Substance Use among Older Adults Age 50 Current

Substance Use among Older Adults (Age 50+): Current Prevalence and Future Expectations Presented by Joe Gfroerer U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Office of Applied Studies

National Survey on Drug Use and Health (NSDUH) • Representative of U. S. and each State • Civilian, noninstitutionalized population • Age 12 or older • Anonymous face-to-face interview • Computer-assisted self-interviewing • 67, 500 respondents each year • 5, 980 respondents age 50+ in 2003 (population 81 million) 2

Patterns of Substance Use 3

Past Month Substance Use: Age 50+, 2003 Alcohol Use 44% (36 million) Binge Alcohol Use 12% (10 million) Tobacco Use 21% (17 million) Illicit Drug Use 2% (1. 4 million) (No statistically significant [. 05 level] changes from 2002. ) 4

Illicit Drug Use, by Age: 2003 Percent Using in Past Month Age 50+ 12 -13 14 -15 16 -17 18 -20 21 -25 26 -29 30 -34 35 -39 40 -44 45 -49 50 -54 55 -59 60 -64 65+ Age in Years 5

Use of Selected Illicit Drugs: Age 50+, 2002 -2003 Annual Averages Percent Using in Past Month Any Drug Marijuana Prescription Cocaine Drug Nonmedically Hallucinogen 6

Nonmedical Prescription Drug Use: NSDUH Definition “Not prescribed for you” OR “You took the drug only for the experience or feeling it caused” (Excludes OTC) 7

Types of Drugs Used by Past Month Illicit Drug Users: Age 50+, 2002 -2003 Annual Averages Other Prescription Drugs Only Marijuana and Prescription Drugs 1. 4 Million Illicit Drug Users (1. 8%) 8

Types of Drugs Used by Past Month Illicit Drug Users: Age 12 to 49 and 50+, 2002 -2003 Annual Averages Percent of Current Users All Other Marijuana & Prescription Drugs Only Marijuana Only Age 12 to 49 Age 50+ 9

Marijuana and Prescription Drug (Nonmedical) Use, by Gender: Age 50+, 2002 -2003 Annual Averages Percent Using in Past Month Male Female Marijuana Prescription Drug Nonmedically Note: Difference between male and female rates is statistically significant (. 05 level) for marijuana, not prescription drugs. 10

Marijuana and Prescription Drug (Nonmedical) Use, by Gender: Age 12 to 17, 2003 Percent Using in Past Month Male Female Marijuana Prescription Drug Nonmedically Note: Difference between male and female rates is statistically significant (. 05 level) for marijuana, not prescription drugs. 11

Illicit Drug Use, by County Type: Age 50+, 2002 -2003 Annual Averages Percent Using in Past Month Large Metro Small Metro Note: No statistically significant differences (. 05 level). Nonmetro 12

Illicit Drug Use, by Race/Ethnicity: Age 50+, 2002 -2003 Annual Averages Percent Using in Past Month White Black or African American Note: No statistically significant differences (. 05 level). Hispanic or Latino 13

Past Year Illicit Drug Use, by Serious Mental Illness: Age 50+, 2002 -2003 Annual Averages Percent Using in Past Year Serious Mental Illness Note: Difference is statistically significant (. 05 level). No Serious Mental Illness 14

Substance Dependence, Abuse, and Treatment Need (DSM-IV, Past Year) 15

Illicit Drug or Alcohol Dependence or Abuse, by Age: 2003 Percent Dependent or Abusing in Past Year Age 50+ 12 -13 14 -15 16 -17 18 -20 21 -25 26 -29 30 -34 35 -39 40 -44 45 -49 50 -54 55 -59 60 -64 65+ Age in Years 16

Substance Dependence or Abuse: Age 50+, 2003 Total 2. 5 million (3. 0%) Alcohol Only 2. 2 million (90%) Illicit Drug Only 169, 000 (7%) Both Drugs and Alcohol 73, 000 (3%) (No statistically significant [. 05 level] changes from 2002. ) 17

Alcohol and Illicit Drug Dependence or Abuse, as a Percentage of Total Substance Dependence or Abuse, by Age: 2003 Percent of Substance Dependence/Abuse Alcohol Only Illicit Drug Age 12 to 25 Age 26 to 49 Age 50+ 18

Dependence or Abuse of Illicit Drugs: Age 50+, 2002 -2003 Annual Averages Number (in Thousands) 19

Substance Dependence or Abuse, by Gender: Age 50+, 2002 -2003 Annual Averages Percent Dependent or Abusing in Past Year Male Note: Difference is statistically significant (. 05 level). Female 20

Substance Dependence or Abuse, by County Type: Age 50+, 2002 -2003 Annual Averages Percent Dependent or Abusing in Past Year Large Metro Small Metro Note: No statistically significant differences (. 05 level). Nonmetro 21

Substance Dependence or Abuse, by Race/Ethnicity: Age 50+, 2002 -2003 Annual Averages Percent Dependent or Abusing in Past Year White Black or African American Note: No statistically significant differences (. 05 level). Hispanic or Latino 22

Treatment Need and Specialty Treatment for Alcohol or Drug Abuse: Age 50+, 2002 -2003 Annual Averages Did Not Receive Treatment and Felt No Need for Treatment 8. 6% 85. 0% 6. 5% Received Treatment Did Not Receive Treatment and Felt Need for Treatment (44% Made Effort) 2. 6 Million with Treatment Need (Based on DSM-IV) 23

Expected Future Trends in Substance Use among Older Adults 24

Alcohol or Illicit Drug Dependence or Abuse, by Lifetime Use of Illicit Drugs: Age 50+, 2003 Percent Dependent or Abusing in Past Year Used Illicit Drugs in Lifetime Note: Difference is statistically significant (. 05 level). Never Used Illicit Drugs 25

Lifetime Use of Illicit Drugs, by Year of Birth: 2002 -2003 Annual Averages Percent Ever Used Baby Boom Cohort (Born 1946 -64) 26

Illicit Drug Dependence or Abuse, by Age of First Marijuana Use: Lifetime Marijuana Users Age 50+, 2002 -2003 Annual Averages Percent Dependent or Abusing in Past Year First Use Before Age 18 Note: Difference is statistically significant (. 05 level). First Use at Age 18 or Older 27

Average Age of First Use of Marijuana among Lifetime Marijuana Users, by Year of Birth: 2002 -2003 Annual Averages Avg. Age of First Use Baby Boom Cohort (Born 1946 -64) 28

Substance Dependence or Abuse: Age 50+, 2000/2001 and 2020 2000/2001 2020 % Increase Population 75 m 112 m 50% % Dep/Ab 2. 3% 3. 9% 70% # Dep/Ab 1. 7 m 4. 4 m 150% Note: 2000/2001 estimates are not comparable with 2002 and 2003 estimates. 29

Past Year Marijuana Use: Age 50+, 1999 -2001 and 2020 1999 -2001 2020 % Increase 74 m 112 m 50% % Use 1. 0% 2. 9% 190% # Use 0. 7 m 3. 3 m 370% Population Note: 1999 -2001 estimates are not comparable with 2002 and 2003 estimates. 30

Recent Trends in Substance Abuse Treatment among Older Adults (Treatment Episode Data Set) 31

Proportion of Substance Abuse Treatment Admissions Involving an Illicit Drug, by Age: 2001 Alcohol Only Illicit Drug Age Group 32

Treatment Admissions for Primary Illicit Drug Problems: Age 50+, 2002 Number (in Thousands) 33

Alcohol and Drug Treatment Admissions: Age 50+, 1992 -2002 Admissions in Thousands Alcohol Only Drugs 34

Major Drugs of Abuse in Treatment Admissions with Illicit Drug as Primary Substance: Age 50+, 1992 -2002 Admissions in Thousands Heroin Cocaine 35

Older Adult Substance Use: Conclusions • Currently, abuse problem is mainly alcohol • Treatment need will increase due to baby boom cohort – Population increase – Higher abuse rate • Illicit drug problems will become more prominent as cohorts with drug experience reach age 50 – Evident in treatment admission data since early 1990 s 36