May 31, 2007

Adults Aged 65 or Older in Substance Abuse Treatment: 2005

The U.S. population is aging, with important consequences for substance abuse treatment. Estimates indicate that the number of adults aged 65 or older will reach 40 million by 2010 and 55 million by 2020.¹ The number of adults aged 65 or older with problem substance use is projected to reach between 609,000 (projection for those aged 70 or older) and 1.9 million (projection for those aged 60 or older) by 2020.²

Trends in older adult substance abuse treatment can be monitored with the Treatment Episode Data Set (TEDS), an annual compilation of data on the demographic characteristics and substance abuse problems of those admitted to substance abuse treatment, primarily at facilities that receive some public funding. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once during a single year.³

This report examines substance abuse treatment admissions of adults aged 65 or older—referred to below as "older" adult admissions. In 2005, this age group comprised approximately 37 million people in the United States⁴—13 percent of the total population—and there were 11,300 admissions aged 65 or older to substance abuse treatment (Table 1). The admission rate for adults aged 65 or older was 30.7 per 100,000, which was considerably lower than the rate of 707.3 admissions per 100,000 for the population younger than 65.

While the total substance abuse treatment population increased by 10 percent between 1995 and 2005, the number of substance abuse treatment admissions among persons aged 65 or older decreased by 7 percent, from 12,100 to 11,300 admissions (Table 1). Adults aged 65 to 69 made up the largest part of this group, increasing from 56 percent of older adults in treatment in 1995 to 59 percent in 2005 (Figure 1).

Figure 1. Admissions Aged 65 or Older, by Age Group: 1995-2005

In each year from 1995 to 2005, alcohol was the most frequently reported primary substance of abuse⁵ for substance abuse treatment admissions aged 65 or older. However, the proportion of older admissions reporting alcohol as their primary substance declined from 84.7 percent in 1995 to 75.9 percent in 2005 (Table 1). The number of primary alcohol admissions among older men decreased by 18 percent from 8,200 in 1995 to 6,700 in 2005 (Figure 2). The number of primary alcohol admissions among older women was nearly the same in 1995 and 2005, around 1,900 admissions.

Figure 2. Admissions Aged 65 or Older, by Gender and Primary Substance: 1995-2005

By contrast, treatment admissions for abuse of primary substances other than alcohol among older adults increased over the same time period, from 1,000 men and 400 women in 1995 to 1,600 men and 600 women in 2005—despite the decrease in overall substance abuse treatment admissions in this age group.

Increases in admissions for abuse of opiates, cocaine, and sedatives contributed to the growth in primary drug abuse treatment admissions among admissions aged 65 or older. Between 1995 and 2005, primary opiate admissions increased from 6.6 to 10.5 percent of admissions aged 65 or older (Table 1). Most of these primary opiate admissions were for heroin, but admissions for non-heroin opiates—including codeine, Dilaudid, morphine, oxycodone, and Demerol—accounted for 1.4 percent of admissions aged 65 or older in 1995 and 2.4 percent in 2005. During the same time period, primary cocaine admissions increased from 2.1 to 4.4 percent of admissions aged 65 or older, and primary sedative admissions (especially barbiturates) increased from 0.5 to 1.3 percent of admissions in this age group.

In 2005, 76 percent of substance abuse treatment admissions aged 65 or older were male. Sixty-four percent of substance abuse treatment admissions aged 65 or older were White, 18 percent were Black, 14 percent were Hispanic, and 4 percent were other race/ethnicities. Most admissions aged 65 or older were between 65 and 69 years of age (59 percent), while 26 percent were between 70 and 74 years of age, 9 percent were between 75 and 79 years of age, and 6 percent were 80 years of age or older.

In 2005, 44 percent of substance abuse treatment admissions aged 65 or older were referred to treatment by themselves or another individual, and 26 percent were referred through the criminal justice system.⁶ Fifty-two percent of admissions aged 65 or older reported no prior substance abuse treatment episodes, 40 percent reported one to four prior treatment episodes, and 8 percent reported five or more prior treatment episodes.

Seventy-nine percent of substance abuse treatment admissions aged 65 or older in 2005 were not in the labor force (i.e., not employed and not looking for work), 10 percent were unemployed, 7 percent were employed full time, and 4 percent were employed part time.⁷ Among those adults aged 65 or older not in the labor force, 72 percent were retired and 17 percent were disabled.⁸ Twenty-six percent of older admissions reported as their source of payment that they expected to pay for treatment themselves.⁹

In 2005, the most populous States tended to have the largest numbers of older adults entering substance abuse treatment, but not necessarily the highest admission rates per 100,000 population (Table 2). Admission rates among adults aged 65 or older tended to be highest in northern and northeastern States.

SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.    Site Map | Contact Us | Accessibility | Privacy Policy | Freedom of Information Act  Disclaimer | Department of Health and Human Services | SAMHSA | White House | USA.gov * PDF formatted files require that Adobe Acrobat Reader® program is installed on your computer. Click here to download this FREE software now from Adobe. What's New Highlights Topics Data Drugs Pubs Short Reports Treatment Help Mail OAS