Department of Psychiatry (SY, LL, LT, PK), Yale University School of Medicine, New Haven, CT; Department of Psychiatry (SY, LT, PK), Veteran's Affairs Connecticut Healthcare System, West Haven, CT.
Department of Psychiatry (SY, LL, LT, PK), Yale University School of Medicine, New Haven, CT.
Am J Geriatr Psychiatry. 2020 Feb;28(2):226-236. doi: 10.1016/j.jagp.2019.06.005. Epub 2019 Jun 21.
Substance use disorders (SUDs) among older persons are among the fastest growing health problems in the United States. The number of older persons is projected to exceed 72.1 million persons by 2030, following a trend of general population growth in the mid-1940s to 1960s. The generation, known as "baby boomers," who refashioned drug use during their 20-30s, are increasingly continuing drug habits into later life. This review aims to assess the epidemiology, impact, and treatment of geriatric SUDs. Academic databases including PubMed, PsychInfo, Ovid, and Medline, were queried up to December 2018 for terms of "geriatric," "older," "elderly," "substance abuse," "drug," "drug use," "drug abuse," "drug dependency," "illicit drugs," and "geriatric psychiatry." Articles identified included 17 government documents, 29 studies based upon government documents, 43 studies not related to US government surveys, 19 review articles, 9 commentary pieces, 4 newspaper articles, 2 textbooks, and 1 published abstract. Evaluated studies and documents together suggest that older individuals are using illicit drugs and meeting criteria for SUDs at higher rates than previous geriatric cohorts resulting in substantial negative impacts on medical and psychiatric conditions. These findings represent a novel trend since previous cohorts of older individuals were thought to rarely use illicit substances. Current treatment models are inadequate to address the new wave of older individuals with SUDs. The fields of geriatrics, addiction, and geriatric psychiatry must work together to establish comprehensive care models and treatment modalities for addressing this emerging public health concern.
老年人的物质使用障碍（SUDs）是美国增长最快的健康问题之一。预计到 2030 年，老年人的数量将超过 7210 万人，这是自 20 世纪 40 年代中期到 60 年代中期人口普遍增长以来的趋势。被称为“婴儿潮一代”的一代人在 20 至 30 多岁时重塑了吸毒习惯，他们越来越多地将吸毒习惯延续到晚年。本综述旨在评估老年 SUD 的流行病学、影响和治疗。学术数据库包括 PubMed、PsychInfo、Ovid 和 Medline，截至 2018 年 12 月，使用了“老年”、“年长”、“老年人”、“物质滥用”、“药物”、“药物使用”、“药物滥用”、“药物依赖”、“非法药物”和“老年精神病学”等术语进行检索。确定的文章包括 17 份政府文件、29 份基于政府文件的研究、43 份与美国政府调查无关的研究、19 篇综述文章、9 篇评论文章、4 篇新闻文章、2 本教科书和 1 篇已发表的摘要。评估的研究和文件表明，与之前的老年群体相比，老年人使用非法药物和符合 SUD 标准的比率更高，这对医疗和精神状况造成了巨大的负面影响。这些发现代表了一种新趋势，因为以前的老年人群体被认为很少使用非法物质。当前的治疗模式不足以解决新一波患有 SUD 的老年人。老年学、成瘾和老年精神病学领域必须共同努力，为解决这一新兴的公共卫生问题建立全面的护理模式和治疗方式。
