Increased Admissions of Older Adults to Substance Use Treatment Facilities and Associated Changes in Admission Characteristics, 2000-2017.

Although substance use disorder (SUD) among older adults is increasing, little has been documented about recent increases in admissions to treatment facilities and associated patient and population characteristics. We used nationwide data from the Treatment Episode Data Set: Admissions to examine annual admissions to SUD treatment facilities between 2000-2001 and 2016-2017 among adults 55 years and older compared to those aged 21 to 54. Analyses addressed the impact on admission rates of increases in the general older adult population and in sociodemographic and clinical characteristics of those admitted using bivariate and multivariate logistic regressions. From 2000 to 2017, the number of older adults admitted to SUD treatment facilities increased by 203.7% as compared to 13.0% among younger adults. Admissions per 1,000 adults in the general population moderated these differences to 98.4% vs 7.2%. Older adults showed greater increases relative to younger adults in proportions admitted for cocaine/crack (odds ratio [OR], 5.35; 95% confidence interval [CI], 5.20-5.51) and cannabis (OR, 1.81; 95% CI, 1.72-1.91) use and a relative decrease in admission for opiates (OR, 0.76; 95% CI, 0.73-0.80) and alcohol (OR, 0.79; 95% CI, 0.78-0.80) along with changes in some demographics. Multivariate analysis showed that the OR for admission among older adults, as compared to younger adults, was 1.73 (95% CI, 1.65-1.80) in 2016-2017 compared to 2000-2001, adjusting for other factors. The number and proportion of older adults admitted to SUD treatment facilities increased substantially from 2000 to 2017 and were associated with changes in both population numbers and patient characteristics, especially a relative increase among older adults in cocaine/crack and cannabis use and a relative decrease for use of alcohol and opioids.