Duke University Medical Center, Durham, NC 27710, USA.
J Aging Health. 2011 Apr;23(3):481-504. doi: 10.1177/0898264310386224. Epub 2010 Nov 17.
Substance abuse among older adults is a looming public health concern. The number of Americans aged 50+ years with a substance use disorder is projected to double from 2.8 million in 2002-2006 to 5.7 million in 2020. The authors provide a review of epidemiological findings for this understudied area of research by focusing on illicit drug use disorders and nonmedical use of prescription drugs among adults aged 50+ years.
MEDLINE and PsychInfo were searched using keywords drug use, drug abuse, drug misuse, substance use disorder, and prescription drug abuse. Using the related-articles link, additional articles were screened for inclusion. This review included articles published between 1990 and 2010.
Rates of treatment admissions involving primary use of illicit and misuse of prescription drugs have increased, while rates involving primary use of alcohol only have decreased. Alcohol, opioids/heroin, and cocaine were more likely than other substances to be associated with treatment use. Limited research data suggested the effectiveness of treatments, especially for women. Furthermore, older adults appeared to be less likely than younger adults to perceive substance use as problematic or to use treatment services.
There is robust evidence showing that an increased number of older adults will need substance abuse care in the coming decades. Increasing demands on the substance abuse treatment system will require expansion of treatment facilities and development of effective service programs to address emerging needs of the aging drug-using population.
老年人药物滥用是一个迫在眉睫的公共卫生问题。预计年龄在 50 岁及以上、患有物质使用障碍的美国人数量将从 2002-2006 年的 280 万增加到 2020 年的 570 万。作者通过关注年龄在 50 岁及以上的成年人中非法药物使用障碍和非医疗用途处方药物,对这一研究相对较少的领域的流行病学研究结果进行了综述。
使用关键词“drug use”、“drug abuse”、“drug misuse”、“substance use disorder”和“prescription drug abuse”,在 MEDLINE 和 PsychInfo 上进行了搜索。使用“related-articles”链接,筛选了其他相关文章以供纳入。本综述纳入了 1990 年至 2010 年期间发表的文章。
涉及主要使用非法药物和误用处方药物的治疗入院率有所增加,而主要使用酒精的治疗入院率有所下降。酒精、阿片类药物/海洛因和可卡因比其他物质更有可能与治疗使用相关。有限的研究数据表明了治疗方法的有效性,特别是对女性而言。此外,与年轻人相比,老年人似乎不太可能将药物使用视为问题,也不太可能使用治疗服务。
有强有力的证据表明,在未来几十年,将有更多的老年人需要药物滥用护理。滥用物质治疗系统需求的增加将需要扩大治疗设施,并制定有效的服务计划,以满足不断增长的老年药物使用人群的新兴需求。