Health Conditions Among Aging Narcotics Addicts: Medical Examination Results
ABSTRACT The study examined health conditions among an aging cohort of male narcotics addicts. This prospective cohort study (1964-1998) included interviews and medical testing for 108 surviving subjects who had been admitted to the California Civil Addict Program during the years 1962 through 1964. Medical testing results were: 51.9% had high blood pressure, 22.4% showed hyperlipidemia, 13.3% had elevated levels of blood glucose, 33.6% had abnormal pulmonary function, half of the sample had abnormal liver function, and 94.2% tested positive for hepatitis C, 85.6% for hepatitis B, 3.8% for syphilis, and 27.3% for TB. The study empirically demonstrated poor health conditions and high morbidity among surviving narcotics addicts.
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- "These findings suggest that older adults with an OUD have complex health needs compared to both younger adults with OUDs, and older adults who do not have an OUD. Older adults with OUDs typically have high rates of mental illness and chronic diseases, as well as long histories of health risks such as cigarette smoking and poor nutrition (Hser et al., 2004; Rosen et al., 2011, 2008). In this sample of older adults with OUD, we observed high rates of comorbid, non-opioid substance use disorders. "
ABSTRACT: The population of people with opioid use disorders (OUD) is aging. There has been little research on the effects of aging on mortality rates and causes of death in this group. We aimed to compare mortality in older (≥50 years of age) adults with OUD to that in younger (<50 years) adults with OUD and older adults with no history of OUD. We also examined risk factors for specific causes of death in older adults with OUD. Using data from the Veteran's Health Administration National Patient Care Database (2000-2011), we compared all-cause and cause-specific mortality rates in older adults with OUD to those in younger adults with OUD and older adults without OUD. We then generated a Cox regression model with specific causes of death treated as competing risks. Older adults with OUD were more likely to die from any cause than younger adults with OUD. The drug-related mortality rate did not decline with age. HIV-related and liver-related deaths were higher among older OUD compared to same-age peers without OUD. There were very few clinically important predictors of specific causes of death. Considerable drug-related mortality in people with OUD suggests a need for greater access to overdose prevention and opioid substitution therapy across the lifespan. Elevated risk of liver-related death in older adults may be addressed through antiviral therapy for hepatitis C virus infection. There is an urgent need to explore models of care that address the complex health needs of older adults with OUD. Copyright © 2015. Published by Elsevier Ireland Ltd.Drug and Alcohol Dependence 12/2014; 147. DOI:10.1016/j.drugalcdep.2014.12.019 · 3.42 Impact Factor
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- "Additional factors contributing to excess mortality, and common amongst this group, were not measured, including: high rates of smoking, high levels of alcohol consumption that is not acknowledged as problematic, low socioeconomic status, low quality of life, high rates of depression and co-morbidity, and poor diet (Copeland et al., 2012). It is also important to note that whilst our findings should inform management of older, active, opioid users, we are unable to make inferences about longer-term mortality outcomes for those who desist from use at a younger age, although this may not be the norm (Termorshuizen et al., 2005; Hser et al., 2004). Treatment effects on mortality risk were not considered here but are being investigated in parallel work. "
ABSTRACT: Globally, opioid drug use is an important cause of premature mortality. In many countries, opioid using populations are ageing. The current study investigates mortality in a large cohort of opioid users; with a focus on testing whether excess mortality changes with age.Methods198,247 opioid users in England were identified from drug treatment and criminal justice sources (April, 2005 to March, 2009) and linked to mortality records. Mortality rates and standardised mortality ratios (SMRs) were calculated by age-group and gender.ResultsThere were 3974 deaths from all causes (SMR 5.7, 95% Confidence Interval: 5.5 to 5.9). Drug-related poisonings (1715) accounted for 43% of deaths. Relative to gender-and-age-appropriate expectation, mortality was elevated for a range of major causes including: infectious, respiratory, circulatory, liver disease, suicide, and homicide. Drug-related poisoning mortality risk continued to increase beyond 45 years and there were age-related increases in SMRs for specific causes of death (infectious, cancer, liver cirrhosis, and homicide). A gender by age-group interaction revealed that whilst men have a greater drug-related poisoning mortality risk than women at younger ages, the difference narrows with increasing age.Conclusion Opioid users’ excess mortality persists into old age and for some causes is exacerbated. This study highlights the importance of managing the complex health needs of older opioid users.Drug and Alcohol Dependence 11/2014; 146(1). DOI:10.1016/j.drugalcdep.2014.09.782 · 3.42 Impact Factor
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- "Aging is a process that brings about changes that can have a profound impact on a person's health and well-being. The same applies to methadone patients, and often even more so, since many of them have aged prematurely as a result of a history of long-standing substance use , and they often suffer from chronic diseases [20,23,25,47,48]. Health problems resulting from prolonged substance use can accelerate the decline in health some older persons already experience. "
ABSTRACT: Data from the US indicates that methadone-maintained populations are aging, with an increase of patients aged 50 or older. Data from European methadone populations is sparse. This retrospective cohort study sought to evaluate the age trends and related developments in the methadone population of Basel-City, Switzerland. The study included methadone patients between April 1, 1995 and March 31, 2003. Anonymized data was taken from the methadone register of Basel-City. For analysis of age distributions, patient samples were split into four age categories from '20-29 years' to '50 years and over'. Cross-sectional comparisons were performed using patient samples of 1996 and 2003. Analysis showed a significant increase in older patients between 1996 and 2003 (p < 0.001). During that period, the percentage of patients aged 50 and over rose almost tenfold, while the proportion of patients aged under 30 dropped significantly from 52.8% to 12.3%. The average methadone dose (p < 0.001) and the 1-year retention rate (p < 0.001) also increased significantly. Findings point to clear trends in aging of methadone patients in Basel-City which are comparable, although less pronounced, to developments among US methadone populations. Many unanswered questions on medical, psychosocial and health economic consequences remain as the needs of older patients have not yet been evaluated extensively. However, older methadone patients, just as any other patients, should be accorded treatment appropriate to their medical condition and needs. Particular attention should be paid to adequate solutions for persons in need of care.Substance Abuse Treatment Prevention and Policy 05/2011; 6(1):9. DOI:10.1186/1747-597X-6-9 · 1.16 Impact Factor