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Thursday, March 1, 2012Older Folks Doing Dope
The percentage of American 50- to 59-year-olds who
reported having abused illicit or prescription drugs during the past year more
than doubled, from 2.7 percent to 6.2 percent, between 2002 and 2009. Not
coincidentally, by the end of that period baby boomers—the generation born
between 1946 and 1964—had filled out that age cohort. Baby boomers' histories
of illicit drug use, and their relatively tolerant attitudes toward it, along
with the fact that they now comprise nearly 30 percent of the Nation’s
population, have raised the stakes on understanding and responding effectively
to drug abuse among older adults.
The social and physical changes that accompany aging may
well increase vulnerability to drug-related problems. The loss of loved ones,
juggling of multiple roles, and retirement or other alterations in employment
and income may cause some older people to use illicit drugs as self-medication
for anxiety or depression, especially if they have a history of taking drugs to
cope. Slowing metabolism can increase sensitivity to the effects of drugs.
Furthermore, the effects of drugs of abuse in older adults may be influenced by
age-related health conditions and medications—contingencies that are more problematic
when patients hide their drug abuse.
Scientists have much to learn about the intersection of
drug abuse, aging, and the neurobiological systems that underlie addiction.
Basic animal research will be required to describe the impact of drugs on the changing
neurochemical balance in the aging brain and trace the combined impact of
addictive substances and aging.
We do know that older adults respond at least as well as
younger ones to substance abuse therapies. That is why recognizing drug
problems in older patients is critical. Clinicians need to be aware of patterns
of drug abuse among older people and alert to the possibility that some
physical problems of older adults, for example falls and other accidents, may
stem from illicit drug use. Primary care physicians have a key role in
screening older people for drug abuse and related issues: Although it is not
specifically targeted to the aging population, the NIDAMED toolkit can guide doctors in
assessing a patient’s risk of developing an addiction problem, advising
patients on the health effects of substance abuse, and, if needed, arranging a
referral to specialty care. With this age group, as with every other, the goal
is to help people live longer, healthier, and more productive lives.
December 2011
NIDA Director, Nora
D. Volkow, M.D.