionKhat use among women of reproductive age was found to be very high. From individual-level factors: advanced ages of women, secondary and above education, live in the richer wealth quintile, mass media exposure, low knowledge on khat effects, positive attitude towards khat use, strong social support, and from community-level variables: residing in rural area were significantly associated with khat use. Khat use screening for all women of childbearing age, as well as referral to substance use disorder centers for those women identified as having khat use disorder, should become a standard of care in all health facilities.

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Section: Discussionmentioning

confidence: 99%

Individual and community-level factors associated with khat (Catha edulis) use among women of reproductive age in Halaba zone, South Ethiopia: a multilevel mixed effect analysis

Wogayehu,

Demissie,

Wolka

et al. 2024

Front. Psychiatry

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“…When elderly people present with complications of cocaine use that may have resulted from vasospasms due to cocaine use, these symptoms are usually attributed to some other known baseline disease that they already have been diagnosed with such as cardiovascular and neurologic disorders. 16 Memory can be severely impaired in patients using cocaine, and if these patients are elderly adults-especially adults who have been diagnosed with dementia-the symptoms may immediately be attributed to their baseline clinical condition. 52 These challenges with the diagnosis of cocaine in the elderly are attributable to inadequate research as well as the assumption that any presenting symptoms are due to pre-existing medical conditions (particularly in the hospital setting, where providers are less likely to be familiar with an individual's behavioral habits than a primary care provider), relatively short healthcare provider visits that do not allow enough time for deeper exploration of the patient's problems, low index of suspicion by the clinician, and the fact that denial is not uncommon by both the elderly and their caretakers.…”

Section: Challenges Faced With Diagnosis and Treatment Of Cocaine Use...mentioning

confidence: 99%

“…8,12,13 Despite these trends, multiple studies have found that SUD in the elderly is underidentified, under-diagnosed, and under-treated, possibly due to low clinical suspicion and denial of substance use by the elderly and their care takers, in addition to misconceptions among healthcare providers. 12,[14][15][16][17][18][19][20][21] While most existing literature on SUD in the elderly has focused on alcohol, opioids, and prescription drugs, the number of users of stimulant drugs like cocaine and methamphetamine is also growing. 2,3 There is evidence that use among this population is significant-the US Substance Abuse and Mental Health Services Administration estimates that each day, 4300 individuals age ≥65 years use cocaine.…”

Section: Introductionmentioning

confidence: 99%

Use, Effects, and Diagnostic Challenges of Cocaine Use in “Baby Boomers” and Older Adults

Akwe,

Moussa,

Hall

2023

Journal of Brown Hospital Medicine

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Introduction: Substance use disorder (SUD) is frequently recognized in the literature as an epidemic in the United States, but less attention has been paid to the scale of the epidemic among people older than 60 years of age. As the cohort of individuals in this age group grows as a proportion of the population—the so-called aging of the population—the incidence of SUD in older adults will increase numerically as well. While most existing literature on SUD in the elderly has focused on alcohol, opioids, and prescription drugs, the number of users of stimulant drugs like cocaine and methamphetamine is also growing. We review literature on the use, effects, and diagnostic challenges of cocaine in adults in the so-called “Baby Boomer generation” (ages 59-77 in 2023), particularly those ≥65 years. Methods: We performed a literature review of PubMed and Web of Science databases, supplemented by Google Scholar using combinations of “cocaine,” “elderly,” and “older adults.” We searched the reference sections of particularly salient articles and utilized PubMed’s and Google Scholars’ “Cited By” and “Similar Articles” functions to find additional materials to include. We produced an annotated bibliography containing title and author information for each paper along with its abstract to select the papers to include; each author reviewed this bibliography to determine if articles were relevant, and if so, in which section(s) the material should be included. A total of 66 references have been included in this review. Results: Both lifetime and current cocaine use appear to be more prevalent among members of the “Baby Boomer generation” than older cohorts. Though there has been limited research to inform clinical care for older adults who use cocaine, negative physical and psychosocial impacts have been noted in the literature. Cocaine use disorder may negatively affect the elderly more than younger users because of the increased vulnerability of their aging bodies to the physiological and cognitive effects of cocaine. Underdiagnosis of cocaine use in the elderly may be attributable to the assumption that any presenting symptoms are due to pre-existing medical conditions or that older adults are less likely to consume cocaine. Conclusions: There is little information currently in the literature to help clinicians understand patterns and epidemiology of cocaine use, its effects on older adults and their common presentations after experiencing adverse events, and challenges of diagnosing and treating cocaine use in older adults. Additional research is needed to describe use and effects of cocaine on the elderly, particularly on age-related comorbid conditions and interactions with medications.

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“…There are no known pharmacokinetic studies of buprenorphine/naloxone in older adults with opioid use disorder. Current evidence suggests using buprenorphine and methadone (Ghantous et al , 2022). A recent systematic review noted that older adults with opioid use disorder may be presenting for treatment for their first time at 50–70 years of age.…”

Section: Approach To Substance Use Disorders In Older Adults With Neu...mentioning

confidence: 99%

“…When pain management is needed, lower doses of opioids are recommended, and adequate pain control can be achieved via a combination of non-pharmacological and pharmacological interventions. Comorbid depression, anxiety and sleep disturbances should be adequately managed to avoid relapsing into substance use to cope or self-medicate (Ghantous et al , 2022).…”

Section: Approach To Substance Use Disorders In Older Adults With Neu...mentioning

confidence: 99%

Neurocognitive and substance use disorders in older adults: challenges and evidence

Agrawal

Sawaya

Ojeahere

et al. 2022

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Purpose This study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable population. Design/methodology/approach Electronic data searches of PubMed, Medline and the Cochrane Library (years 2000–2021) were performed using the keywords “neurocognitive,” “dementia,” “substance use,” “addiction,” “older adults” and “elderly.” The authors, in consensus, selected pivotal studies and conducted a narrative synthesis of the findings. Findings Research about substance use disorders in older adults is limited, especially in those with superimposed neurocognitive disorders. Having dual diagnoses can make the identification and treatment of either condition challenging. Management should use a holistic multidisciplinary approach that involves medical professionals and caregivers. Originality/value This review highlights some of the intertwining aspects between substance use disorders and neurocognitive disorders in older adults. It provides a comprehensive summary of the available evidence on treatment in this population.

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Illicit Drug Use in Older Adults

Cited by 11 publications

References 73 publications

Individual and community-level factors associated with khat (Catha edulis) use among women of reproductive age in Halaba zone, South Ethiopia: a multilevel mixed effect analysis

Individual and community-level factors associated with khat (Catha edulis) use among women of reproductive age in Halaba zone, South Ethiopia: a multilevel mixed effect analysis

Use, Effects, and Diagnostic Challenges of Cocaine Use in “Baby Boomers” and Older Adults

Neurocognitive and substance use disorders in older adults: challenges and evidence

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