Substance Use in Older Adults

2022 ◽  
pp. 39-48
Author(s):  
Paroma Mitra
Keyword(s):  
Older Adults ◽  
Substance Use

scholarly journals Low Back Pain and Substance Use: Diagnostic and Administrative Coding for Opioid Use and Dependence Increased in U.S. Older Adults with Low Back Pain

Pain Medicine ◽  
2021 ◽  
Author(s):  
Beth B Hogans ◽  
Bernadette C Siaton ◽  
Michelle N Taylor ◽  
Leslie I Katzel ◽  
John D Sorkin
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
Low Back Pain ◽  
Back Pain ◽  
National Sample ◽  
Cross Sectional Study ◽  
Diagnostic Code ◽  
Low Back ◽  
Opioid Use ◽  
Cross Sectional

Abstract Objective Low back pain (LBP) is a leading cause of pain and disability. Substance use complicates the management of LBP, and potential risks increase with aging. Despite implications for an aging, diverse U.S. population, substance use and LBP comorbidity remain poorly defined. The objective of this study was to characterize LBP and substance use diagnoses in older U.S. adults by age, gender, and race. Design Cross-sectional study of a random national sample. Subjects Older adults including 1,477,594 U.S. Medicare Part B beneficiaries. Methods Bayesian analysis of 37,634,210 claims, with 10,775,869 administrative and 92,903,649 diagnostic code assignments. Results LBP was diagnosed in 14.8±0.06% of those more than 65 years of age, more in females than in males (15.8±0.08% vs. 13.4±0.09%), and slightly less in those more than 85 years of age (13.3±0.2%). Substance use diagnosis varied by substance: nicotine, 9.6±0.02%; opioid, 2.8±0.01%; and alcohol, 1.3±0.01%. Substance use diagnosis declined with advancing age cohort. Opioid use diagnosis was markedly higher for those in whom LBP was diagnosed (10.5%) than for those not diagnosed with LBP (1.5%). Most older adults (54.9%) with an opioid diagnosis were diagnosed with LBP. Gender differences were modest. Relative rates of substance use diagnoses in LBP were modest for nicotine and alcohol. Conclusions Older adults with LBP have high relative rates of opioid diagnoses, irrespective of gender or age. Most older adults with opioid-related diagnoses have LBP, compared with a minority of those not opioid diagnosed. In caring for older adults with LBP or opioid-related diagnoses, health systems must anticipate complexity and support clinicians, patients, and caregivers in managing pain comorbidities. Older adults may benefit from proactive incorporation of non-opioid pain treatments. Further study is needed.

Substance use disorder among older adults in the United States in 2020

Addiction ◽  
2009 ◽  
Vol 104 (1) ◽  
pp. 88-96 ◽  
Author(s):  
Beth Han ◽  
Joseph C. Gfroerer ◽  
James D. Colliver ◽  
Michael A. Penne
Keyword(s):  
United States ◽  
Older Adults ◽  
Substance Use ◽  
Substance Use Disorder ◽  
The United States

scholarly journals Daily factors driving daily substance use and chronic pain among older adults with HIV: An exploratory study using ecological momentary assessment

Alcohol ◽  
2019 ◽  
Vol 77 ◽  
pp. 31-39 ◽  
Author(s):  
Alexis Kuerbis ◽  
M. Carrington Reid ◽  
Jordan E. Lake ◽  
Suzette Glasner-Edwards ◽  
Jessica Jenkins ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Substance Use ◽  
Ecological Momentary Assessment ◽  
Exploratory Study ◽  
Ecological Momentary ◽  
Momentary Assessment

Treatment of Substance Use Disorders in Older Adults: Implications for Care Delivery

2015 ◽  
Vol 63 (11) ◽  
pp. 2317-2323 ◽  
Author(s):  
Ethan Sahker ◽  
Susan K. Schultz ◽  
Stephan Arndt
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Care Delivery

Conclusion

2016 ◽  
Author(s):  
Maria A. Sullivan
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
The Elderly ◽  
Social Consequences ◽  
Individual Therapy ◽  
Older Individuals ◽  
Prescribing Practices ◽  
Elderly Age ◽  
Age Related ◽  
The Impact

Addiction in older adults very often goes unrecognized, for several reasons: social biases about the elderly, age-related metabolic changes, and the inappropriate use of prescription benzodiazepines and opioids to address untreated anxiety and mood conditions. Alcohol or substance-use disorders (SUDs) in older individuals may present in subtle and atypical ways. Strategies to overcome such difficulties include systematic screening using validated instruments, patient education regarding the impact of psychoactive substances on health, and cautious prescribing practices. Relying on standard DSM criteria may result in a failure to detect an SUD that presents with cognitive symptoms or physical injury, as well as the absence of work or social consequences. Older individuals can benefit from the application of risk-stratification measures, and they can be referred, e.g., to age-appropriate group therapy and non-confrontational individual therapy focusing on late-life issues of loss and sources of social support, as well as be offered medication management for alcohol or substance use disorder. Although research has been limited in this population, treatment outcomes have been found to be superior in older adults than younger adults.

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