Anne Marie Carew
Trinity College Dublin
Ms Carew is a PhD student at the School of Nursing and Midwifery, Trinity College Dublin, Ireland. Her research aims to interrogate an EU designed national drug treatment monitoring system to inform current international policy questions relating to ageing and substance misuse.
Aim of review
Historically issues relating to problem substance use among older people have received little attention, and these issues have only recently been recognised. A review was conducted aiming to assess the current state of outcome research among older adults treated for opioid dependence.
Search and review methodology
A systematic review of relevant primary material was conducted. The review aim, inclusion/exclusion criteria, search concepts and search strategy were developed and tested. Electronic databases (ASSIA, CINAHL, Medline, PsycINFO, Pubmed, Cochrane Library) were searched in November 2015 and results supplemented by grey literature, library and online searches. References included in relevant articles were checked for additional articles. The results were extracted, deduped, and reviewed to identify major findings and recommendations.
Findings
A total of 15,509 titles were identified, following exclusions (7,990 duplicates, 7,443 ineligible titles) 76 were included in the final review. Although drug use is a recognised globally as a serious public health concern and those in treatment have been studied for decades, little is known about older people. Problematic drug use (of which heroin/opiates make up the largest proportion) has been incorrectly assumed to end as patient’s age, however in reality, older drug users are growing in numbers and have a unique profile, different to their younger counterparts. The life expectancy of drug users have increased due to advances in harm reduction and drug treatment initiatives, along with advances in general medicine. Programmes providing opioid treatment are seeing larger volumes of older patients than ever before, many presenting for the first time aged 50-70 years old. Most of the current research conducted on older adults is predominately from the United States and involves alcohol and prescription medications. The literature has identified older drug users as a neglected subject and calls for more attention to be given to this topic.
Conclusions and Implications
Currently, there is insufficient research and evidence for interventions treating problem substance use among older people. Addiction and other healthcare services are insufficiently aware of the needs of older drug users and need to anticipate and prepare for predicted increases in demand from this group.
