Substance Use Among Older Adults: Current Prevalence and Future Expectations
Joseph C. Gfroerer
Although substance abuse has historically been concentrated primarily among youths and young adults, there is increasing concern about the problem in older adults. With the aging of the baby boomer cohort, the older adult population will soon comprise a large proportion of persons who have used marijuana and other illicit drugs in their lifetimes.
Combined with the fact that the baby boomer cohort is larger than prior cohorts, we should expect to see substantial increases in the number of older adults with substance use problems in the next two decades. Joseph Gfroerer used the most recent data from the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health (NSDUH) and Treatment Episode Data Set to present current patterns and prevalence and recent trends in alcohol and illicit drug use and treatment among persons age 50 and older in the United States. He also presented the estimated prevalence of substance use problems among older adults in 2020, based on a statistical model that merges NSDUH data with U.S. Census population projections.
Long-Term Trajectory of Substance Abuse and Psychiatric Comorbidity: Vietnam Era Study
Rumi Kato Price, Ph.D.
The study sample for this presentation was a cohort of 1,227 nonofficer Army men who returned from their Vietnam duty in September 1971, including drug-positive (D+) veterans (a probability sample of those who tested positive after urinalysis in 1971, n=512); drug-negative (D–) veterans (a probability sample of all returnees, n=431); and nonveteran controls (a sample from Selective Service registration lists who were individually matched to those in the second sample, n=284).
The presentation addressed four questions: (1) What is the trajectory of drug use and abuse among male baby boomers at risk of continuous drug use and psychiatric problems? (2) What are the predictors for continuation of, or remission from, drug abuse? (3) How have drug use and abuse affected other areas of baby boomers’ lives over 30 years? (4) What are the emerging patterns of drug use and abuse when baby boomer drug users reach middle age? The presentation concluded with assessments of the
ways in which youthful drug use and abuse were harmful for baby boomers up to their mid-lives, resiliency factors for continuous drug use, potential intervention and prevention areas to promote remission from drug abuse or to minimize harm of continuous drug use, and readiness of the current health care system for baby boomers with a history of youthful drug abuse. Although the study cohort is unique, the results can be generalized to male baby boomers with war experience, who currently constitute over 20 percent of the U.S. male population aged 40 to 60.
Continuity in Substance Use Problems Among Baby Boomers in the National Comorbidity Survey Replication
Ronald C. Kessler, Ph.D.
Slides not available.
Dr. Ronald Kessler’s presentation covered continuity in substance use problems among baby boomers, using data from the National Comorbidity Survey (NCS), the NCS Replication Survey (NCSR), and the NCS Panel Survey (NCS2). The NCS, a nationally representative survey of substance use and mental disorders, was carried out from 1990 to 1992 to assess the prevalence and correlates of DSM-III-R disorders. The NCS2 is a re-interview survey of the original NCS respondents a decade after the baseline survey. NCSR is a replication of the NCS in a new sample of respondents; comparison of NCS and NCSR data is used to study aggregate trends in substance use disorders. Using these data, Dr. Kessler examined intercohort differences among baby boomers, such as baseline predictors of lifetime alcohol, nicotine, and illicit drug use disorders and speed of recovery (publication pending).
Use of Medications, Alcohol, and Smoking in Elderly Japanese-American Men in Hawaii:
A Report From the Honolulu-Asia Aging Study (HAAS)
Lon R. White, M.D.
The Honolulu-Asia Aging Study is an ongoing population-based investigation with a conceptual focus on neurodegenerative diseases and stroke. It utilizes the cohort and accrued data of the Honolulu Heart Program, which began in 1965 with the interview and examination of 8,006 Japanese-American men who were born between 1900 and 1919 and living on Oahu. Information on smoking and alcohol intake has been collected at eight examination cycles between that time and today. Information on use of all medications as well as use of traditional medical treatment (including herbals) has been collected at three exam cycles since 1991. While alcohol intake declined as the men became older, it did remain a significant health problem in a small number of the participants. Data were presented on the prevalence and correlates of mid- and late-life alcohol intake, and on the use of specific medications, multiple medications, over-the-counter medications, and herbals.