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December 7, 2001

Older Adults in Substance Abuse Treatment

In Brief
  • In 1999, 50,700 persons aged 55 or older were admitted to publicly funded substance abuse treatment
  • Alcohol was the primary substance of abuse among older adults
  • Alcohol abuse admissions among older adults declined between 1994 and 1999, but illicit drug admissions increased

This report examines trends in admissions of adults aged 55 or older to publicly funded substance abuse treatment facilities. In 1999, this age group comprised approximately 58 million people in the United States. The aging of the baby boom generation (those born between 1946 and 1964) will cause that number to almost double by 2030, reaching 108 million.

If the relatively low rates of substance abuse among older adults were to remain the same as in 1995, treatment need would be 1½ times greater in 2030 because of this population growth.1 However, the baby boom generation has higher rates of lifetime alcohol and drug use than did the previous generation, and evidence suggests that these higher rates will persist as the group ages.2, 3 Thus, the need for substance abuse treatment among older adults is expected to increase.

The Treatment Episode Data Set (TEDS) permits monitoring of trends among older adults admitted to substance abuse treatment in publicly funded facilities.

In 1999, there were 50,700 admissions aged 55 or older to publicly funded substance abuse treatment (Table 1). The majority (81 percent) were male. The admission rate for adults aged 55 or older was 88 per 100,000, which was considerably lower than the rate of 719 admissions per 100,000 for the population aged 12 or older (data not shown).

Trends in Treatment Admissions
Between 1994 and 1999, annual substance abuse treatment admissions among persons aged 55 or older decreased by 3 percent, from 52,200 to 50,700 (Table 1). This decrease was similar to that shown in the total treatment population.

Adults aged 55 to 59 made up the largest part of the older adult treatment population. This proportion increased from 49 percent in 1994 to 55 percent in 1999 (Figure 1).

Alcohol was the primary substance of abuse at admission for all age groups, including individuals aged 55 or older (Table 1). However, alcohol admissions declined by 9 percent between 1994 and 1999 both for men and for women in that age group (Figure 2). Among older adults, admissions for illicit drugs increased by 25 percent for men and 43 percent for women over this time period, although overall admissions remained low.
Table 1. Admissions Aged 55 or Older, by Primary Substance at Admission: 1994-1999
Figure 1. Admissions Aged 55 or Older, by Age Group: 1994-1999
 
1994
1995
1996
1997
1998
1999
Admissions Aged 55 or Older (Thousands)
52.2
50.3
51.3
46.8
49.9
50.7
Primary
Substance
Percent
Alcohol
82.0
80.9
81.0
79.1
78.3
76.1
Opiates
9.7
10.3
10.0
11.4
11.0
12.6
Cocaine
2.6
3.0
3.2
3.6
4.2
4.5
Marijuana
0.7
0.8
0.9
1.0
1.1
1.3
Sedatives/
Tranquilizers
0.9
0.8
0.9
1.0
0.8
0.7
Stimulants
0.3
0.3
0.3
0.4
0.5
0.6
Other
3.8
3.9
3.5
3.7
4.1
4.1
Figure 1, Admissions Aged 55 or Older, by Age Group between 1994 and 1999

Source: 1999 SAMHSA Treatment Episode Data Set (TEDS).

Referral Source
Older adults were more likely than younger adults to be referred to treatment by health care providers and less likely to enter treatment through the criminal justice system (data not shown). Among adults aged 55 or older, 13 percent were referred by health care providers, compared with 7 percent of admissions under age 55. Thirty percent of adults aged 55 or older were referred through the criminal justice system, compared with 37 percent of younger admissions.
 
Age at First Use
First use of drugs or first alcohol intoxication occurred at a younger age among men aged 55 or older than among women in that age group (Figure 3). Fifty percent of the men in this age group had initiated drug or alcohol use by the age of 17. Women in this group, however, were generally older when they began their drug and alcohol use, with more than one quarter reporting that their first use occurred after age 30.
Figure 2. Admissions Aged 55 or Older, by Sex and Primary Substance: 1994-1999
Figure 3. Age at First Use of Drugs or First Alcohol Intoxication, Admissions Aged 55 or Older, by Sex: 1999
Figure 2, Admissions Aged 55 or Older, by Sex and Primary Substance between 1994 and 1999 Figure 3, Age at First Use of Drugs or First Alcohol Intoxixcation, Admissions Aged 55 or Older, by Sex, in 1999

Source: 1999 SAMHSA Treatment Episode Data Set (TEDS).

Admissions by State
In 1999, the most populous States tended to have the largest numbers of older adults entering substance abuse treatment, but not necessarily the highest admission rates (Table 2). Admission rates among adults aged 55 or older tended to be highest in northern and northeastern States.
Table 2. States with Largest Numbers and Highest Rates of Admissions Aged 55 or Older, by Rank: 1999
End Notes
1Gfroerer, J.C., & Epstein, J.F. (1999). Marijuana initiates and their impact on future drug abuse treatment need. Drug and Alcohol Dependence 54, 229-237.

2Substance Abuse and Mental Health Services Administration. (2000). Summary of findings from the 1999 National Household Survey on Drug Abuse (NHSDA Series: H-12, DHHS Publication No. SMA 00-3466). Rockville, MD: Author.

3Center for Substance Abuse Treatment. (1998). Substance abuse among older adults (DHHS Publication No. SMA 98-3179). Rockville, MD: Substance Abuse and Mental Health Services Administration.

State Number   State Rate per 100,000
Aged 55 or Older
New York 7,026 Alaska 378
California 6,063 Colorado 335
Florida 2,782 Oregon 225
Colorado 2,631 Connecticut 214
Massachusetts 2,218 Minnesota 185
Minnesota 1,820 District of Columbia 179
Oregon 1,737 New York 177
Maryland 1,636 Vermont 171
Connecticut 1,605 South Carolina 170
Washington 1,491 South Dakota 167
New Jersey 1,421 Massachusetts 163
Michigan 1,416 Utah 163
South Carolina 1,387 Maryland 160
Indiana 1,304 Montana 139
Pennsylvania 1,276 Maine 136

Source: 1999 SAMHSA Treatment Episode Data Set (TEDS).
The Drug and Alcohol Services Information System (DASIS) is an integrated data system maintained by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). One component of DASIS is the Treatment Episode Data Set (TEDS), a national-level dataset comprising State administrative data from treatment facilities receiving public funds. The TEDS system includes records for some 1.6 million substance abuse treatment admissions annually. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once.

The DASIS Report is prepared by the Office of Applied Studies, SAMHSA; Synectics for Management Decisions, Inc., Arlington, Virginia; and RTI, Research Triangle Park, North Carolina.

Information and data for this issue are based on data reported to TEDS through April 16, 2001.

Access the latest TEDS reports at:
www.oas.samhsa.gov/dasis.htm

Access the latest TEDS public use files at:
webapp.icpsr.umich.edu/cocoon/SAMHDA-SERIES/00056.xml

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This page was last updated on December 31, 2008.