Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut.
VA Connecticut Healthcare System, West Haven, Connecticut.
J Clin Psychiatry. 2022 Mar 28;83(3):21m13938. doi: 10.4088/JCP.21m13938.
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.
尽管老年人的物质使用障碍（SUD）正在增加，但关于最近治疗设施入院人数的增加以及相关患者和人群特征的记录却很少。我们使用全国范围内的治疗阶段数据集中的数据：2000-2001 年和 2016-2017 年 55 岁及以上成年人与 21-54 岁成年人相比，调查了 SUD 治疗设施的年度入院情况。使用双变量和多变量逻辑回归分析，研究了总人口中老年人数量的增加以及入院患者的社会人口学和临床特征对入院率的影响。从 2000 年到 2017 年，与 21-54 岁成年人相比，接受 SUD 治疗设施治疗的老年人数量增加了 203.7%。而普通人群中每 1000 名成年人的入院人数使这些差异有所缓和，分别为 98.4%和 7.2%。与年轻人相比，老年人因可卡因/快克（优势比 [OR]，5.35；95%置信区间 [CI]，5.20-5.51）和大麻（OR，1.81；95% CI，1.72-1.91）使用而入院的比例增加，而阿片类药物（OR，0.76；95% CI，0.73-0.80）和酒精（OR，0.79；95% CI，0.78-0.80）的入院比例相对减少，人口统计学方面也发生了一些变化。多变量分析显示，与年轻人相比，2016-2017 年与 2000-2001 年相比，老年人的入院优势比（OR）为 1.73（95%CI，1.65-1.80）。从 2000 年到 2017 年，接受 SUD 治疗设施治疗的老年人数量和比例大幅增加，这与人口数量和患者特征的变化有关，尤其是老年人可卡因/快克和大麻使用相对增加，以及酒精和阿片类药物使用相对减少。
