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Substance Abuse by Older Adults:  Estimates of Future Impact on the Treatment System

Table Of Contents


This report provides evidence concerning the projected demand for substance abuse treatment services for older Americans over the next 20 to 30 years and suggests approaches for refining these projections. It was developed in response to two trends in the United States—the aging of the population and the higher consumption of alcohol and illicit substances by people born between 1946 and 1964 (the baby boom generation) than was true in earlier cohorts. A work group of Federal agency representatives and university researchers was established by the Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies (OAS), to examine and assess the ability of available data to provide sufficient information to guide planning to address the possible doubling of the number of those older adults requiring substance abuse treatment services. The work group identified and reviewed available information, gaps in data, assumptions concerning data collection and analysis, important variables, and estimation methods and models. This report includes original analyses of a wide variety of data sources undertaken by an invited panel of experts. It was prepared to demonstrate approaches to the issues raised and the suggestions of the Federal work group.

The chapters in this report review the issues in anticipation of the substance abuse treatment needs of the future elderly. To make reliable forecasts of the demand for substance abuse treatment services, more updated and expanded information is needed concerning the life course of persons who abuse substances and are in recovery, those who continue to abuse substances throughout their lives and may or may not be in treatment, and those who begin abusing substances later in life. Patterns of relapse and recovery must be better understood. The report highlights uses of available data and provides examples of analyses and methodological issues required to refine forecasts of the demand for substance abuse treatment services emerging over the next several decades. The final chapter discusses the implications and suggests approaches to extending our knowledge in the area.

Key highlights include the following:

In summary, this report underscores the expected change in the magnitude of the requirement for substance abuse treatment in future generations of older Americans. Complementing the accelerated aging and changing demographic profile of the U.S. population will be a new constellation of factors, including longer life span, increased per capita use of multiple prescription drugs, increased pressure to retain older people in the workforce, and the enhanced propensity of those entering their senior years to abuse both licit and illicit drugs. These factors will have an impact on both the Nation's substance abuse treatment and the greater health care system. Therefore, it is suggested that more informed policy will require new approaches, including the following:

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This page was last updated on June 16, 2008.