Health Conditions Among Aging Narcotics Addicts: Medical Examination Results
University of California, Los Angeles, California 90025, USA. Journal of Behavioral Medicine
(Impact Factor: 3.1).
01/2005; 27(6):607-22. DOI: 10.1007/s10865-004-0005-x
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.
Available from: Sarah Larney
- "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. "
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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.
Available from: Matthias Pierce
- "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. "
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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.
Available from: Katherine Lovinger
- "However, few studies have examined the health status of heroin users as they enter into middle-and older-age (Rosen, Hunsaker, Albert, Cornelius, & Reynolds, 2011). In a 33-year follow-up study of male heroin users, a subsample (n =108; average age of 58) that completed medical tests had several indicators of poor health (Hser et al., 2004). Over half had elevated blood pressure, were overweight, and had abnormal liver function; about one fifth had elevated glucose levels; and, overall, the sample rated their health more poorly than men in the general population of comparable age. "
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ABSTRACT: This paper examines the health status and functioning of an aging cohort of individuals with a history of heroin dependence with a focus on gender differences.
Study subjects were originally sampled from methadone maintenance clinics in California in the 1970s and completed follow-up interviews in 2005-09. Out of the original study sample (N=914), 343 participants (44.3% female) were interviewed (70.6% of those not deceased). Bivariate analyses examined gender differences in participants' overall health status and physical and mental health problems. Scores on SF-36 scales were compared with general population norms by gender and age, as well as between participants in the study sample who did and did not report past-year drug use.
Average age of the study sample was 58.3 (SD=4.9) years for males and 55.0 (SD=4.1) years for females. There were no significant gender differences in past-year drug use (38% of sample) or injection drug use (19%). Women reported significantly more chronic health problems and psychological distress compared with men, and overall poorer health and functioning compared with general population norms. Men under 65 had poorer physical health and social functioning compared with population norms. Men in the study sample reporting past-year substance use had poorer physical functioning, but less bodily pain, than non-users, whereas women with past-year substance use had poorer mental health than other women.
Individuals with a history of heroin dependence have poorer health and functioning than their counterparts in the general population. At a younger age, women reported poorer overall health status and more chronic health and mental health problems than men. Study findings may inform interventions for this population, particularly related to gender-specific treatment needs.
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