Information staff are regularly asked about young people and drugs, whereas enquiries about substance misuse amongst older people arise less frequently. But quite recently this topic has been cropping up more often.

Statistical data from Drug misuse declared: findings from the 2004/05 British Crime Survey: England and Wales shows that the use of illicit drugs is less prevalent amongst older than younger people. However there are other issues that may affect this in the future, such as the aging population. Estimates indicate that by 2025 more than 25% of the UK’s population will be over 60 years old and this generation will have grown up in a period when illicit drug use was more prevalent. In the USA a new survey predicts that the number of Americans aged 50 or older who are addicted to drugs or alcohol will double by 2020.

Research on the issue of substance misuse amongst older people in the UK has been reported as “under-recognised”, “under- reported” or hidden. A search on DrugData for material published since 2000 produces 10 for the UK and 43 for the USA and a selection of these are listed below:

106608
Excluded older people: Social Exclusion Unit interim report.
UK. Office of the Deputy Prime Minister. Social Exlusion Unit.
London: ODP, 2005. 67p.
This paper includes a discussion of the physical and mental health of older people, including a brief section on substance use.

106514
Dawn of the geriaddicts.
Hart S. DrugScope.
From: Druglink: January-February, 21(1), 2006, p.16-17.
As the population of long-term drug users grows older, doctors and campaigners say health officials will have to take on a fresh treatment challenge. This article reports on the issues.
Available for document delivery

106335
Substance abuse relapse prevention for older adults: a group treatment approach.
US. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Center for Substance Abuse Treatment.
US: Rockville MD: SAMHSA, 2005 205p.
(DHHS publication (SMA) 05-4053).
This manual presents a relapse-prevention approach that uses the cognitive-behavioral and self-management intervention (CB/SM) in a counselor-led group treatment setting to help older adults overcome substance use disorders.

104882
Report of the Older Adult Workgroup of the Florida Commission on Mental Health and Substance Abuse.
Parks S., Singleton J., Dupree L. USA. Florida. Commission on Mental Health and Substance Abuse.
US: Tampa, FL.: Florida Commission on Mental Health and Substance Abuse, [2001?].
The number and percentage of older Floridians is rising, as is their need for mental health and substance use services.

104660
Factors associated with psychotropic drug use among community-dwelling older persons: a review of empirical studies.
Voyer P., Cohen D., Lauzon S., Collin J.
From: BMC Nursing: 3(3), 2004. 13p.
Empirical reports with data on at least benzodiazepine or antidepressant drug use in samples of older persons published between 1990 and 2001 (n = 32) were identified from major databases and analyzed to determine which factors are most frequently associated with psychotropic drug use in multivariate analyses. Most studies focused on individual characteristics of respondents, neglecting the potential contribution of health care professionals to the phenomenon of psychotropic drug use among seniors.

104486
Best practices [for the] treatment and rehabilitation for seniors with substance use problems.
Canada. Health Canada.
Canada: Ottawa: Health Canada, 2002. 135p.
ISBN 0662333942
The purpose of this project is to identify best practices in treatment and rehabilitation for seniors with substance use problems. It includes issues related to the accessibility and provision of services. The outcomes of the research are intended to be a resource for service providers and program planners who deliver specialized substance abuse programs to seniors.

104204
Computerized screening of substance abuse problems in a primary care setting: older vs. younger adults.
Nemes S., Rao P.A., Zeiler C., Munly K., Holtz K.D., Hoffman J.
From: American Journal of Drug and Alcohol Abuse: 30(3), 2004, p.627-642.
The purpose of the current study was to examine differences in responses of older adults (age 55 and above) and younger adults (ages 18 to 54) to the Drug Abuse Problem Assessment for Primary Care (DAPA-PC), a computerized drug and alcohol abuse screening instrument developed for primary care settings.
Available for document delivery

103891
Older adults in substance abuse treatment: update.
US. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration.
US: Rockville MD: SAMHSA, 2005. 3p.
(Drug and Alcohol Services Information System). (The DAWN report).
In 2002, 66,500 admissions aged 55 or older were admitted to substance abuse treatment facilities in the United States. Alcohol was the most frequent-ly reported primary substance of abuse among older adults in treatment for all years from 1995 to 2002. Primary drug admissions among older adults increased by 106 percent for men and 119 percent for women between 1995 and 2002.

103733
Substance use among older adults: 2002 and 2003 update.
US. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Office of Applied Studies.
US: Rockville MD: SAMSHA, 2005. [3]p.
(National Survey on Drug Use and Health). (The NSDUH Report).
Based on SAMHSA’s 2002 and 2003 National Surveys on Drug Use & Health (NSDUH), an annual average of 13.7 million persons aged 50 or older (17.1%) smoked cigarettes and 36 million (45.5%) drank alcohol during the past month. About 12.2% of older adults reported binge alcohol use and 3.2% reported heavy alcohol use. Among older adults, 1.4 million (1.8%) used an illicit drug during the past month. Marijuana was the most commonly used illicit drug (used by 1.1% older adults), followed by prescription-type drugs used nonmedically (0.7%), and cocaine (0.2%).

102797
Community treatment programs take up buprenorphine.
Casadonte P.P., Kolodner G.F., Horton T., McMurphy S.M.
From: Science & Practice Perspectives: 2(2), 2004, p.24-29.
Clinicians have been working out ways to incorporate buprenorphine into their treatment models. Representatives of three addiction treatment programs – a Veterans Affairs methadone clinic, a group of outpatient mental health centers, and a nationwide organization of therapeutic communities – talk about their plans and experiences.
Available for document delivery

102707 (Classification HDL)
Substance abuse problems among older adults.
Farkas K.J.
London: Guilford, In: Clinical work with substance-abusing clients. Straussner S.L.A. (ed.) 2004. p.330-346.
ISBN 1593850670
This book chapter provides information and tools to help clinicians recognise substance use problems in elderly clients and to make treatment decisions appropriate to their needs.
Available for document delivery

102686
Five-year alcohol and drug treatment outcomes of older adults versus middle-aged and younger adults in a managed care program.
Satre D D., Mertens J R., Areán P A., Weisner C.
From: Addiction: 99(10), 2004, p.1286-1297.
This study compared 5-year treatment outcomes of older adults to those of middle-aged and younger adults in a large managed care chemical dependency program. Results indicate that older adults have favourable long-term outcome following treatment relative to younger adults, but these differences may be accounted for by variables associated with age such as type of substance dependence, treatment retention, social networks and gender. Age differences in these characteristics inform intervention strategies to support long-term recovery of older adults and provide direction for investigation of how age affects outcome.
Available for document delivery

102524
The silent epidemic of our time the aging ‘baby boom’ generation has problems.
Colleran C.
From: Addiction Today: 15(87), 2004, p.22-23.
The relative isolation of older people, combined with symptoms of ill health which could be attributed to ageing, can mask alcohol or other drug dependency- but their recovery rate is higher than other age groups.
Available for document delivery

101260
Senior moments: assessing older adults.
Shulman J.
From: Addiction Today: 15(82), 2003, p.17-19.
The extent of alcohol, prescription and over-the-counter medication misuse among older adults has been greatly underestimated.
Available for document delivery

100782
Drug use among the elderly: an assessment of California’s need for prevention and treatment services.
US. California. Department of Alcohol and Drug Programs., University of California Los Angeles. Drug Abuse Research Center.
US: Los Angeles, Calif.: UCLA, 2000. vi, 150.
This is the report of a study that assessed the need for alcohol and other drug (AOD) prevention and treatment services for California’s elderly community. It defines “elderly” as 65 years and older. The study comprised a literature review; secondary analyses of several databases from general and special populations; and qualitative analyses based on focus groups and interviews with a diverse sample of elderly people.

99167 (Classification HM)
Group psychotherapy for elderly substance abusers.
Rathbone-McCuan E., Nelson R.
London: Haworth Medical, In: The group therapy of substance abuse. Brook D.W., Spitz H.I. (ed.) 2003. p.309-324.
ISBN 0789017822
The focus of this chapter is group treatment approaches applicable to older people who experience biological, psychosocial, and environmental factors that influence the development and continuation of substance use.
Available for document delivery

99151
Utilization of veterans’ health services for substance abuse: a study of aging baby boomer veterans.
Booth B.M., Blow F.C. US. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Office of Applied Studies.
In: Substance use by older adults: estimates of future impact on the treatment system. Korper S.P., Council C.L. (ed.) 2002. p.143-155.
Are there changes in veterans’ utilization of substance abuse services as they became older? The study used national Department of Veterans Affairs (VA) inpatient utilization data from fiscal years 1988, 1991, 1994 and 1998 and national outpatient data from fiscal year 1988. Conclusion: veteran substance abusers from the baby boomer generation continue to occupy the largest proportion of VA substance abuse services, and there is little evidence of declining need for treatment or “aging out” among this group of substance-using veterans.
Available for document delivery

98783
Alcohol and other drug use disorders among older-aged people.
Lynskey M.T., Day C., Hall W.
From: Drug and Alcohol Review: June, 22(2), 2003, p.125-133.
In Australia people aged 65 years or older currently comprise 12.1% of the population. This has been estimated to rise to 24.2% by 2051. Despite the age-related decline in the prevalence of substance use disorders, they do still occur among those aged 65 years or older and, given historical changes in exposure to and use of illicit drugs, it likely that the prevalence of these disorders among older-aged individuals will rise. Specific issues faced by older-aged individuals with alcohol and other drug use problems are discussed. These include: interactions with prescribed medications, under-recognition and treatment of alcohol and drug problems, unintentional injury and social isolation.
Available for document delivery

98759
Marginality among older injectors in today’s illicit drug culture: assessing the impact of ageing.
Anderson T.L., Levy J.A.,
From: Addiction: 98 (6), 2003, p.761-770.
This study highlighted the need to refine theoretical and practical understandings of what it means to be marginal and its consequences for older drug users and people in general. The results also point to what happens when society changes but some of its members do not.
Available for document delivery

98545 (Classification H)
Understanding the whole person: developmental issues in the patient-centered approach to substance abuse.
Cook J.D., Graham A.V.
Oxford: Radcliffe Medical, In: Substance abuse: a patient-centered approach. Floyd M.R., Seal J.P. (ed.) 2002. p.53-71.
ISBN 1857759125
This book chapter focuses on issues related to the patient’s stage in life, looking at differences in presentation of substance use disorder in adolescence, adulthood and the geriatric age-group. It also explores the patient’s life context, and how substance abuse is affected by the patient’s gender and cultural background.
Available for document delivery

Christine Goodair
Head of Information Services