Prevention, Diagnosis and Treatment
Substance Abuse Prevention, Screening and Identification, and Assessment for Older Adults
Frederic C. Blow, Ph.D.
There is a growing proportion of individuals in the United States who are near or in retirement, and a larger cohort of baby boomers who will reach late life in the coming decades. These cohorts may drink alcohol and abuse prescription and illicit drugs at higher levels than previously reported. They also may experience greater alcohol- and drug-related consequences related to the use of these substances. Although there is a paucity of research on effective prevention, screening, and assessment approaches for this rapidly growing and vulnerable population, research on these important issues is beginning to be conducted and reported in the scientific literature. Dr. Frederic Blow highlighted existing knowledge in substance abuse prevention and early identification, identified important gaps in our knowledge in these areas, and elucidated critical topics for future research.
Substance Abuse Treatment in the Elderly
Lawrence Schonfeld, Ph.D.
This presentation focused on treatment of older adults for alcohol abuse, prescription and over-the-counter medication misuse, and illicit substance use. Research studies describing treatment modalities used in the United States and Canada were presented by Dr. Lawrence Schonfeld. While alcohol
remains the most frequently abused substance, there are indications that illicit drug use in later years may increase as baby boomers age. Dr. Schonfeld discussed studies on mixed-age and elder-specific treatment approaches, as well as recommended treatment focus areas, such as teaching skills necessary to cope with depression and loneliness, enhancing social support and activities, and preventing relapse in older adults.
Medication misuse, an often unintentional occurrence, was discussed in terms of patients’ knowledge and providers’ education. Florida BRITE, a pilot project funded by the State of Florida’s Substance Abuse Program Office, also was highlighted. BRITE involves the implementation and evaluation of screening, brief intervention, and brief treatment approaches for older adults residing in three counties. This recently initiated project offers several sessions of brief intervention to those who screen positive, or if more intensive treatment is required, cognitive-behavioral/self-management approaches.
Drug and Alcohol Treatment Outcomes in Older Adults
Derek D. Satre, Ph.D.
The adverse consequences of drug and alcohol problems in older adults are substantial. However, treatment research in this population has been very limited.
Studies including women and privately insured individuals have been especially lacking. To help address these research gaps, this presentation summarizes the results of recent studies conducted by the Drug and Alcohol Research Team at the Kaiser Permanente Division of Research in an outpatient Kaiser Chemical Dependency Recovery Program.
Three treatment outcome studies analyzed individual, treatment, and extra-treatment factors that may influence outcomes. These studies investigated baseline clinical characteristics, as well as 6-month and 5-year outcomes of older adults (aged 55 and over) compared with middle-aged adults (aged 40 to 54) and younger adults (aged 18 to 39), including gender differences and social networks. Kaiser automated health plan records were used to identify medical conditions of patients in treatment and age group differences in health service utilization and cost. The findings will contribute to understanding the service needs of older adults in treatment, factors associated with positive treatment outcomes, and the effects of drug and alcohol treatment on other aspects of health care.