Notable shifts found in demographic background
including gender and ethnicity among older adults
Newswise, December 1, 2015 — Recent years have seen a change
in drug use patterns, especially for older adults, with an increase in their
admission to substance abuse treatment and increased injection drug use among
those over the age of 50.
Yet, there has been little research regarding the
epidemiology, health status, and functional impairments in the aging population
of adults accessing opioid treatment.
Of the few studies on this population to date, most have been based off of a limited dataset that only accounts for treatment admissions, and therefore may not fully capture the utilization of substance abuse treatment over time.
Of the few studies on this population to date, most have been based off of a limited dataset that only accounts for treatment admissions, and therefore may not fully capture the utilization of substance abuse treatment over time.
Furthermore the treatment episode dataset (TEDS), defines an older adult as
aged over 50 or 55, and may not fully demonstrate how the population is aging.
Given the gaps in existing data, researchers affiliated with
New York University's Center for Drug Use and HIV Research (CDUHR), and NYU’s
School of Medicine (NYUSoM) sought to elucidate age trends for opioid treatment
programs, with an emphasis on older adults, in a new study published in the Journal of Substance Use & Misuse.
The
investigation focuses on such trends in New York City, as it has one of the
largest methadone treatment systems in the U.S. and consistently provides
access to treatment in the public system.
The study, “Demographic Trends of Adults in New York City
Opioid Treatment Programs- An Aging Population,” used data collected by New York
State's Office of Alcoholism and Substance Abuse Services (OASAS). OASAS
provides more detailed information on the treatment population than what is
available nationally through the TEDS dataset, allowing the NYU researchers to
characterize basic demographic, self-reported other substance use, and
self-reported physical impairments.
“Most notably,” says Benjamin Han, MD, MPH, an instructor at
NYUSoM and the study’s principle investigator, “we found a pronounced age trend
in those utilizing opioid treatment programs from 1996 to 2012, with adults
aged 50 and older becoming the majority treatment population.”
Specifically, individuals aged 50-59 which made up 7.8% (N=
2,892) of the total patient population in 1996, accounted for 35.9% (N= 12,301)
of the population in 2012. Patients aged 60-69, also saw a dramatic increase in
numbers, originally constituting 1.5% of patients (N= 558) to 12.0% of patients
(N= 4,099).
“These increases are especially striking, considering there
was about a 7.6% decrease in the total patient population over that period of
time, and suggests that we are facing a never before seen epidemic of older
adults with substance use disorders and increasing numbers of older adults in
substance abuse treatment.
Unfortunately there is a lack of knowledge about the
burden of chronic diseases and geriatric conditions or the cognitive and
physical function of this growing population” says Dr. Han.
During the same period, those age 40 and below, who in 1996
accounted for 56.2% of patients (N= 20,804), were a fraction of that in 2012,
responsible for 20.5% of total patients (N= 7,035).
There were also notable shifts with regards to race and ethnicity. During this period older adults over the age of 60 were increasingly white, with a 10.3% increase in representation, while there was a 13.8% decrease in the percentage of black patients.
There were also notable shifts with regards to race and ethnicity. During this period older adults over the age of 60 were increasingly white, with a 10.3% increase in representation, while there was a 13.8% decrease in the percentage of black patients.
There was a small increase in the Hispanic constituency from
35.0% in 1996 to 38.8% in 2012. These trends, however, were different for those
aged 50-59. In this age group there were smaller decreases in both the white
(3.5%) and black (5.9%) populations, and a larger increase in Hispanic patients
(9.2%).
However, when looking at all age groups during this period, the overall
white population remained steady (-0.4%), with a slight decrease in black
patients (3.5%) and a slight increase in Hispanic patients (3.4%).
Researchers believe the increase in older adults utilizing
opioid treatment programs is likely to continue into the next decade. Further
studies are required to better understand the specific and unique health needs
of this growing population from a geriatric perspective.
More research is also
need to understand how other substance use can complicate care and how to
address the changing ethnic and racial demographics of this population in New
York City.
Researcher Affiliations: Benjamin H. Han, MD, MPH1*; Soteri
Polydorou, MD2; Rosie Ferris, MPH1; Caroline Blaum, MD, MS1; Stephen Ross, MD2;
Jennifer McNeely, MD, MS3.
1 NYU School of Medicine, Department of Medicine, Division of Geriatrics.
2 NYU School of Medicine, Division of Alcoholism and Substance Abuse
3 NYU School of Medicine, Department of Population Health and the Department of
Medicine.
1 NYU School of Medicine, Department of Medicine, Division of Geriatrics.
2 NYU School of Medicine, Division of Alcoholism and Substance Abuse
3 NYU School of Medicine, Department of Population Health and the Department of
Medicine.
Declaration of Interest: Gail Dorn, MS1 and Dawn
Lambert-Wacey, MA1 provided the aggregated dataset used in this study, and
assisted in the editing of the article.
1NYS Office of Alcoholism and Substance Abuse Services
Division of Outcome Management and System Information
1450 Western Ave, Albany, NY 12203-3526
Division of Outcome Management and System Information
1450 Western Ave, Albany, NY 12203-3526
About CDUHR
The mission of the Center for Drug Use and HIV Research (CDUHR) is to end the HIV and HCV epidemics in drug using populations and their communities by conducting transdisciplinary research and disseminating its findings to inform programmatic, policy, and grass roots initiatives at the local, state, national and global levels. CDUHR is a Core Center of Excellence funded by the National Institute on Drug Abuse (Grant #P30 DA011041). It is the first center for the socio-behavioral study of substance use and HIV in the United States and is located at the New York University College of Nursing. For more information, visit www.cduhr.org
About NYU Langone Medical Center
NYU Langone Medical Center, a world-class, patient-centered, integrated academic medical center, is one of the nation’s premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals—Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, the Medical Center’s dedicated inpatient orthopaedic hospital; and Hassenfeld Children’s Hospital, a comprehensive pediatric hospital supporting a full array of children’s health services across the Medical Center—plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The Medical Center’s tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education, and research. For more information, go to www.NYULMC.org
About New York University College of Nursing
NYU College of Nursing is a global leader in nursing education, research, and practice. It offers a Bachelor of Science in Nursing, a Master of Science and Post-Master’s Certificate Programs, a Doctor of Philosophy in Research Theory and Development, and a Doctor of Nursing Practice degree. For more information, visit www.nursing.nyu.edu/
The mission of the Center for Drug Use and HIV Research (CDUHR) is to end the HIV and HCV epidemics in drug using populations and their communities by conducting transdisciplinary research and disseminating its findings to inform programmatic, policy, and grass roots initiatives at the local, state, national and global levels. CDUHR is a Core Center of Excellence funded by the National Institute on Drug Abuse (Grant #P30 DA011041). It is the first center for the socio-behavioral study of substance use and HIV in the United States and is located at the New York University College of Nursing. For more information, visit www.cduhr.org
About NYU Langone Medical Center
NYU Langone Medical Center, a world-class, patient-centered, integrated academic medical center, is one of the nation’s premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals—Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, the Medical Center’s dedicated inpatient orthopaedic hospital; and Hassenfeld Children’s Hospital, a comprehensive pediatric hospital supporting a full array of children’s health services across the Medical Center—plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The Medical Center’s tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education, and research. For more information, go to www.NYULMC.org
About New York University College of Nursing
NYU College of Nursing is a global leader in nursing education, research, and practice. It offers a Bachelor of Science in Nursing, a Master of Science and Post-Master’s Certificate Programs, a Doctor of Philosophy in Research Theory and Development, and a Doctor of Nursing Practice degree. For more information, visit www.nursing.nyu.edu/
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