Substance use, health status and service utilisation of older clients attending specialist drug and alcohol services.
OBJECTIVE
The number of older clients attending drug and alcohol (D&A) services is increasing, although there is insufficient knowledge regarding service needs for this group. The aim of this study was to document the patterns of substance use, health status, cognition, social conditions, and health service utilisation of older clients in D&A treatment.


METHODS
A cross-sectional observational study of 99 clients aged ≥50 years (M = 55, SD = 4.5; 77% male) attending specialist D&A services (N = 30 alcohol treatment, N = 69 opioid treatment) in Sydney, Australia. Participants completed a confidential research interview. Findings were compared to aggregated data from younger opioid substitution treatment (OST) clients attending the same services (N = 214).


RESULTS
Alcohol (46%), benzodiazepines (40%) and cannabis (38%) were the most commonly reported substances used in the past 4 weeks; 23% reported no recent substance use, and 17% reported using three or more drugs. Participants reported high levels of physical and mental health problems, social isolation, low levels of employment, and a third reported difficulties with daily living activities. Forty percent had been injured in a fall in the past 12 months. The mean Addenbrooke's Cognitive Examination-R score was 82.4 ± 9.6, with 40% performing at a level consistent with severe cognitive impairment. A significantly higher proportion of older participants used alcohol and benzodiazepines than younger clients, and older participants had significantly poorer psychological health, physical health and quality of life.


CONCLUSIONS
D&A services will require strategies to address the complex physical, mental, cognitive and social problems of older clients.
Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.|Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
Nicholas
N
Lintzeris
Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.
Consuelo
C
Rivas
Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.|Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
Lauren A
LA
Monds
Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.|Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
Stefanie
S
Leung
School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
Adrienne
A
Withall
School of Psychiatry, University of New South Wales, Sydney, Australia.|Sydney and Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, Australia.
Brian
B
Draper
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology / Q000534:rehabilitation; D003072:Cognition Disorders / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation; D011788:Quality of Life; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D055815:Young Adult
health needs; older population; substance use treatment