# Presentation: 664921

## 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)**

**Notes:**
Civilian, noninstitutionalized population:

 98% of total population

 INCLUDES: households, dorms, homeless shelters

 EXCLUDES: active military, institutions, homeless people not in shelters

## Patterns of Substance Use 

## 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.)

## Illicit Drug Use, by Age: 2003

**Illicit Drug Use, by Age: 2003**

**Age in Years**

**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+**

**Percent Using in Past Month**

- Age 50+

## Use of Selected Illicit Drugs:Age 50+, 2002-2003 Annual Averages

**Percent Using in Past Month**

**Any Drug**

**Prescription    Drug Nonmedically**

**Hallucinogen**

**Marijuana**

**Cocaine**

**Notes:**
Psychotherapeutics: Nonmedical use of prescription-type drugs (without own prescription or for the feeling it caused)
    Pain Relievers (1.9%)
    Stimulants (0.5%)
    Tranquilizers (0.8%)
    Sedatives (0.2%)

Past month marijuana users--1/3 used 20 or more days
  (5 million)

## 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)**

## Types of Drugs Usedby Past Month Illicit Drug Users:Age 50+, 2002-2003 Annual Averages

**Other**

**Marijuana Only**

**Only Marijuana and Prescription Drugs**

**1.4 Million Illicit Drug Users (1.8%)**

**Prescription Drugs Only**

## Types of Drugs Used by Past Month Illicit Drug Users: Age 12 to 49 and 50+, 2002-2003 Annual Averages

**Age**** 12 to 49**

**Age**** 50+**

**Percent of Current Users**

**Marijuana & Prescription Drugs Only**

**Marijuana Only**

**Prescription Drugs Only**

**All Other**

## Marijuana and Prescription Drug (Nonmedical) Use, by Gender: Age 50+, 2002-2003 Annual Averages

**Percent Using in Past Month**

**Marijuana**

**Prescription Drug Nonmedically**

- Note: Difference between male and female rates is statistically significant (.05 level) for marijuana, not prescription drugs.

## Marijuana and Prescription Drug (Nonmedical) Use, by Gender: Age 12 to 17, 2003

**Percent Using in Past Month**

**Marijuana**

**Prescription Drug Nonmedically**

- Note: Difference between male and female rates is statistically significant (.05 level) for marijuana, not prescription drugs.

## Illicit Drug Use, by County Type: Age 50+, 2002-2003 Annual Averages

**Large Metro**

**Nonmetro**

**Small Metro**

**Percent Using in Past Month**

- Note: No statistically significant differences (.05 level).

## Illicit Drug Use, by Race/Ethnicity:         Age 50+, 2002-2003 Annual Averages

**White**

**Percent Using in Past Month**

**Black or African American**

**Hispanic or Latino**

- Note: No statistically significant differences (.05 level).

## Past Year Illicit Drug Use, by Serious Mental Illness: Age 50+, 2002-2003 Annual Averages

**Percent Using in Past Year**

**No Serious Mental Illness**

**Serious  Mental Illness**

- Note: Difference is statistically significant (.05 level).

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

## Illicit Drug or AlcoholDependence or Abuse, by Age: 2003

**Illicit Drug or Alcohol****Dependence or Abuse, by Age: 2003**

**Percent Dependent or Abusing in Past Year**

**Age in Years**

**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 50+

## 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.)

## Alcohol and Illicit Drug Dependence or Abuse, as a Percentage of Total Substance Dependence or Abuse, by Age: 2003

**Alcohol and Illicit Drug Dependence or Abuse, as a Percentage of Total Substance Dependence or Abuse, by Age: 2003**

**Age****12 to 25**

**Age****26 to 49**

**Age**** 50+**

**Percent of Substance Dependence/Abuse**

**Alcohol Only**

**Illicit Drug**

## Dependence or Abuse of Illicit Drugs:Age 50+, 2002-2003 Annual Averages

**Number (in Thousands)**

## Substance Dependence or Abuse, by Gender: Age 50+, 2002-2003 Annual Averages

**Male**

**Female**

**Percent Dependent or Abusing in Past Year**

- Note: Difference is statistically significant (.05 level).

## Substance Dependence or Abuse, by County Type: Age 50+, 2002-2003 Annual Averages

**Large Metro**

**Nonmetro**

**Small Metro**

**Percent Dependent or Abusing in Past Year**

- Note: No statistically significant differences (.05 level).

## Substance Dependence or Abuse, by     Race/Ethnicity: Age 50+, 2002-2003 Annual Averages

**White**

**Percent Dependent or Abusing in Past Year**

**Black or African American**

**Hispanic or Latino**

- Note: No statistically significant differences (.05 level).

## Treatment Need and Specialty Treatment for Alcohol or Drug Abuse: Age 50+, 2002-2003 Annual Averages

**Did Not Receive Treatment and** **Felt Need for Treatment**

**Did Not Receive Treatment and Felt No Need for Treatment**

**85.0%**

**2.6 Million with Treatment Need**
**(Based on DSM-IV)**

**Received Treatment**

**6.5%**

**8.6%**

***(44% Made Effort)***

## Expected Future Trends in Substance Use among        Older Adults

## Alcohol or Illicit Drug Dependence or Abuse, by Lifetime Use of Illicit Drugs: Age 50+, 2003

**Percent Dependent or Abusing in Past Year**

**Never Used Illicit Drugs**

**Used Illicit Drugs in Lifetime**

- Note: Difference is statistically significant (.05 level).

## Lifetime Use of Illicit Drugs, by Year of Birth: 2002-2003 Annual Averages

**Lifetime Use of Illicit Drugs, by Year of Birth: 2002-2003 Annual Averages**

**Percent Ever Used**

- Baby Boom Cohort (Born 1946-64)

## 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 at Age 18 or Older**

**First Use Before Age  18**

- Note: Difference is statistically significant (.05 level).

## Average Age of First Use of Marijuana among Lifetime Marijuana Users, by Year of Birth: 2002-2003 Annual Averages

**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)

## Substance Dependence or Abuse: Age 50+, 2000/2001 and 2020

|  | 2000/2001 | 2020 | % Increase |
| --- | --- | --- | --- |
| Population |   75m | 112m | 50% |
| % Dep/Ab   |      2.3% | 3.9% | 70% |
| # Dep/Ab |    1.7m | 4.4m | 150%
 |

- Note: 2000/2001 estimates are not comparable with 2002 and 2003 estimates.

## Past Year Marijuana Use: Age 50+, 1999-2001 and 2020

|  | 1999-2001 | 2020 | % Increase |
| --- | --- | --- | --- |
| Population |   74m | 112m | 50% |
| % Use   |      1.0% | 2.9% | 190% |
| # Use |    0.7m | 3.3m | 370%
 |

- Note: 1999-2001 estimates are not comparable with 2002 and 2003 estimates.

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

## Proportion of Substance Abuse Treatment Admissions Involving an Illicit Drug,        by Age: 2001

**Alcohol Only**

**Illicit Drug**

**Age Group**

## Treatment Admissions for Primary Illicit Drug Problems: Age 50+, 2002

**Number (in Thousands)**

## Alcohol and Drug Treatment Admissions: Age 50+, 1992-2002

**Admissions in Thousands**

**Alcohol Only**

**Drugs**

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

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

**Admissions in Thousands**

**Heroin**

**Cocaine**

## 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 1990s**