Tailoring Treatment for Substance Use Disorders in Older Adults: A Mixed-methods Study.

Area of Science:

• Gerontology
• Public Health
• Addiction Medicine

Background:

• The population of older adults with substance use disorders (SUDs) has tripled in the U.S. over 20 years, primarily due to opioid use disorder.
• Older individuals with SUDs present unique medical, psychological, and social needs requiring specialized care.
• There is limited understanding of the availability of tailored SUD treatment programs for older adults and the factors influencing their implementation.

Purpose of the Study:

• To investigate the availability of specialized SUD treatment programs for older adults.
• To identify barriers and facilitators to implementing these services.
• To examine characteristics affecting older adults' engagement in SUD treatment.

Main Methods:

• A mixed-methods study combining qualitative interviews with counselors and quantitative analysis of national surveys (SAMHSA N-SUMHSS, N-SSATS).
• Utilized the Behavioral Model of Health Services Utilization for Vulnerable Populations and Framework Analysis.
• Examined data from 10 outpatient SUD treatment facilities in Connecticut and national survey data.

Main Results:

• SUD treatment facilities offering "a tailored program for seniors or older adults" increased from 2010 to 2022.
• Of facilities offering older adult services, social, structural, and mental health services were common (64%-86%), but medical services were less frequent (39%-52%).
• Predisposing, enabling, need-based, and healthcare system factors influence older adults' SUD treatment engagement.

Conclusions:

• A significant gap exists between the treatment needs of older adults with SUDs and the services currently available.
• Enhanced integrated medical services, screening for geriatric syndromes, and workforce training are essential for optimizing SUD treatment for older adults.
• Addressing these needs is critical, particularly given the ongoing opioid use disorder epidemic.