Treatment Outcomes for Older Adults Who Abuse Substances

Outlaw, Freida H.; Marquart, Jules M.; Roy, Aditi; Luellen, Jason K.; Moran, Mary A.; Willis, Amy C.; Doub, Thomas W.

doi:10.1177/0733464810382906

Cited by 54 publications

(28 citation statements)

References 30 publications

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“…Although definitions of the level of attendance at which patients can be considered to have completed treatment vary (Najavits et al, 1998; Wolitzky-Taylor et al, 2012), treatment completion has often been defined as between 60% and 80% of sessions attended (Brady et al, 2001; Hien et al, 2012; Outlaw et al, 2012). …”

Section: Methodsmentioning

confidence: 99%

Who benefits from additional drug counseling among prescription opioid-dependent patients receiving buprenorphine–naloxone and standard medical management?

Weiss

Griffin

Potter

et al. 2014

Drug and Alcohol Dependence

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Background In the multi-site Prescription Opioid Addiction Treatment Study (POATS), conducted within the National Drug Abuse Clinical Trials Network, participants randomly assigned to receive individual drug counseling in addition to buprenorphine-naloxone and medical management did not have superior opioid use outcomes. However, research with other substance dependent populations shows that subgroups of participants may benefit from a treatment although the entire population does not. Method We conducted a secondary analysis of POATS data to determine whether a subgroup of participants benefited from drug counseling in addition to buprenorphine-naloxone and medical management, either due to greater problem severity or more exposure to counseling as a result of greater treatment adherence. Problem severity was measured by a history of heroin use, higher Addiction Severity Index drug composite score, and chronic pain. Adequate treatment adherence was defined a priori as attending at least 60% of all offered sessions. Results Patients who had ever used heroin and received drug counseling were more likely to be successful (i.e., abstinent or nearly abstinent from opioids) than heroin users who received medical management alone, but only if they were adherent to treatment and thus received adequate exposure to counseling (OR=3.7, 95% CI=1.1-11.8, p=0.03). The association between severity and outcome did not vary by treatment condition for chronic pain or ASI drug severity score. Conclusions These findings emphasize the importance of treatment adherence, and suggest that patients with prescription opioid dependence are a heterogeneous group, with different optimal treatment strategies for different subgroups.

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Section: Methodsmentioning

confidence: 99%

Who benefits from additional drug counseling among prescription opioid-dependent patients receiving buprenorphine–naloxone and standard medical management?

Weiss

Griffin

Potter

et al. 2014

Drug and Alcohol Dependence

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“…As people who use opioids are surviving longer than 40 years, the cut-off point of 40 years has been used to define the 'older' population (Crome et al, 2009). There is no consensus in the literature on what 'old' is; it ranges from 37 to 55, 40+, 45+, 50+, 60+, 65+, 49 to 61, 50 to 59, and 50 to 74 Beynon et al, 2007;Boeri et al, 2011;Crome et al, 2011b;Doukas, 2011;European Monitoring Centre for Drugs and Drug Addiction, 2010;Han et al, 2009;Han et al, 2015;Institute of Medicine, 2012;Lofwall et al, 2008;Outlaw et al, 2012;Raffoul et al, 1981;Roe et al, 2010;Rosen et al, 2011;Schonfeld et al, 2000;Wu and Blazer, 2011).…”

Section: Defining Ageing Based On Current Literaturementioning

confidence: 99%

Treatment for opioid use and outcomes in older adults: a systematic literature review

Carew

Comiskey

2018

Drug and Alcohol Dependence

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A B S T R A C TBackground: Historically, issues relating to problem substance use among older people have received little attention, and have only recently been recognised. Methods: A literature review of relevant material was conducted in November 2015 to assess current outcome research among older adults treated for opioid dependence. Multiple electronic databases were searched and results were supplemented by grey literature, library and online searches, and relevant references within selected articles. Retrieved articles were assessed for relevance against the inclusion and exclusion criteria. Results were reviewed to identify major findings and recommendations. Results: A total of 76 titles were included in the review. Most research conducted on older adults involves alcohol and prescription medications. Older drug users are growing in number and have a unique profile, with many presenting for treatment for the first time aged 50-70 years. Findings reveal (1) opioid treatment numbers are decreasing, however the average age of treatment admissions is increasing, (2) there is no consensus on what old is (3) two distinct types of older opioid substance users exist (early/late onset), (4) older clients achieve better treatment outcomes than younger counterparts, and (5) older women achieve better treatment outcomes than men. Conclusions: Findings suggest that little is known about treatment outcomes among older people. Problematic drug use (of which opioids make up the largest proportion) had been incorrectly assumed to end as patients age. Defining an age limit for 'older' is important. Addiction and healthcare services must anticipate and prepare for increased demand by this group.

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“…Rates of substance use disorders (Han, Gfroerer, Colliver, & Penne, 2009), past-year treatment (Sacco, Kuerbis, Goge, & Bucholz, 2013), and need for treatment (Gfroerer, Penne, Pemberton, & Folsom, 2003) among older adults are projected to increase in coming years as well. A plurality of approaches to treating older adults with alcohol-related problems has shown positive outcomes (Kuerbis & Sacco, 2013; Outlaw et al, 2012; Schonfeld et al, 2010). …”

Section: Background: Alcohol Use and Older Adultsmentioning

confidence: 99%

Feasibility and Utility of Experience Sampling to Assess Alcohol Consumption Among Older Adults

et al. 2014

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In the literature on alcohol use and aging, drinking has often been conceptualized as a means of coping with negative feelings, such as stress, yet much of the literature on older adults and drinking has utilized cross-sectional or other data ill-suited for exploring dynamic processes. Experience sampling methods have the ability to measure and analyze dynamic processes in real time, such as relations between alcohol use and mood states. Nonetheless, these approaches are intensive and may burden respondents. Therefore, this study evaluated the feasibility, acceptability, and validity of a modified daily diary to measure alcohol use and explored alternate methods of collecting diary data. Findings suggest that a modified diary was acceptable and not burdensome. Respondents were reluctant to consider technology (e.g., cellphone)-based means of data collection. Measures of alcohol use showed little within-person variation suggesting that for those who drink at all, drinking is a daily habit.

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Treatment Outcomes for Older Adults Who Abuse Substances

Cited by 54 publications

References 30 publications

Who benefits from additional drug counseling among prescription opioid-dependent patients receiving buprenorphine–naloxone and standard medical management?

Who benefits from additional drug counseling among prescription opioid-dependent patients receiving buprenorphine–naloxone and standard medical management?

Treatment for opioid use and outcomes in older adults: a systematic literature review

Feasibility and Utility of Experience Sampling to Assess Alcohol Consumption Among Older Adults

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