Treatment Needs and Service Utilization in Older U.S. Adults Evidencing High-Risk Substance Use

• Published in: Journal of aging and health 2020-12, Vol.32 (10), p.1363-1375
• Main Authors: Fairman, Kathleen A., Early, Nicole K.
• Format: Article
• Language: English
• Subjects: Aged; Alcohol abuse; Drug use; Facilities and Services Utilization - statistics & numerical data; Female; Health Services Needs and Demand - statistics & numerical data; Health Surveys; Health technology assessment; Humans; Male; Middle Aged; Prescription drugs; Psychological Distress; Retrospective Studies; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Substance-Related Disorders - therapy; United States - epidemiology
• ISSN: 0898-2643; 1552-6887
• DOI: 10.1177/0898264320929537

Objectives: Because substance misuse by older adults poses clinical risks and has not been recently assessed, we examined substance use patterns, treatment needs, and service utilization in those evidencing high-risk use. Methods: We identified National Survey on Drug Use and Health respondents (2015–2018) aged ≥50 years reporting multiple-occasion binge drinking, illicit drug use, prescription drug misuse, or substance dependence. Past-year psychological symptoms were assessed using validated scales. Results: The sample, representing 10.2% of community-dwelling older U.S. adults, evidenced clinically important risks: 65.2% past-month binge drinking, 27.3% mental illness, 14.3% psychological distress, 10.6% combined alcohol/drug use, and 6.5% suicidality. Treatment receipt was uncommon (27.7%), positively associated with distress, and negatively associated with binge drinking. Of those not receiving treatment, 3.8% perceived treatment need. Discussion: Findings highlight the value of substance misuse screening and brief interventions, suggesting potential treatment referral opportunities for those evidencing psychological distress.