There is an increase in alcohol and drug misuse among people aged over 50, public health experts warn today.
Dr Rahul Rao of South London and Maudsley NHS Foundation Trust, UK, and Professor Ann Roche of Flinders University Adelaide, Australia, point out that the number of older people in developing countries with substance misuse issues is growing alongside the ageing population.
"The numbers receiving treatment expected to treble in the US and double in Europe by 2020," they state in today’s BMJ. "There is also a strong upward trend for episodic heavy drinking in this age group. The rise of alcohol misuse in ‘baby boomers’ (people born between 1946 and 1964) has also been noted in Asian countries."
They add that older people with substance misuse tend to fall into one of three groups: maintainers (unchanged lifetime patterns), survivors (long term problem users), and reactors (later uptake or increased patterns).
Improved alcohol screening to detect risky drinking is needed, with effective treatment programmes adapted for older people. The authors encourage health professionals to consider the possibility of coexisting mental or physical disorders such as depression or pain.
"Future health care for older people with substance misuse will continue to present challenges for service delivery, particularly with the growing influence of baby boomers," they write. "Guidance for service commissioners has begun to acknowledge the needs of older people with substance misuse, particularly in the context of dual diagnosis."
But they conclude: "So far, there has been little sign of a coordinated international approach to integrated care."
Rao, R. and Roche, A. Substance misuse in older people. BMJ 23 August 2017; doi: 10.1136/bmj.j3885 [abstract]
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