Prevention & Older Adults: Don t You Forget About Us!

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1 Prevention & Older Adults: Don t You Forget About Us! Sponsored by the Utah Department of Human Services Substance Abuse and Mental Health Facilitated by Mary Ellen Shannon, JBS International

2 Who We Are Since our founding in 1985, JBS International has worked with every state and jurisdiction in the United States to develop strong behavioral health prevention, treatment, and recovery systems that reduce the toll of alcohol, tobacco, and other drugs for all citizens.

3 Who I am

4 Which one are you? Baby Boomers Generation X Generation Y/Millennials Postmillennial/Generation Z Present

5 In 2014, 14.5 percent of the U.S. population was aged 65 or older; by 2060 it is projected to comprise 23.5 percent of the population. 2 Baby Boomers Misuse or abuse illicit drugs and alcohol at higher rates than previous generations. Researchers warn that the projected growth of this population, combined with the increase in substance abuse, could create a public health crisis Colby, Sandra L. and Jennifer M. Ortman, Projections of the Size and Composition of the U.S. Population: 2014 to 2060, Current Population Reports, P , U.S. Census Bureau, Washington, DC, Mattson, M., Lipari, R.N., Hays, C. and Van Horn, S.L. A day in the life of older adults: Substance use facts. The CBHSQ Report: MONTH XX, 20XX. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD.

6 An Emerging Public Health Crisis 6

7 alcohol

8 Any alcohol consumption U.S. adults, and % +22.4% p<0.05 for all values Grant Hasin, JAMA Psychiatry 2017

9 High-risk drinking (4+/5+ drinks) U.S. adults, and % +65.2% Grant Hasin, JAMA Psychiatry 2017

10 DSM-IV Alcohol Use Disorder (Abuse or Dependence) U.S. adults, and % % Grant Hasin, JAMA Psychiatry 2017

11 What s a Standard Drink? 11

12 NIAAA Drinking Limits

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14 Alcohol Issues and Older Adults Complicates management of health problems common in older adults, including: Diabetes High blood pressure Congestive heart failure Liver problems Osteoporosis Memory problems Mood disorders 14

15 Prescription Misuse in Older Adults Alcohol and medication misuse affect 19 % of older adults. 15 Substance Abuse and Mental Health Services Administration. (2011). Leading change: A plan for SAMHSA s roles and actions (HHS Publication No. SMA ). Rockville, MD: Substance Abuse and Mental Health Services Administration.

16 Medication Use and Misuse (cont.) 80 percent of older adults take prescription medications. Of these: 63 percent take five or more medications daily Nearly a third take a medicine with abuse potential. 16 Qato, D. M., Alexander, G. C., Conti, R. M., Johnson, M., Schumm, P., Lindau, S. T. (2008). Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States. JAMA : The Journal of the American Medical Association, 300(24):

17 Medication Use & Misuse Older adults are prescribed more medications than any other age group. 17 Qato, D. M., Alexander, G. C., Conti, R. M., Johnson, M., Schumm, P., Lindau, S. T. (2008). Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States. JAMA : The Journal of the American Medical Association, 300(24):

18 Opioids Codeine (Tylenol #3) Ocycodone (OxyContin, Percodet, Percodan) Hydrocodone (Vicodin, Lortab) Fentanyl (Duragesic transdermal patch) Tramadol (Ultram) Morphine (MS Contin, Roxanol) 18 Simoni-Wastila L, Yang HK. (2006). Psychoactive drug abuse in older adults. American Journal of Geriatric Pharmacotherapy, 4:

19 Misuse of Opioids and Opioid Use Disorders among Older Americans

20 Why Are Older Adults at Higher Risk? Biological Demographic External 20

21 Biological Factors Alcohol and drugs affect older adults differently due to biological changes associated with aging. 21 SAMHSA State TA Project, Fact Sheet: High-Risk Alcohol and Opioid Use Among Adults Ages 55 and Older, 2018.

22 Demographics - Rural Older Adults More likely to be economically disadvantaged and live in poverty More limited access to health care Reduced health literacy More likely to experience depression and social isolation More likely to be raising a grandchild because their adult child is addicted to opioids. 22 Heartache, Pain and Hope: Rural Communities, Older People, and the Opioid Crisis An Introduction for Funders (2017)

23 Depression in Late Life Highly prevalent (14-20%) Not part of normal aging, but risk is increased Risk Factor for substance use disorders and suicide Linked to social isolation Impacts quality of life, function, management of chronic conditions Under-recognized and under-treated 23

24 Stressful Life Events and Transitions 24

25 Impact on Service Providers Opioid-related problems in rural America are expected to place enormous pressure on already strained rural service providers, including aging and healthcare providers, emergency response teams, adult protective services, and law enforcement. 25 Heartache, Pain and Hope: Rural Communities, Older People, and the Opioid Crisis An Introduction for Funders (2017)

26 Taking Action What does Prevention Look Like? 26

27 Some Potential Partners Funders or potential funders Medicaid representatives Local government Area agencies on aging Community mental health centers Substance use disorder treatment providers Prevention programs/coalitions Federally qualified health centers Schools of nursing, social work, and public health Elected officials Senior service centers Older adults Tribes Businesses Faith-based organizations Physicians/hospitals Geriatric education centers. 27

28 What can YOU do to include a focus on older adults within prevention efforts?

29 Thank You! More Questions? Contact Us! Mary Ellen Shannon