The Epidemiology of Substance Use and Disorders Among Middle Aged and Elderly Community Adults: National Survey on Drug Use and Health

Objective: To estimate the prevalence, distribution, and correlates of drug use among middle aged and elderly persons in the United States and to compare with alcohol use in this age group. Setting: The 2005 and 2006 National Surveys oil Drug Use and Health. Participants: A total of 10,953 subjects age 50 years and older (6,717 subjects age 50-64 years and 4,236 subjects age 65+ years). Measurements: Social and demographic variables detailed assessment of alcohol and drug use and disorders (marijuana, cocaine, inhalants, hallucinogens, methamphetamine, and heroin), major depression, and self-rated health. Results: Nearly 60% of subjects used alcohol during the past year, 2.6% marijuana, and 0.41% cocaine. Both alcohol and drug use were far more frequent in subjects age 50-64 years and among men. Drug use, in contrast to alcohol use, was not associated with education but was more common among those not married and those with major depression. The prevalence of drug abuse or dependence in the 50+ age group was very low (only 0-33% for any abuse or dependence, 0.12% for marijuana abuse or dependence, and 0.18% for cocaine abuse or dependence). Nevertheless, the use of marijuana approached 4% in the 50-64 age group in comparison with 0.7% in the 65+ age group. Conclusions: Drug use is not prevalent, although use is much more common in the middle aged, suggesting that prevalence may rise substantially in the 65+ age group as the younger cohort ages. (Am J Geriatr Psychiatry 2009; 17:237-245)