Clinical Medicine and Substance Misuse

Medication use among older Australians seeking alcohol and other drug treatment

“…A recent study of 16 838 patients accessing treatment services for a substance use disorder in the Netherlands found that older adults with a late-onset substance use disorder used three and half times more medications than both younger adults and older adults with an early-onset substance use disorder. 7 However, the study did not examine whether the patients' medications had a high risk of interacting with alcohol, nor whether the use of alcohol might reduce the efficacy of the medications. The present study aimed to describe medication use among older adults drinking at levels that placed them at-risk of experiencing alcohol-related harm.…”

“…Yet, many health-care professionals do not ask older adult patients about their alcohol consumption. 7 Despite older adults who drink alcohol at harmful levels being the most likely population to experience alcohol-related adverse medication interactions, there is limited research about the use of medications in this population. A recent study of 16 838 patients accessing treatment services for a substance use disorder in the Netherlands found that older adults with a late-onset substance use disorder used three and half times more medications than both younger adults and older adults with an early-onset substance use disorder.…”

“…The most common medications were cardiovascular agents (61.3%), metabolic agents (36.5%), central nervous system agents (22.4%) and psychiatric medications (9.6%). Yet, many health‐care professionals do not ask older adult patients about their alcohol consumption …”

“…Over 90% of patients were taking at least one medication deemed to have serious adverse side effects when consumed with alcohol, which was higher than 77.8% of participants identified in the NHANES. 6 This might reflect the finding that older people who are engaging in hazardous alcohol consumption are more likely to experience diverse medical co-morbidities, 7 increasing their overall likelihood of taking a medication. Alternatively, given the threshold for inclusion of medications that could interact with alcohol was low in the analysis of the NHANES data, previous estimates of medication usage among older people who drink might be low.…”

Substance Addiction in Old Age

“…Older adults are prone to the use of substances often because of age-related burdens such as physical complaints and pain, retirement and lack of daily structure, financial losses, changes of the living situation, or social losses. One may assume that the problem is aggravated by present demographic trends: The absolute number of older substance users will likely increase (Colleran, 2004; Han, Gfroerer, Colliver, & Penne, 2009; Wu & Blazer, 2011; Sacco, Kuerbis, Goge, & Bucholz, 2012; SAMHSA, 2012; Geppert & Taylor, 2015; Arora, O’Neill, Crome, & Martin, 2015), including the use of illegal drugs (Chapman & Wu, 2015a; Crome, Wu, Rao, & Crome, 2015; EMCDDA, 2008; Purvis, 2010) and analgesics (Maxwell, 2015; McLachlan et al, 2011; Mitchell, Hilmer, & McLachlan, 2009). Moreover, perceived cognitive decline may easily be attributed to old age, although the inappropriate use of substances may contribute to their deficits (Wolter, 2011).…”