Chhatre Sumedha, Cook Ratna, Mallik Eshita, Jayadevappa Ravishankar
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4051, Philadelphia, Pennsylvania, 19104, USA.
Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
BMC Health Serv Res. 2017 Aug 22;17(1):584. doi: 10.1186/s12913-017-2538-z.
Substance abuse is a growing, but mostly silent, epidemic among older adults. We sought to analyze the trends in admissions for substance abuse treatment among older adults (aged 55 and older).
Treatment Episode Data Set - Admissions (TEDS-A) for period between 2000 and 2012 was used. The trends in admission for primary substances, demographic attributes, characteristics of substance abused and type of admission were analyzed.
While total number of substance abuse treatment admissions between 2000 and 2012 changed slightly, proportion attributable to older adults increased from 3.4% to 7.0%. Substantial changes in the demographic, substance use pattern, and treatment characteristics for the older adult admissions were noted. Majority of the admissions were for alcohol as the primary substance. However there was a decreasing trend in this proportion (77% to 64%). The proportion of admissions for following primary substances showed increase: cocaine/crack, marijuana/hashish, heroin, non-prescription methadone, and other opiates and synthetics. Also, admissions for older adults increased between 2000 and 2012 for African Americans (21% to 28%), females (20% to 24%), high school graduates (63% to 75%), homeless (15% to 19%), unemployed (77% to 84%), and those with psychiatric problems (17% to 32%).The proportion of admissions with prior history of substance abuse treatment increased from 39% to 46% and there was an increase in the admissions where more than one problem substance was reported. Ambulatory setting continued to be the most frequent treatment setting, and individual (including self-referral) was the most common referral source. The use of medication assisted therapy remained low over the years (7% - 9%).
The changing demographic and substance use pattern of older adults implies that a wide array of psychological, social, and physiological needs will arise. Integrated, multidisciplinary and tailored policies for prevention and treatment are necessary to address the growing epidemic of substance abuse in older adults.
药物滥用在老年人中呈增长态势，但大多悄无声息。我们试图分析老年人（55岁及以上）药物滥用治疗入院情况的趋势。
使用2000年至2012年期间的治疗事件数据集 - 入院情况（TEDS - A）。分析了主要药物入院趋势、人口统计学特征、药物滥用特征及入院类型。
2000年至2012年期间，药物滥用治疗入院总数略有变化，但老年人所占比例从3.4%增至7.0%。注意到老年人入院的人口统计学、药物使用模式及治疗特征发生了显著变化。多数入院是因为酒精作为主要药物。然而，这一比例呈下降趋势（从77%降至64%）。以下主要药物的入院比例有所上升：可卡因/快克、大麻/哈希什、海洛因、非处方美沙酮以及其他阿片类药物和合成药物。此外，2000年至2012年期间，非裔美国人（从21%增至28%）、女性（从20%增至24%）、高中毕业生（从63%增至75%）、无家可归者（从15%增至19%）、失业者（从77%增至84%）以及有精神问题者（从17%增至32%）的老年人入院人数增加。有药物滥用治疗既往史的入院比例从39%增至46%，报告有不止一种问题药物的入院人数也有所增加。门诊仍是最常见的治疗场所，个人（包括自我转诊）是最常见的转诊来源。多年来药物辅助治疗的使用率一直较低（7% - 9%）。
老年人不断变化的人口统计学和药物使用模式意味着将出现一系列广泛的心理、社会和生理需求。需要综合、多学科且量身定制的预防和治疗政策来应对老年人中日益严重的药物滥用问题。
