Characteristics and consequences of heroin use among older adults in the United States: a review of the literature, treatment implications, and recommendations for further research.
This review reports on the results of a comprehensive literature search of studies examining the physical and mental health characteristics of older adults in the United States who use heroin. Multiple databases were searched for papers meeting the inclusion criteria of heroin users who were age 50 years or older. A total of 14 articles covering 9 different studies met the review inclusion criteria. All of the studies were convenience samples, and seven of the nine studies (77.8%) were entirely drawn from substance abuse treatment programs, primarily methadone maintenance programs. Findings from the qualitative studies suggest that the marginalization of older heroin users was a predominant experience that impacted the intent to seek treatment as well as treatment retention. While articles reported high levels of physical and psychological/psychiatric comorbidities with substance misuse, research on heroin use and methadone treatment among older adults is scant and the quantitative findings are inconsistent. The articles reviewed in this study demonstrate that the needs of this population will be significant, yet the development of appropriate interventions and treatment for older adult heroin users will be contingent on empirical research that adequately describes mental and physical health problems.
School of Social Work, University of Pittsburgh, Pittsburgh, PA 15260, USA. dar15@pitt.edu
Daniel
D
Rosen
Amanda
A
Hunsaker
Steven M
SM
Albert
Jack R
JR
Cornelius
Charles F
CF
Reynolds
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006556:Heroin Dependence / Q000453:epidemiology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D015995:Prevalence; D036301:Qualitative Research; D014481:United States / Q000453:epidemiology
D009294:Narcotics; D008691:Methadone
Arch Intern Med. 2007 Jan 22;167(2):166-73
17242318
J Addict Dis. 2007;26(1):51-60
17439868
BMC Geriatr. 2009 Oct 09;9:45
19818114
J Psychiatr Pract. 2009 May;15(3):227-34
19461397
J Subst Abuse Treat. 2003 Oct;25(3):125-34
14670518
Gerontologist. 2004 Aug;44(4):543-7
15331811
Am J Geriatr Psychiatry. 2008 Jun;16(6):488-97
18515693
Int J Geriatr Psychiatry. 2003 Sep;18(9):839-43
12949852
J Behav Med. 2004 Dec;27(6):607-22
15669446
J Opioid Manag. 2009 Jan-Feb;5(1):27-37
19344046
Drug Alcohol Depend. 1995 Dec;40(2):139-50
8745136
Arch Gen Psychiatry. 2001 May;58(5):503-8
11343531
J Nutr Health Aging. 2009 Feb;13(2):141-3
19214343
J Subst Abuse Treat. 2005 Apr;28(3):265-72
15857727
Am J Public Health. 2004 Nov;94(11):1985-91
15514241
J Women Aging. 2009;21(2):111-24
19418342
Addiction. 2003 Jun;98(6):761-70
12780364
Drug Alcohol Depend. 2003 Mar 1;69(2):127-35
12609694
Prev Med. 2007 Apr;44(4):369-74
17291577
Psychiatr Serv. 1999 Sep;50(9):1184-8
10478905
J Am Geriatr Soc. 2000 Aug;48(8):985-95
10968307
Arch Gen Psychiatry. 1973 Aug;29(2):237-41
4741515
J Gerontol Soc Work. 2009 Oct;52(7):653-67
19787525
Addiction. 1996 Dec;91(12):1765-72
8997759
Eval Rev. 2007 Dec;31(6):515-47
17986706
J Nerv Ment Dis. 2008 Dec;196(12):898-905
19077857
Drug Alcohol Rev. 2005 Sep;24(5):411-8
16298835
Arch Gen Psychiatry. 1966 Dec;15(6):599-609
5925134
Am J Geriatr Psychiatry. 2004 Sep-Oct;12(5):539-41
15353395
Eval Rev. 2007 Dec;31(6):548-63
17986707
Ann Epidemiol. 2006 Apr;16(4):257-65
16275134
Addiction. 2009 Jan;104(1):88-96
19133892
Drug Alcohol Rev. 2010 May;29(3):233-4
20565513