Older Adults & Substance Use: New Data Highlight Concerns

http://samhsa.gov/samhsaNewsletter/Volume_17_Number_1/OlderAdults.aspx

Older Adults & Substance Use: New Data Highlight Concerns

By Kristin Blank

In 2006, 41 million adults age 50 and older drank alcohol in the past month, 19 million used tobacco—mostly cigarettes—and 2.2 million used illicit drugs, according to data from SAMHSA’s National Survey on Drug Use and Health (NSDUH).

“The ‘baby boomer’ cohort—people born from 1946 to 1964—is the first in U.S. history with a majority having used illicit drugs sometime in their lives,” said Joseph C. Gfroerer, Director of the Division of Population Surveys at SAMHSA’s Office of Applied Studies (OAS). “As a result, we expect an increase in substance abuse among older adults.”


Of the 2.2 million adults age 50 and older who used illicit drugs in the past month, 54 percent of them used only marijuana; 28 percent used only prescription drugs nonmedically; and 17 percent used a different illicit drug, such as cocaine.

According to 2004 to 2007 data, some factors are associated with elevated rates of past-year illicit drug use among adults age 50 to 59. These factors include being male, being unmarried, initiating use at an early age, and having experienced depression, alcohol use, and tobacco use in the past year.

Abuse and Dependence

In 2006, 3.2 million older adults (3.6 percent of population) had a substance use disorder, said Mr. Gfroerer. Of these, 83 percent (2.6 million) had only an alcohol use disorder, 12 percent had only an illicit drug disorder, and 5 percent had both alcohol and illicit drug use disorders. A recent OAS study projected that the number of older adults with a substance use disorder will increase to 5.7 million by 2020, Mr. Gfroerer added.

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Older Adult Treatment Admissions

Data from 2002 to 2006 show that each year, on average, 139,000 adults age 50 and older abused or were dependent on marijuana; 131,000 abused or were dependent on cocaine; and 120,000 abused or were dependent on pain relievers.

Are these people seeking treatment? Not in droves, according to 2005 to 2006 data, which show that 83 percent of the 3.2 million adults age 50 and older who needed treatment—a need based on standard criteria—felt no need for treatment and did not seek help. Eleven percent received treatment, and 6 percent felt a need for treatment but did not receive it.
Treatment Stats

Treatment Episode Data Set (TEDS) data relay important facts about treatment admissions of older adults. “Despite long-standing substance use, many older admissions have not been in treatment before,” said Deborah H. Trunzo, DASIS Team Leader at OAS.
In 2006, data show that adults age 50 and older who entered treatment for the first time displayed the following median duration of use of their primary substance:

Alcohol only: 38 years

Alcohol and another drug: 37 years

Marijuana: 35 years

Heroin: 34 years.

The peak years of first use of alcohol, heroin, and marijuana for admissions age 50 and older were 1969 to 1971. For cocaine, the peak year of initiating use was 1986, and for narcotic analgesics, it was 2004.

Special Concerns

Some special concerns arise when surveying older adults, said Mr. Gfroerer. This age group displays a 69-percent response rate in NSDUH, which is lower than for younger populations. Older adults may ignore the survey out of concern about scams, or they may not see drug use as something that demands attention.

Adults over age 80 may be physically or mentally incapable of answering the survey questions, and some may relate inaccurate answers because of memory, hearing, or cognitive difficulties. They also may be less comfortable with a computer or not understand the definitions and terms used.

For more data on older adults, visit SAMHSA’s OAS Web site.