Just Say Know: An Examination of Substance Use Disorders among Older Adults in Gerontological and Substance Abuse Journals

Rosen, Daniel; Engel, Rafael J.; Hunsaker, Amanda; Engel, Yael; Reynolds, Charles F.

doi:10.1080/19371918.2013.774668

Cited by 17 publications

(13 citation statements)

References 15 publications

(18 reference statements)

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“…8,14-16 To date, no nationally representative studies have examined variations in the use of opioids in older adults and how the use was associated with state regulations. 5,17-18 To address this gap in knowledge, we use 2007-2012 national data of Medicare beneficiaries to investigate this escalating public health issue. Understanding multilevel factors associated with opioid use and outcomes in older adults and the impact of policy will offer important insights into developing guidelines for safe and effective use of opioids in this population.…”

Section: Introductionmentioning

confidence: 99%

Trends in Opioid Prescriptions Among Part D Medicare Recipients From 2007 to 2012

Kuo

Raji

Chen

et al. 2016

The American Journal of Medicine

113

118

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Background There is growing concern about potential overuse of, and toxicity from, opioid analgesics. No nationally representative study has examined inter-state variations in opioid use and impact of policy on opioid use among older adults. Methods We used national Medicare data from 2007-2012 to assess temporal and geographic trends in rates of opioid prescription and relationship to opioid toxicity and different state regulations in Part D Medicare recipients. We excluded those with a cancer diagnosis. Multilevel, multivariable regression analyses evaluated rates of prolonged prescriptions for schedule II, schedule III, and combination II/III opioid for each state, adjusting for patient characteristics. Results The percent of Part D recipients receiving prescriptions for combined schedule II/III opioid more than 90 days in a year increased from 4.62% in 2007 to 7.35% in 2012. Large variations existed among states in rates of opioid prescriptions: from 2.84% in New York to 10.93% in Utah, in 2012 data. The state variation was larger for schedule III than schedule II. Individual characteristics independently associated with prolonged use included older age, female gender, white race, low-income, living in a lower education area, and comorbidity of drug abuse, rheumatoid arthritis, depression. Only state law regulating pain clinic was associated with reduction of schedule II opioid prescriptions. Prolonged opioid prescription use increased the odds of opioid overdose-related emergency room visits or hospitalization by 60%. Conclusions Analyses of Medicare Part D data demonstrated a substantial growth in opioid prescriptions from 2007 to 2011 and large variation in opioid prescriptions across states.

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Section: Introductionmentioning

confidence: 99%

Trends in Opioid Prescriptions Among Part D Medicare Recipients From 2007 to 2012

Kuo

Raji

Chen

et al. 2016

The American Journal of Medicine

113

118

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“…Although not a particularly high-risk group the higher rates of DPD in women than men in the 65+ age group in all but 3 western states suggests greater research and education is needed for the elderly about DPD. In reviewing literature on substance abuse among those >50, Rosen et al (2013) found that only 1% of articles in the top ten gerontology and substance abuse journals addressed substance abuse in the >50s. This is a research gap that needs addressing.…”

Section: Discussion and Future Researchmentioning

confidence: 99%

Spatial analysis of drug poisoning deaths in the American West, particularly Utah

Kerry

Goovaerts

Vowles

et al. 2016

International Journal of Drug Policy

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Background Most states in the Western US have high rates of drug poisoning death (DPD), especially New Mexico, Nevada, Arizona and Utah (UT). This seems paradoxical in UT where illicit drug use, smoking and drinking rates are low. To investigate this, spatial analysis of county level DPD data and other relevant factors in the Western US and UT was undertaken. Methods Poisson kriging was used to smooth the DPD data, populate data gaps and improve the reliability of rates recorded in sparsely populated counties. Links between DPD and economic, environmental, health, lifestyle, and demographic factors were investigated at four scales using multiple linear regression. LDS church membership and altitude, factors not previously considered, were included. Spatial change in the strength and sign of relationships was investigated using geographically weighted regression and significant DPD clusters were identified using the Local Moran’s I. Results Economic factors, like the sharp social gradient between rural and urban areas were important to DPD throughout the west. Higher DPD rates were also found in areas of higher elevation and the desert rural areas in the south. The unique characteristics of DPD in UT in terms of health and lifestyle factors, as well as the demographic structure of DPD in the most LDS populous states (UT, Idaho, Wyoming), suggest that high DPD in heavily LDS areas are predominantly prescription opioid related whereas in other Western states a larger proportion of DPD might come from illicit drugs. Conclusions Drug policies need to be adapted to the geographical differences in the dominant type of drug causing death. Educational materials need to be marketed to the demographic groups at greatest risk and take into account differences in population characteristics between and within States. Some suggestions about how such adaptations can be made are given and future research needs outlined.

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“…Studies also show that there is lack of focus on the elevated use of alcohol and psychotropic drugs when healthcare personnel and GPs apply for or facilitate services for older people (Duckert, Lossius, Ravndal, & Sandvik, 2008;Johannessen, Engedal, & Helvik, 2014;Johannessen, Helvik, Engedal, Ulstein, & Sørlie, 2015;Sandvik, 2014). A review study indicates that there has been little research addressing substance abuse in older adults (Rosen, Engel, Hunsaker, Engel, & Reynolds, 2013). What is more, studies examining the differences and similarities between referral sources and selfreported use of alcohol and psychotropic drugs, as well as the reasons for these differences, are not well documented (Helseth, Lykke-Enger, Aamot, & Johnsen, 2005;Høiseth et al, 2013).…”

mentioning

confidence: 99%

Alcohol and prescribed psychotropic drug use among patients admitted to a department of old-age psychiatry in Norway

Johannesen

Engedal

Larsen

et al. 2017

Nordic Studies on Alcohol and Drugs

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Background: Although alcohol and prescribed psychotropic drug use has increased among older people, the usefulness of information provided about these substances in patients’ referrals to departments of old-age psychiatry (OAPsy) is unknown. Aims: To examine whether patients’ self-reported elevated use of alcohol and prescribed psychotropic drugs corresponds with information provided in the referrals to OAPsy departments and to explore the factors associated with elevated self-reported use of these substances. Methods: We recorded the information provided in referrals about the elevated use of alcohol and psychotropic drugs in a sample of 206 patients (69 men) from 12 OAPsy departments. The Alcohol Use Disorders Identification Test (AUDIT) and Drug Use Disorders Identification Test (DUDIT) helped to assess self-reported use. We also collected demographic data, as well as information about cognitive functioning and symptoms of anxiety and depression. Results: Seventy-three patients (35%) scored above the cut-off for alcohol use for women/men (AUDIT ≥ 3/4) or psychotropic drugs (DUDIT ≥ 6/8), if not both. Twenty patients (10%) reported an elevated use of both alcohol and psychotropic drugs, and the referrals for eight (40%) and ten (50%) of them, respectively, included information about this use. There was a significant association between self-reported use of alcohol above the cut-off and information about elevated use in the referrals. However, no such association was found between information in the referrals and self-reported use of prescribed psychotropic drugs. Elevated alcohol use was associated with more years of education, while elevated use of psychotropic drugs was associated with younger age and severe symptoms of anxiety and depression. Conclusion: The information reported in referrals about the elevated use of alcohol and psychotropic drugs demonstrated a trend in associations with self-reported use. However, the risk factors for elevated use of alcohol and psychotropic drugs in the elderly need to be examined further.

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Just Say Know: An Examination of Substance Use Disorders among Older Adults in Gerontological and Substance Abuse Journals

Cited by 17 publications

References 15 publications

Trends in Opioid Prescriptions Among Part D Medicare Recipients From 2007 to 2012

Trends in Opioid Prescriptions Among Part D Medicare Recipients From 2007 to 2012

Spatial analysis of drug poisoning deaths in the American West, particularly Utah

Alcohol and prescribed psychotropic drug use among patients admitted to a department of old-age psychiatry in Norway

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