Treatment of Substance Use Disorders in Older Adults: Implications for Care Delivery.
OBJECTIVE
To compare substance use treatment differences of individuals aged 65 and older with that of those younger than 65 by analyzing smaller age groupings.


METHODS
A retrospective analysis using Kruskal-Wallis chi-square and chi-square tests of association. Covariates were entered into an adjusted logistic regression to predict successful treatment completion.


METHODS
Iowa substance use disorder treatment centers.


METHODS
Individuals aged 30 to 96 admitted to substance use treatment in Iowa between 2010 and 2013 (N = 57,591).


METHODS
Successful treatment completion, program length of stay, primary problem substance, referral source, and client demographic characteristics were analyzed to explore differences between age groupings in those aged 65 and older and between those aged 65 and older and those younger than 65.


RESULTS
Findings demonstrated that individuals aged 65 to 69 were more likely to complete treatment successfully than those aged 75 and older (2 log likelihood χ(2) = 102.06, degrees of freedom = 6, P < .001), and treatment referrals were increasingly more likely to occur from a primary care setting with increasing age. The eldest group reported significantly more hospitalizations because of their substance use (Wald z = 3.05, P < .002). Finally, referrals for driving under the influence were more likely in those aged 70 and older.


CONCLUSIONS
Excluding the oldest group (7,596), older age was associated with greater successful treatment completion. Overall, greater screening and earlier detection may be a critically important means of enhancing safety for older persons with substance use disorders.
Iowa Consortium for Substance Abuse Research and Evaluation, University of Iowa, Iowa City, Iowa.|Department of Psychological and Quantitative Foundations, College of Education, Counseling Psychology Program, University of Iowa, Iowa City, Iowa.
Ethan
E
Sahker
Iowa Strategic Healthcare Alliance for Rural Education, University of Iowa, Iowa City, Iowa.|Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, Iowa.
Susan K
SK
Schultz
Iowa Consortium for Substance Abuse Research and Evaluation, University of Iowa, Iowa City, Iowa.|Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, Iowa.|Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa.
Stephan
S
Arndt
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010352:Patient Dropouts / Q000706:statistics & numerical data; D012017:Referral and Consultation; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D019966:Substance-Related Disorders / Q000628:therapy*; D016896:Treatment Outcome
care delivery; geriatrics; substance use disorders; treatment