Five‐year alcohol and drug treatment outcomes of older adults versus middle‐aged and younger adults in a managed care program

Abstract

Aims This study compared 5-year treatment outcomes of older adults to those of middle-aged and younger adults in a large managed care chemical dependency program. We examined age group differences in individual, treatment and extra-treatment factors, which may influence long-term outcome. Design Seventy-seven per cent of original study participants completed a telephone interview 5 years after out-patient chemical dependency treatment at Kaiser Permanente. This sample (N = 925) included 65 patients aged 55-77, 296 patients aged 40-54 and 564 patients aged 18-39 (age at baseline). Measurements Measures at follow-up included alcohol and drug use, Addiction Severity Index (ASI), Alcoholics Anonymous Affiliation Scale, social resource and self-reported health questions. Mortality data were obtained from contact with family members of patients as well as automated health plan records. Findings Older adults were less likely to be drug-dependent at baseline than younger and middle-aged adults, and had longer retention in treatment than younger adults. At 5 years, older adults were less likely than younger adults to have close family or friends who encouraged alcohol or drug use. Fifty-two per cent of older adults reported total abstinence from alcohol and drugs in the previous 30 days versus 40% of younger adults. Older women had higher 30-day abstinence than older men or younger women. Among participants dependent only on alcohol, there were no significant age differences in 30-day abstinence. In logistic regression analysis, age group was not significant. Variables associated with greater age that independently predicted 30-day abstinence in the logistic regression model included longer retention in treatment and having no close family or friends who encouraged alcohol or drug use at 5 years; female gender was also significant. Conclusions Results indicate that older adults have favorable long-term outcome following treatment relative to younger adults, but these differences may be accounted for by variables associated with age such as type of substance dependence, treatment retention, social networks and gender. Age differences in these characteristics inform intervention strategies to support long-term recovery of older adults and provide direction for investigation of how age affects outcome.

Testing a Matching Hypothesis for Emerging Adults in Project MATCH: During-Treatment and One-Year Outcomes

“…This analysis extended prior findings showing poorer treatment outcomes for emerging adults (Satre et al, 2004) by exclusively focusing on alcohol outcomes and sampling emerging adults and older adults from a randomized study. Nevertheless, results should be interpreted with caution in light of several limitations.…”

Effects of Gender, Ethnicity, and Medical Illness on Drinking Cessation in Older Primary Care Patients

“…Older women may have higher abstinence rates than older men following formal alcohol dependence treatment Satre, Mertens, Areán, et al, 2004). Older women are more likely to have chronic health conditions than men and are more vulnerable to the effects of alcohol (Blow, 2000; National Institute on Alcohol Abuse and Alcoholism, 2000).…”

Patología dual en poblaciones especiales: una revisión narrativa

“…En cuanto al tratamiento, las intervenciones terapéuticas breves (Blow & Barry, 2003;Blow et al, 2007), la terapia cognitivo conductual, la terapia comunitaria (D'Agostino, Barry, Blow, & Podgorski, 2006) y la participación en grupos de ayuda mutua, en conjunto con el tratamiento farmacológico (Oslin, Liberto, O'Brien, Krois, & Norbeck, 1997;Satre, Blow, Chi, & Weisner, 2007), han mostrado resultados promisorios en esta población. Finalmente se sabe que en algunos casos, la prevención de recaídas puede resultar mejor en adultos mayores que en pacientes más jóvenes, pues los primeros se mantienen en abstinencia hasta después de cuatro años de haber recibido el tratamiento (Satre et al, 2004;Satre et al, 2007).…”