Substance Use, Health Status & Service Utilisation of Older Clients Attending Specialist Drug & Alcohol Services

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.

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).

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.

D&A services will require strategies to address the complex physical, mental, cognitive and social problems of older clients. Substance use, health status and service utilisation of older clients attending specialist drug and alcohol services.

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By: Lintzeris N1,2, Rivas C1, Monds LA1,2, Leung S1,2, Withall A3, Draper B4,5.

• 1Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.
• 2Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
• 3School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
• 4School of Psychiatry, University of New South Wales, Sydney, Australia.
• 5Sydney and Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, Australia.  

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