Lintzeris Nicholas, Rivas Consuelo, Monds Lauren A, Leung Stefanie, Withall Adrienne, Draper Brian
Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.
Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
Drug Alcohol Rev. 2016 Mar;35(2):223-31. doi: 10.1111/dar.12266. Epub 2015 Oct 26.
The number of older clients attending drug and alcohol (D&A) services is increasing, although there is insufficient knowledge regarding service needs for this group. The aim of this study was to document the patterns of substance use, health status, cognition, social conditions, and health service utilisation of older clients in D&A treatment.
A cross-sectional observational study of 99 clients aged ≥50 years (M = 55, SD = 4.5; 77% male) attending specialist D&A services (N = 30 alcohol treatment, N = 69 opioid treatment) in Sydney, Australia. Participants completed a confidential research interview. Findings were compared to aggregated data from younger opioid substitution treatment (OST) clients attending the same services (N = 214).
Alcohol (46%), benzodiazepines (40%) and cannabis (38%) were the most commonly reported substances used in the past 4 weeks; 23% reported no recent substance use, and 17% reported using three or more drugs. Participants reported high levels of physical and mental health problems, social isolation, low levels of employment, and a third reported difficulties with daily living activities. Forty percent had been injured in a fall in the past 12 months. The mean Addenbrooke's Cognitive Examination-R score was 82.4 ± 9.6, with 40% performing at a level consistent with severe cognitive impairment. A significantly higher proportion of older participants used alcohol and benzodiazepines than younger clients, and older participants had significantly poorer psychological health, physical health and quality of life.
D&A services will require strategies to address the complex physical, mental, cognitive and social problems of older clients.
尽管对药物和酒精（D&A）服务中老年客户的需求了解不足，但寻求此类服务的老年客户数量正在增加。本研究的目的是记录接受D&A治疗的老年客户的物质使用模式、健康状况、认知能力、社会状况以及医疗服务利用情况。
对澳大利亚悉尼99名年龄≥50岁（平均年龄M = 55岁，标准差SD = 4.5岁；77%为男性）的客户进行了横断面观察研究，这些客户接受专科D&A服务（N = 30名酒精治疗客户，N = 69名阿片类药物治疗客户）。参与者完成了一次保密的研究访谈。研究结果与来自接受相同服务的年轻阿片类药物替代治疗（OST）客户的汇总数据（N = 214）进行了比较。
在过去4周内，酒精（46%）、苯二氮䓬类药物（40%）和大麻（38%）是最常被报告使用的物质；23%的人报告近期未使用任何物质，17%的人报告使用三种或更多药物。参与者报告存在高水平的身心健康问题、社会隔离、低就业率，三分之一的人报告日常生活活动存在困难。40%的人在过去12个月内因跌倒受伤。Addenbrooke认知检查-R评分的平均值为82.4 ± 9.6，40%的人表现水平与严重认知障碍相符。老年参与者使用酒精和苯二氮䓬类药物的比例明显高于年轻客户，且老年参与者的心理健康、身体健康和生活质量明显较差。
D&A服务需要制定策略来解决老年客户复杂的身体、心理、认知和社会问题。
