More Older Americans Will Need Substance Abuse Treatment by 2020

By Melissa Capers

The need for substance abuse treatment for older Americans is expected to nearly triple in 2020 as the baby boom carries its substance abuse into older ages. This is the conclusion of a study by Joseph Gfroerer of SAMHSA's Office of Applied Studies and Michael Penne, Michael Pemberton, and Ralph Folsom of the Research Triangle Institute, published in the March issue of the journal Drug and Alcohol Dependence.

The study projects that the number of adults age 50 and older, who will need treatment for a substance abuse problem, will grow to 4.4 million in 2020, compared to 1.7 million in 2000 and 2001.

According to the authors, baby boomers and the post-baby-boom birth cohort (those Americans born between 1946 and 1970) have used alcohol and illicit drugs at higher rates than earlier birth cohorts and will as a result exhibit problematic drug and alcohol use at higher rates than their elders.

Using data collected from a representative sample of 13,000 Americans age 50 and older through SAMHSA's National Household Survey on Drug Abuse in 2000 and 2001, the authors used logistic regression analysis to identify significant variables predicting the need for substance abuse treatment among this population. Gender, cigarette use, age at first alcohol use, and age at first marijuana use were found to be significant predictors of treatment need: males were more likely than females to need treatment; those who smoked cigarettes daily before age 31, those who used alcohol before age 15, and those who used marijuana before age 31 were more likely to need treatment than those who did not. In addition, the younger the age at first marijuana use, the greater the risk of treatment need.

Regression model results were then applied to the projected U.S. population age 50 and older in 2020, based on Household Survey data on Americans age 30 and older in the 2000 survey and age 31 and older in the 2001 survey, combined with U.S. Census Bureau population projections for 2020. Population projections were adjusted to account for future shifts in the population by age, gender, and race, as well as the higher mortality rates experienced by substance abusers.

In 2020, the number of people age 50 and older will be 50 percent larger than in 2000/2001 (112.5 million in 2020 versus 74.8 million in 2000/2001). In addition, the lifetime rate of reported illicit drug use among baby boomers is nearly twice that of the older group: only 26 percent of those age 50 to 69 in 2000/2001 had ever used illicit drugs or used prescription drugs non-medically; but 56 percent of those who will be age 50 to 69 in 2020 (age 30 to 49 in 2000/2001) reported these behaviors. As a result, 3.9 percent of those who will be age 50 and older in 2020 were projected to need substance abuse treatment, nearly twice the rate of need estimated for those who were age 50 and older in 2000/2001 (2.3 percent).

In response to the magnitude of the problems projected, the authors call for an increase in substance abuse treatment capacity and increased focus on the special needs of an older population of substance abusers.

Commenting on the study findings, SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W., said, "This study warns us that we will have to focus increased resources on older citizens within the next 2 decades. Baby boomers continue to use both illicit drugs and prescription drugs non-medically as they age. This Administration's effort to expand treatment capacity in communities nationwide provides the opportunity for baby boomers to recognize their dependence and seek help now, before their drug abuse is complicated by the challenges of old age."

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