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The Center
for Substance Abuse Prevention (CSAP), in conjunction with its State Prevention
Advancement and Support Project, is developing a national strategy for
preventing alcohol and drug use problems among older adults by:
Defining
the problem
By
analyzing the available knowledge of national surveys, databases and current
research findings, such as Health, United States 2001; U.S. Census, 2000,
Population Projections; Federal Interagency Forum on Aging-Related Statistics,
Older Americans 2000: Key Indicators of Well-Being; National Long-Term Care
Survey; National Health Interview Survey; Health and Retirement Survey; Vital
statistics; Morbidity and Mortality Weekly Reports, CDC; American Association
of Retired Persons (50+); National Household Survey on Drug Abuse, 2001; and
current research literature, key highlights have been identify.
They include:
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By 2010,
the baby boomers will swell the ranks of older adults to 40 million and begin
to depend on Medicare.
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By 2030,
the 65 and over population will grow to 70 million- DOUBLE the current number-
or 1 out of every 5 Americans.
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The
older population will become more culturally diverse.
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Historically,
problem-drinking rates have declined sharply with age; however,researchers
believe baby boomers’ drinking habits may not decline as much given their
generation’s social acceptance of alcohol.
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Potentially
inappropriate use of prescription drugs affects up to 23.5% of older adults who
live in the community.
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Mental
health disorders, especially depression, often co-occur with alcohol and drug
use in older adults.
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This
“hidden epidemic” increases the need for prevention and early detection.
Identifying
risk and protective factors
Numerous
methods were used to identify risk and protective factors.
First, through a researcher consensus panel, prescription drugs having
the greatest potential for problems in older adults were discussed.
A listing of approximately 30 prescription drugs were identified as high
risk, including for example, tranquilizers, sleeping pills, antidepressants and
pain relievers. Additionally, it
was concluded that many of these drugs should not be taken with alcohol and
that some of these drugs have the potential to produce dependence and
addiction. Second, an extensive
literature search was conducted, to identify articles and research regarding
risk and protective factors. National
meeting, such as the Summit, National Aging Conferences and National Public
Health Conference, also were held to draw on the experience and expertise of
policy and program leaders regarding risk and protective factors in the older
adult population. Additionally, the work currently being conducted with six
State (see below) policy and program leaders helped identified risk and
protective factors. Lastly, the
Medicare Current Beneficiary Survey was analyzed.
What was learned about risk and protective factors include:
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Frequency
of use of potentially inappropriate prescription drugs.
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Patterns
of drug use and potential misuse and abuse by subgroups (e.g., age, gender,
marital status, living arrangements, chronic health condition, income).
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Risk
and protective factors associated with vulnerability to, or avoidance of, drug
misuse and addiction in this older population.
Working
with States to build partnerships, policy, and programs
CSAP is
currently working with six States to shape policy and program directions that
strengthen State capacity to reduce risk factors and increase protective
factors. These six States,
Arizona, Colorado, Florida, New York, Oregon, and Pennsylvania, have identified
a variety of resources and strategies such as statewide aging and behavioral
health coalitions, State legislative mandates, screening tools, referral
systems, and State-wide peer counseling programs.
Additionally, these States are looking to their State partners as the
development of policy and program continues.
These partners include the State Substance Abuse Agency, State Quality
Improvement Organizations, State Medical Associations, the State Aging Agency,
and the State Mental Health Agency.
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