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Oldies but Goodies

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In 2000, the population of adults 65 & older in the United States was around 35 million. ... New York, NY: The Guilford Press. U.S. Census Bureau (2004, March 18) ... – PowerPoint PPT presentation

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Title: Oldies but Goodies


1
Oldies but Goodies
  • A brief look into the life of the elderly dealing
    with addiction

2
Baby Boomers
  • In 2000, the population of adults 65 older in
    the United States was around 35 million. That
    number is expected to increase to over 86 million
    by the year 2050. (Bureau of the Census, 2004)
  • In 2005, 76 of substance abuse treatment
    admissions for adults 65 and older were males,
    while 24 of admissions were females
  • (SAMSHA, 2007)
  • It is estimated that the number of older adults
    with substance abuse problems will increase from
    2.5 million in 1999 to 5 million in 2020.
    (Gfroerer et al. 2008)
  • In 2005, older adults aged 65 to 69 made up the
    largest part of the substance abuse treatment
    population aged 65 and older (SAMSHA, 2007)

3
Age As A Factor
  • 3 age groups
  • Young-old (60-74)
  • Old-old(75-84)
  • Oldest-old(85)
  • Factors that affect use in these groups
  • Social Changes
  • Age-related changes
  • Grief Loss

4
Illicit Drug Use Among Older Adults
  • In 2000, an estimated 568,000 persons aged 55 or
    older had used illicit drugs in the past month
    (1 of the population of older adults)
  • Most common were psychotherapeutics used
    nonmedically and marijuana (The NHSDA Report,
    2001)
  • According to Gfroerer et al. (2008)
  • Rates of problematic illicit drug use have been
    shown to decline with increasing age.
  • Cohorts that experience high rates of illicit
    drug use in youth have subsequently shown higher
    rates of use and associated problems as they age.

5
Alcohol Abuse
  • Range of Rates in Alcohol Abuse Among Older
    Adults
  • 3 to 25 for heavy alcohol use
  • 2.2 to 9.6 for alcohol abuse (Straussner,
    2004)
  • Alcohol abuse was the most frequently reported
    primary substance of abuse among older adults
    each year from 1995 to 2005
  • (SAMHSA, 2007)

6
Recommendations
  • Recommended
  • 1 alcoholic drink a day is the limit for anyone
    over the age of 65 who has not been diagnosed
    with a drinking problem (12 ounces of beer, 1.5
    ounces of distilled spirits, or 5 ounces of wine)

7
Signals that may indicate an alcohol or
medication-related problem
  • Memory trouble after having a drink or taking
    medicine
  • Loss of coordination (walking unsteadily,
    frequent falls)
  • Changes in sleeping habits
  • Unexplained bruises
  • Being unsure of yourself
  • Irritability, sadness, depression
  • Unexplained chronic pain

8
Signals that may indicate an alcohol or
medication-related problem (CONTD)
  • Changes in eating habits
  • Wanting to stay alone a lot of the time
  • Failing to bathe or keep clean
  • Having trouble finishing sentences
  • Having trouble concentrating
  • Difficulty staying in touch with family or
    friends
  • Lack of interest in usual activities

9
Reasons for Misuse of Medications
  • Difficulties reading and following prescription
  • Cognitive deficits
  • Cost
  • Complexity of drug treatment

10
Prescription Drug Use
  • Admissions into treatment facilities for abuse of
    opiates in adults 65 and older increased from 6.6
    to 10.5 between 1995 and 2005.
  • (SAMSHA, 2007)
  • According to Patterson, 2005
  • Approximately 30 percent of prescriptions are
    consumed by adults over age 65, and 15 billion
    is spent each year by older adults on those
    prescriptions
  • While we are unsure of the number of older adults
    addicted to prescription drugs, in 1999 nearly
    7.2 million older adults were medically exposed
    to prescription drugs with addictive potential.

11
Types of Misuse
  • Over dose
  • Under dose
  • Use for other than prescribed
  • Drug combinations

12
Factors associated with abuse
  • Genetics
  • Stress
  • Depression
  • Co-morbidities
  • Metabolism
  • Structural Problems
  • Research not consider aged
  • Dosage one size fits all

13
Onset Patterns of Substance Abuse
  • Early onset
  • People who have lived with substance abuse
    problems throughout adulthood
  • Late onset
  • History of substance abuse after midlife
  • Intermittent substance abuse
  • Problems with abuse occurred earlier in life and
    ended in recover, however, the abuse is present
    again in late life

14
Treatment Issues
  • Ageism
  • Stigma
  • Misdiagnosis
  • Lack of Inquiry by the helping professional
  • Indicators of abuse differ in this population

15
Screening
  • Prescription Misuse
  • The Solano County Senior Medication Education
    Project Noncompliance Screening Form
  • 21 Question Screening form that covers a variety
    of issues that may lead to problems of
    overmedication or undermedication in elderly
    people. (Straussner, 2004)

16
Screening (CONTD)
  • Alcohol Abuse
  • CAGE
  • Cut down, Annoyed, Guilt, Eye Opener
  • HEAT
  • Asks open-ended questions that promote discussion
    of reasons behind use
  • CHARMM
  • Pattern of use, role of alcohol, problem
    interactions with Meds
  • MAST-G
  • Inquires about alcohol use as a coping mechanism
    for loneliness and lack of sleep

17
Therapeutic Implications
  • Inquire about the older adults feelings regarding
    substance use and abuse
  • Build rapport
  • Clear and concise, Non stigmatizing questions
  • Provide a safe, private environment
  • Client education on substance abuse
  • Consideration of spirituality
  • 2 Cs Competence Caring

18
Assessment
  • Assessment that considers age related health and
    mental health problems
  • Consideration of factor such as Alzheimers
    Disease, Dementia, or depression
  • Consideration of past experiences that could have
    affected abuse
  • Family history
  • Support systems
  • Etc.

19
Community Resources
  • Substance Abuse
  • http//dasis3.samhsa.gov/PrxInput.aspx?STATEGeorg
    ia
  • Opioid Dependency Treatment
  • http//dpt2.samhsa.gov/treatment/

20
References
  • Substance Abuse and Mental Health Services
    Administration (2008, April    8). Find
    Treatment. Retrieved July 10, 2008 from SAMHSA, 
      U.S. Department of Health and Human Services
    Web site    http//www.samhsa.gov/treatment/inde
    x.aspxsa
  • Benshoff, J.J., Harrawood, L.K., Koch, D.S.
    (2003). Substance abuse and    the elderly
    unique issues and concerns. Journal of
    Rehabilitation
  • Drug and Alcohol Services Information System
    (2007, May 31). Adults    Aged 65 or Older in
    Substance Abuse Treatment 2005. Retrieved   
    July 10, 2008 from SAMHSA, Office of Applied
    Studies Web site    http//www.drugabusestatisti
    cs.samhsa.gov/2k7/olderTX/olderTX.pd
  • Gfroerer, J.C., Penne M.A., Pemberton, M.R.,
    Folson, R.E. (2008, June    16). The Aging Baby
    Boom Cohort and Future Prevalence of   
    Substance Abuse. Retrieved July 9, 2008 from
    SAMHSA, U.S.    Department of Health and Human
    Services Web site  http//www.drugabusestatistic
    s.samhsa.gov/aging/chap5.htm  

21
References CONTD
  • Patterson, T.L., PhD (2005, March 9).
    Prescription Drugs and Drug    Interactions.
    Retrieved July 8, 2008 from , National
    Institute    on Drug Abuse Web site   
    http//www.drugabuse.gov/whatsnew/meetings/bbsr/pr
    escription.html
  • Substance Abuse and Mental Health Services
    Administration (2008, April    8). Find
    Treatment. Retrieved July 10, 2008 from SAMHSA, 
      U.S. Department of Health and Human Services
    Web site    http//www.samhsa.gov/treatment/inde
    x.aspxsa
  • SAMHSA (2001, November 3). Substance Use Among
    Older Adults.    Retrieved July 9, 2008 from
    Office of Applied Studies Web site   
    http//www.oas.samhsa.gov/2k1/olderadults/olderadu
    lts.htm
  • Straussner, L.A. (2004). Clinical Work with
    Substance-Abusing    Clients (Second Edition).
    New York, NY The Guilford Press.
  • U.S. Census Bureau (2004, March 18). U.S. Interim
    projections by    Age, Sex, Race, and Hispanic
    Origin. Retrieved July 9, 2008    from , U.S.
    Census Bureau Web site http//www.census.gov/ip
    c/www/usinterimproj/natprojtab02a.pdf
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