Substance Use in Later Life

2019 ◽  
Author(s):  
Stephen J. Bright
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
Subjective Effects ◽  
Later Life ◽  
The United States ◽  
Primary Concern ◽  
Drinking Patterns ◽  
Medical Practitioners ◽  
Healthcare Settings ◽  
History Of

In the 21st century, we have seen a significant increase in the use of alcohol and other drugs (AODs) among older adults in most first world countries. In addition, people are living longer. Consequently, the number of older adults at risk of experiencing alcohol-related harm and substance use disorders (SUDs) is rising. Between 1992 and 2010, men in the United Kingdom aged 65 years or older had increased their drinking from an average 77.6 grams to 97.6 grams per week. Data from Australia show a 17% increase in risky drinking among those 60–69 between 2007 and 2016. Among Australians aged 60 or older, there was a 280% increase in recent cannabis use from 2001 to 2016. In the United States, rates of older people seeking treatment for cocaine, heroin, and methamphetamine have doubled in the past 10 years. This trend is expected to continue. Despite these alarming statistics, this population has been deemed “hidden,” as older adults often do not present to treatment with the SUD as a primary concern, and many healthcare professionals do not adequately screen for AOD use. With age, changes in physiology impact the way we metabolize alcohol and increase the subjective effects of alcohol. In addition, older adults are prone to increased use of medications and medical comorbidities. As such, drinking patterns that previously would have not been considered hazardous can become dangerous without any increase in alcohol consumption. This highlights the need for age-specific screening of all older patients within all healthcare settings. The etiology of AOD-related issues among older adults can be different from that of younger adults. For example, as a result of issues more common as one ages (e.g., loss and grief, identity crisis, and boredom), there is a distinct cohort of older adults who develop SUDs later in life despite no history of previous problematic AOD use. For some older adults who might have experimented with drugs in their youth, these age-specific issues precipitate the onset of a SUD. Meanwhile, there is a larger cohort of older adults with an extensive history of SUDs. Consequently, assessments need to be tailored to explore the issues that are unique to older adults who use AODs and can inform the development of age-specific formulations and treatment plans. In doing so, individualized treatments can be delivered to meet the needs of older adults. Such treatments must be tailored to address issues associated with aging (e.g., reduced mobility) and may require multidisciplinary input from medical practitioners and occupational therapists.

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 Novelty Seeking as a Phenotypic Marker of Adolescent Substance Use

2015 ◽  
Vol 9s1 ◽  
pp. SART.S22440 ◽  
Author(s):  
L. Cinnamon Bidwell ◽  
Valerie S. Knopik ◽  
Janet Audrain-Mcgovern ◽  
Tiffany R. Glynn ◽  
Nichea S. Spillane ◽  
...  
Keyword(s):  
Substance Use ◽  
Family History ◽  
Subjective Effects ◽  
Drug Effects ◽  
Novelty Seeking ◽  
Indirect Pathway ◽  
Phenotypic Marker ◽  
Cross Sectional ◽  
Frequent Use ◽  
History Of

Trait novelty seeking has been consistently implicated in substance use, yet the origins and mechanisms of novelty seeking in substance use proneness are unclear. We aimed to characterize novelty seeking as a phenotypic marker of substance use proneness in adolescence, a critical period for drug use experimentation. To this end, we parsed novelty seeking's two constituent subdimensions – exploratory excitability (drive for novel experience) and impulsiveness (careless decision-making) – and explored the individual relations of these dimensions to: (1) the use of a variety of licit and illicit substances, (2) family history of substance use, and (3) subjective drug effects. Five hundred eighty five adolescents (mean age = 14.5 years) completed surveys of key variables. Results indicated that, when accounting for the covariation among exploratory excitability and impulsiveness, impulsiveness emerged as the more salient correlate of substance use and was independently associated with initiation of nearly all drug classes. Mediation analyses of the mechanisms of novelty seeking-related risk illustrated that impulsiveness mediated the association of family history of substance use with both initiation and past 30-day frequency of use. Both impulsiveness and exploratory excitability were associated with increased positive and negative subjective drug effects, and the analyses supported a significant indirect pathway from impulsiveness to a more frequent use via positive subjective effects. Although limited by a cross-sectional design, these findings suggest that impulsiveness-like aspects of the novelty seeking construct may represent a useful phenotypic marker for early substance use proneness that potentially (1) increases initiation risk, (2) has familial origins, and (3) promotes more frequent use by altering subjective drug response.

scholarly journals Give Thanks in All Circumstances? Gratitude Toward God and Health in Later Life After Major Life Stressors

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 465-465
Author(s):  
Laura Upenieks ◽  
Joanne Ford-Robertson
Keyword(s):  
Older Adults ◽  
Life Course ◽  
Later Life ◽  
Well Being ◽  
The United States ◽  
National Sample ◽  
Life Stressors ◽  
Major Life ◽  
Moderation Effect ◽  
Development Framework

Abstract Gratitude is foundational to well-being throughout the life course, and an emerging body of work suggests that older adults may be more inclined to attribute gratitude to a non-human target (God). Drawing on life course theory and Erikson’s lifespan development framework, we use data from a national sample of Christian older adults from the United States (N = 1,005) to examine whether gratitude towards God buffers the noxious health effects of the death of a loved one or personal illness. Results suggest that gratitude towards God tends to predict better age-comparative and global self-rated physical health in the aftermath of stress, a moderation effect which is partially mediated by stronger beliefs in God-mediated control (that God is a collaborative partner in dealing with problems). We conclude by proposing some interventions for clinicians and counselors centered around gratitude and religiosity that may assist older adults in coping with major life stressors.

scholarly journals Pre-pandemic Ageism Toward Older Adults Predicts Behavioral Intentions During the COVID-19 Pandemic

2020 ◽  
Author(s):  
Ashley Lytle ◽  
MaryBeth Apriceno ◽  
Jamie Macdonald ◽  
Caitlin Monahan ◽  
Sheri R Levy
Keyword(s):  
United States ◽  
Older Adults ◽  
Behavioral Intentions ◽  
The United States ◽  
Prosocial Behaviors ◽  
Future Research ◽  
Supportive Behaviors ◽  
History Of ◽  
Health Complications ◽  
Complications And Mortality

Abstract Objectives During the coronavirus disease 2019 (COVID-19) pandemic, older adults have been disproportionately affected by high rates of health complications and mortality. Reactions toward older adults included a mix of prosocial behaviors and ageist responses, consistent with the history of positive and negative views and treatment of older adults in the United States. Methods In a two-part study (n = 113, Mage = 18.49, SD = 0.50; range 18–19), we examined whether pre-pandemic ageism among undergraduates predicts prosocial behavioral intentions toward older adults both specific to COVID-19 and in general. Results Pre-pandemic ageism toward older adults predicted less intentions to help older adults generally and specific to COVID-19. Whereas viewing older adults as incompetent predicted greater intentions to help specific to COVID-19. Discussion These results reflect the complexity of predicting helping behaviors and suggest that even supportive behaviors toward older adults during the COVID-19 pandemic may be rooted in negative ageist stereotypes. Implications and directions for future research are discussed.

scholarly journals Mental Health, Substance Use, and Suicidal Ideation Among Unpaid Caregivers in the United States During the COVID-19 Pandemic: Relationships to Age, Race/Ethnicity, Employment, and Caregiver Intensity

2021 ◽  
Author(s):  
Mark É Czeisler ◽  
Alexandra Drane ◽  
Sarah S Winnay ◽  
Emily R Capodilupo ◽  
Charles A Czeisler ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Health Care ◽  
Substance Use ◽  
Suicidal Ideation ◽  
The United States ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Race Ethnicity ◽  
Hispanic White

AbstractObjectivesTo estimate the prevalence of unpaid caregiving during the coronavirus disease 2019 (COVID-19) pandemic, and to identify factors associated with adverse mental health symptoms, substance use, and suicidal ideation in this population, which provides critical support in health care systems by providing care to older adults and those with chronic conditions.MethodsIn June 2020, Internet-based surveys with questions about demographics, caregiving responsibilities, and mental health were administered to US adults aged ≥18 years. Demographic quota sampling and survey weighting to improve cross-sectional sample representativeness of age, gender, and race/ethnicity. Prevalence ratios for adverse mental health symptoms were estimated using multivariable Poisson regressions.ResultsOf 9,896 eligible invited adults, 5,412 (54.7%) completed surveys; 5,011 (92.6%) respondents met screening criteria and were analysed, including 1,362 (27.2%) caregivers. Caregivers had higher prevalences of adverse mental health symptoms than non-caregivers, including anxiety or depressive disorder symptoms (57.6% vs 21.5%, respectively, p<0.0001) having recently seriously considered suicide (33.4% vs 3.7%, p<0.0001). Symptoms were more common among caregivers who were young vs older adults (e.g., aged 18–24 vs ≥65 years, aPR 2.75, 95% CI 1.95–3.88, p<0.0001), Hispanic or Latino vs non-Hispanic White (1.14, 1.04–1.25, p=0.0044), living with vs without disabilities (1.18, 1.10–1.26, p<0.0001), and with moderate and high vs low Caregiver Intensity Index scores (2.31, 1.65–3.23; 2.81, 2.00–3.94; both p<0.0001). Suicidal ideation was more prevalent among non-Hispanic Black vs non-Hispanic White caregivers (1.48, 1.15–1.90, p=0.0022).ConclusionsCaregivers, who accounted for one in four US adult respondents in this nationally representative sample, more commonly reported adverse mental health symptoms than non-caregivers. Increased visibility of and access to mental health care resources are urgently needed to address mental health challenges of caregiving.

Substance Use Disorders in the Elderly

2017 ◽  
Author(s):  
Michael Burgard ◽  
Robert Kohn
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Alcohol Use Disorder ◽  
Illicit Drugs ◽  
Nursing Home Residents ◽  
The Elderly ◽  
The United States ◽  
Driving Under The Influence

Substance use disorders in older adults remains lower than in younger adults; however, the prevalence is rising in the elderly population. In the United States, the lifetime prevalence of an alcohol use disorder among persons age 65 and older is 16.1%. Studies of Veteran’s Administration nursing home residents have found that 29% to 49% of those admitted have a lifetime diagnosis of alcohol use disorder. A sizable proportion of the elderly acknowledge driving under the influence. In 2013, 1.5% of the elderly had used illicit drugs. The number requiring treatment for substance abuse is expected to double by 2020. The populations with the fastest increase in opiate mortality are those age 55 and older, including those 65 and older. This chapter presents the epidemiology of substance use among older adults and discusses issues related to elders’ substance use, including use in nursing homes, impaired driving and arrests, use of non-prescription medications, screening for substance use, and treatment.

scholarly journals ANTIDEPRESSANT USE AND MORTALITY RISK IN OLDER ADULTS WITH HISTORY OF STROKE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S269-S269
Author(s):  
Madison B Lenox ◽  
Victor Tran ◽  
Grace Tworek ◽  
Andrew Solow ◽  
Diana Hincapie
Keyword(s):  
Older Adults ◽  
Mortality Risk ◽  
The United States ◽  
Mortality Rates ◽  
Lower Mortality ◽  
Public Health Issue ◽  
Post Stroke ◽  
Cognitive Limitations ◽  
History Of ◽  
Antidepressant Use

Abstract The American Stroke Association reports stroke as the fourth leading cause of death in the United States, with 66% of hospitalized cases being older adults. Recovery from stroke is a public health issue, as post-stroke depression (PSD) is a significant concern. Approximately 20-23% of stroke survivors identified co-occurring diagnoses, which are associated with physical, functional, and cognitive limitations and increased mortality risk. Antidepressant use has exhibited its efficacy in treating PSD. This study explores the association between antidepressant use and mortality risk in older adults with history of stroke. Older adults aged 65 and older (N=3631, 55.4% female, 72.6% Caucasian, Mage=79.64 years, SDage=7.29 years, MEd=14.55 years, SDEd=8.269 years) with history of stroke were selected from the National Alzheimer’s Coordinating Center database to explore the association between antidepressant use and mortality. A chi-squared test of independence was calculated comparing antidepressant use and mortality rates. A significant association was found (χ2 (1) = 15.933, p &lt; .001) between current antidepressant use and mortality. Findings suggest antidepressant use is associated with lower mortality rates in subjects with a history of stroke. Implications include highlighting the role psychologists play in the early identification of PSD and early antidepressant intervention post-stroke to increase life longevity. Although findings only infer association, they demonstrate evidence for the link between PSD, antidepressant use, and lower mortality rates. Future directions include exploring other forms of depression treatment and mechanisms of antidepressant use. Limitations include examining potential moderators (e.g., gender, SES, type of stroke), and substance use within this population.

The effect of time volunteering and charitable donations in later life on psychological wellbeing

2010 ◽  
Vol 31 (4) ◽  
pp. 590-610 ◽  
Author(s):  
NAMKEE G. CHOI ◽  
JINSEOK KIM
Keyword(s):  
Older Adults ◽  
Social Capital ◽  
Later Life ◽  
The United States ◽  
Psychological Wellbeing ◽  
Physical And Mental Health ◽  
Moderate Amount ◽  
Charitable Donations ◽  
Using Data ◽  
Positive Direct

ABSTRACTAlthough accumulated research findings point to both short- and long-term salutary effects of time volunteering on older adults' physical and mental health, little research has been done on the effect of older adults' making charitable donations on their wellbeing. Guided by activity theory and the theory of volunteering and using data from the first and second waves of Midlife Development in the United States (MIDUS, 1995–1996 and MIDUS II, 2004–2006), this study examined the question of whether time volunteering and charitable donations nine years earlier had a positive direct effect on psychological wellbeing among individuals age 55 and above. Controlling for time 1 (T1) psychological wellbeing and T1 human, cultural, and social capital resources, a moderate amount (up to ten hours monthly) of T1 time volunteering and any amount of T1 charitable donations had a direct positive effect on time 2 (T2; nine years later) psychological wellbeing. The findings also show a greater effect on psychological wellbeing of any amount of charitable donations than of any amount of time volunteering, although the extent of the effect of both time volunteering and charitable donations was small. With regard to human, cultural, and social capital resources, T1 self-rated health and generative quality were significant predictors of T2 psychological wellbeing, but T1 social capital had no significant effect on T2 psychological wellbeing.

Through Him and With Him? A Longitudinal Study of How God-Mediated Control Beliefs Shape the Relationship between Divine Forgiveness and Physical Health in Later Life

2021 ◽  
pp. 089826432199656
Author(s):  
Laura Upenieks
Keyword(s):  
Older Adults ◽  
Physical Health ◽  
Later Life ◽  
The United States ◽  
Control Beliefs ◽  
Future Research ◽  
Religion And Health ◽  
Aging And Health ◽  
Divine Forgiveness ◽  
The Relationship

Objectives: While there has been a recent surge in research on forgiveness and health, much less is known about the relationship between divine forgiveness and health. Methods: Using longitudinal data from the 2001–2004 Religion, Aging, and Health Survey from the United States, the current study assesses how changes in beliefs in God-mediated control, a perceived collaborative relationship with a divine power, affect the association between divine forgiveness and physical health among Christian older adults. Results: Older adults with consistently high beliefs in God-mediated control over the study period received stronger health benefits of divine forgiveness. Forgiveness by God also had a stronger relationship with health compared to forgiveness of self and others. Discussion: The findings underscore the importance of subjective beliefs about God. Future research directions are proposed to advance the study of religion and health in later life by conceiving of a more salient role for divine forgiveness.

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