Trends in substance use admissions among older adults

Abstract

BackgroundSubstance abuse is a growing, but mostly silent, epidemic among older adults. We sought to analyze the trends in admissions for substance abuse treatment among older adults (aged 55 and older).MethodsTreatment Episode Data Set - Admissions (TEDS-A) for period between 2000 and 2012 was used. The trends in admission for primary substances, demographic attributes, characteristics of substance abused and type of admission were analyzed.ResultsWhile total number of substance abuse treatment admissions between 2000 and 2012 changed slightly, proportion attributable to older adults increased from 3.4% to 7.0%. Substantial changes in the demographic, substance use pattern, and treatment characteristics for the older adult admissions were noted. Majority of the admissions were for alcohol as the primary substance. However there was a decreasing trend in this proportion (77% to 64%). The proportion of admissions for following primary substances showed increase: cocaine/crack, marijuana/hashish, heroin, non-prescription methadone, and other opiates and synthetics. Also, admissions for older adults increased between 2000 and 2012 for African Americans (21% to 28%), females (20% to 24%), high school graduates (63% to 75%), homeless (15% to 19%), unemployed (77% to 84%), and those with psychiatric problems (17% to 32%).The proportion of admissions with prior history of substance abuse treatment increased from 39% to 46% and there was an increase in the admissions where more than one problem substance was reported. Ambulatory setting continued to be the most frequent treatment setting, and individual (including self-referral) was the most common referral source. The use of medication assisted therapy remained low over the years (7% - 9%).ConclusionsThe changing demographic and substance use pattern of older adults implies that a wide array of psychological, social, and physiological needs will arise. Integrated, multidisciplinary and tailored policies for prevention and treatment are necessary to address the growing epidemic of substance abuse in older adults.

Cognitive function in aging cocaine smokers

“…By 2030, one-fifth of the United States population will be 65 years or older (Mather et al, 2015). Coinciding with the aging population is an increase in the number of older people using drugs of abuse (Chhatre et al, 2017; Duncan et al, 2010; Han et al, 2009; White et al, 2011). The increase of older drug users appears primarily attributable to aging of the “baby boomers”, who represent some 21% of past-month drug users (SAMSHA, 2016).…”

“…The above issues are particularly relevant to cocaine use. From 2000 to 2012, the number of cocaine users aged 55 or older presenting for drug treatment in the US increased by 63% (Chhatre et al, 2017). Cocaine is one of the most commonly used drugs in 50 to 59-year-old people in treatment for substance use disorders (Wu and Blazer, 2011), and older cocaine users are more likely than their younger counterparts to smoke cocaine (Martin et al, 2014; Whitehead et al, 2014).…”

Physical Activity and the Development of Substance Use Disorders: Current Knowledge and Future Directions

“…The prevalence of SUDs in the older adult population is low compared with other age groups; however, the proportional admission rates into substance use treatment programs for older adults more than doubled between 2000–2012. [58] Alcohol is the primary substance of abuse for older adults (64% of admissions), though the admission rates for other substances, including opioids and cannabis have increased sharply by 221% and 150% respectively among older adults. There are also concerning data suggesting that older adults develop SUDs without a past history of abuse, since half of individuals in treatment report that their initiation of substance use occurred after 25 years old.…”

“…There are also concerning data suggesting that older adults develop SUDs without a past history of abuse, since half of individuals in treatment report that their initiation of substance use occurred after 25 years old. [58] Older adults may be at an increased risk of substance use initiation because of the changes that occur with this developmental period such as having fewer daily responsibilities, transitioning to retirement, restructuring or loss of social relationships, and deteriorating physical and mental health, which may further reduce health-related quality of life and increase opportunities for medication misuse. [24]…”

Characteristics of Mental Health and Substance Use Service Facilities for Older Adults: Findings from U.S. National Surveys

“…The 2019 NSDUH showed that 74.3% of individuals aged 50 + with a serious mental illness received any type of treatment, including individual or group, outpatient, or inpatient care (SAMHSA, 2020a). Substance use treatment admission data (Treatment Episode Data Set; TEDS: https://www.samhsa.gov/data/datawe-collect/teds-treatment-episode-data-set) also show ed that the proportions of older adults (aged 55+) seeking treatment for the first time for alcohol use disorder and for illicit drug use increased over the past decade (Chhatre, Cook, Mallik, & Jayadevappa, 2017;Huhn, Hobelmann, Ramirez, Strain, & Oyler, 2019). However, the rate of substance use treatment among this age group is much lower than the rate of mental disorder treatment.…”