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Anthony Adams
Anthony Adams

Baby Boomers And Substance Abuse Recovery



The implications are important for the substance abuse field, since there are 50 million people over age 65 in the United States, and people over 70 are the fastest growing group in the nation, he says. Despite the relatively common occurrence of substance use issues in baby boomers, health care providers often overlook them, Dr. Oslin observes. He adds that doctors and other health care professionals should routinely screen for and consider substance use when caring for older adults.




Baby Boomers and Substance Abuse Recovery



The rate of illicit drug use among baby boomers has been higher than those of older generations, Dr. Oslin noted at the recent California Society of Addiction Medicine meeting. Baby boomers, particularly those born after 1950, had much higher rates of illicit drug use as teenagers and young adults than people born in earlier years.


In 1990, the oldest baby boomers began reaching age 45. Since then, a dramatic increase in rates of boomers alcohol and drug abuse has been seen, hospitalizations due to drug and/or alcohol abuse and overdoses. More older adults die from overdoses than influenza or pneumonia, and the rate of accidental overdoses among this generation is higher than that of people between ages 25-44 for the first time in history. The most commonly abused boomers drugs include marijuana, heroin, prescription opioids and alcohol.[6]


Another explanation for the emergence of the baby boomers drug abuse problem may also be related to the realities of aging. The combination of loneliness, chronic conditions, depression and excess free-time may be leading older adults to abuse drugs and alcohol at higher levels. One in four older adults struggles with mental illness. The total number is expected to reach 15 million by 2030.[11] A Duke University study that surveyed 11,000 people over the age of 50 found a correlation between being separated, divorced or widowed and binge drinking.[12]


Typically, when a patient enters addiction treatment, horror stories about how substance abuse has ruined lives is enough to make him or her want to change. However, this strategy does not work as well with baby boomers because they grew up in an era that glorified substance abuse. Many of their friends have used marijuana and drank alcohol while seemingly living successful lives. For every story an addiction care expert has about the dangers of boomers drug use, baby boomers have several others about people they know who do boomers drugs regularly and are successful in their professional lives.


Perhaps the largest obstacle for baby boomers in the treatment of substance abuse is misdiagnosis. The signs of alcoholism and drug addiction are often overlooked in older adults because of hurried doctor visits and the fact that symptoms of substance use disorders often mimic symptoms from other medical and behavioral conditions.[14]


While most people typically associate drug abuse and addiction, the rate of abuse among baby boomers is quite alarming. Baby boomers were born during a time where drugs were a cultural norm and the risks were not well know. This type of behavior left many individuals addicted to drugs and still in need of treatment.


To complicate matters, the attitudes of family members or a lack of regular communication with family can result in a lack of pursuance of treatment for drug dependency among the baby boomer generation. These attitudes also serve as one barrier in access to treatment for or diagnosis with a substance use disorder.


Baby boomers who have previously been surrounded by children and a spouse are facing an empty household and in some cases the loss of a spouse. Social isolation may result in these dynamics shift. The number of baby boomers who are unmarried or who live alone is growing.


Today, more than 33 percent are in the unmarried category. This tends to put baby boomers in a higher risk category for addiction as this same subgroup is both twice as likely to have a disability as their married counterparts, and more likely to be uninsured. Chronic pain is also more common in an aging population, regardless of marital status, though is underdiagnosed or less likely to be treated in the unmarried baby boomer population.


Detoxification and treatment among Boomers can sometimes be a slower process based on long-term substance abuse and/or serious medical and co-occurring disorders. Due to these challenges, the average length of stay in the Center for Boomer Recovery is 60 to 90 days. After a stabilizing detoxification and assessment, patients participate with their multidisciplinary treatment team in the development of a holistic treatment plan, setting realistic and achievable goals for their recovery. This is a process, not a quick fix, but clients will find the support they need from peers and our highly skilled and credentialed professional team.


Often it is the adult children of substance abusers who are questioning and confronting the disturbing habits and seeking out treatment information for their parents. Thus information and support directed at children on how to help or deal their addict parents will also be needed in coming years.


If an addict is committed to practicing an addiction and refuses to seek help, there is often little that spouses, children, and/or grandchildren can do to make recovery a reality. However, all attempts and possible solutions should be exhausted. The coming years promise to bring new pathways and solutions in treatment and recovery with the aim of providing hope to baby boomers who suffer from addiction.


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.


Even as the number of older adults with substance abuse is on the rise, substance abuse is often undetected and undertreated in this population [15, 16]. Due to the stigma attached to substance abuse, elderly patients may not report this issue [17, 18]. Therefore, the true prevalence of substance abuse in this population remains unknown. In addition, providers are often too busy or may confuse the symptoms of substance abuse disorders with other co-morbidities, age-related changes or reactions to stressful life situations [17, 19]. Number of co-morbidities increase with age and presence of substance abuse can lead to worsening of medical consequences and outcomes of care [19]. Of the total spending for substance abuse disorder treatments, a substantial share is borne by public sources: Medicare, Medicaid, local, state and federal governments. For example, in 2009, 69% of spending on substance abuse treatment came from public sources [20]. One study reported that compared to younger adults, the proportion of older adults seeking treatment for illicit drugs abuse for the first time is on the rise [2].


We used the Treatment Episode Data Set - Admissions (TEDS-A), an administrative public use data system that is maintained and sponsored by the Center for Behavioral Health Statistics and Quality at the Substance Abuse and Mental Health Services Administration (SAMHSA) [24]. All public and private substance abuse treatment facilities that receive public funds are required to report the information about annual flow of admissions via state funding agency to TEDS-A. In TEDS-A, the unit is analysis is an admission. This database also includes information on demographic characteristics (age, race, gender, employment, education, pregnancy, veteran status, health insurance), substance abuse behavior (type of substance, mode of use, frequency of usage, age at first use), treatment characteristics (referral source, prior treatment, service setting), geographic information (region, division), and presence of psychiatric diagnosis at each admission.


Our analysis included all admissions to the publically funded substance abuse treatment programs between 2000 and 2012 for persons who were aged 55 years or older at the time of admission. The unit of analysis is an admission and a person can have multiple admissions in a year. However, it is not possible to identify an individual person and thus dependence of observations cannot be adjusted for. Given the large sample size, a stringent criteria of p


In addition to demographic characteristics, substance characteristics, including the number of substances abused at the time of admission, service treatment setting, referral source, number of prior treatment admission episodes, and use medication assisted therapy were analyzed for cohorts of older adult admissions. Finally, we analyzed the trend in type of substance abuse, and age at first initiation for those with no prior treatment admissions vs. those with at least one prior treatment admission.


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