Substance Use as a Barrier to Healthy Aging: Perceptions and Experiences of Older Adults

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1 Substance Use as a Barrier to Healthy Aging: Perceptions and Experiences of Older Adults Zachary R. Patterson, Sarah Wallingford, Sheena Taha and Oriana Vaccarino Issues of Substance Conference Calgary, Alberta November 14 th 2017

2 Substance Use in Canada Series 2

3 The Landscape in Canada Older adult population surpassed that of youth in 2015 According to the 2013 Canadian Alcohol, Tobacco and Drugs Survey, psychoactive substance use is prevalent among older adults Older adults are at elevated risk for harms associated with substance use 3

4 Focus Groups with Older Adults Study aimed to identify: 1. Experiences of older adults with substance use and any associated harms; 2. Perceptions of how substance use affects the aging process; 3. Views as to the component factors of healthy aging, including the role of substance use as a barrier; and 4. Thoughts on what treatment providers and supports should know to better help those with problematic substance use

5 Methods Qualitative, facilitator-led focus groups using semi-structured interview guide Participants: older adults aged 55+ with a diagnosed substance use disorder, currently engaged in age-specific treatment programs Setting: two geriatric addiction treatment programs in Southern Ontario Duration: up to 120 minutes Compensation: $20 upon completion N = 8 (n = 4 per program) Inductive thematic analysis using NVivo

6 Perspectives on Healthy Aging Mental and physical health Volunteering or helping others and involvement in the community Attitude towards life Good relationships Social support Continued education Leisure Good mental health, having a good memory, having good relationships. Those are all parts of healthy aging

7 Summary of Themes from Focus Groups Barriers to Healthy Aging Managing complex family relationships Isolation Knowing which supports are available Drinking as a Coping Mechanism Relationship issues and conflict Feelings of anger, frustration, fear and anxiety Loss of friends and support system I have lots of friends, but as [name] said, they slowly begin to die off, and that I find it hard to cope with. Illness and dying. That s my last remaining pleasure... Why take away my last remaining pleasure? If it s drinking or if it s smoking or whatever... That it s something that I enjoy. But on the other hand, there are some harms associated with it

8 Initiation of Substance Use Recreational use, gradually moves to more frequent, unhealthy amount of use Relationship issues Stress at home or at work Drinking as a socially acceptable thing Trauma and loss Childhood experiences and abuse Being put down by others Dealing with physical pain and it just got to be not only Friday night. It got to be Saturday night. Then it got to be Sunday night.... And it creeps up on you, or it did me, anyway. I never thought about it until much later, after I got divorced, that, you know what? I m drinking a heck of a lot of booze

9 Contributing Factors to Continued Alcohol Use 1. Feelings that nobody would understand your situation 2. The people you ve surrounded yourself with 3. Ease with which excessive drinking can be hidden 4. Challenges with harm reduction Because I m feeling this way, nobody will understand me. It doesn t matter who it is, nobody will understand me. Why would you want to do that? You have work. You have a place to live. You have a beautiful daughter. Nobody would understand how I feel, that was all. So I just kept drinking. And I tried for quite a long time to be controlled in the drinking. I d say, two drinks a night. And it hasn t worked. Anything bad happens, and [consumption] goes up again

10 Harms Associated with Substance Use 1. Harming Relationships 2. Physical and Mental Health 3. Potential to Harm Others 4. Decreasing Quality of Life it harmed my wife, number one.... And my daughter who I adore... I harmed everyone that I loved, really, when I think about it."

11 Age-Specific Supports and Access to Care 1. Professional support 2. Personal support network 3. Knowing what supports are available and how to access supports was highlighted as a crucial element That was one of the reasons for my falling into the heavy drinking, was because I didn t know who to contact. I really didn t. And that s years ago. I think if you have the right supports, and you know you re getting the right help, then it s easier

12 Advice to Others and Their Supports 1. Need for openness 2. Need for kindness, respect and listening from supports 3. Need for self-vigilance when trying to stop use and I ve been in groups with young people, and you re at two different ends. This is why it s, we say, age-appropriate because they can t relate to you, and you can t relate to [them]

13 Issues Specific to Fentanyl Participants struggling with fentanyl use had unique experience: Prescribed by doctor Lack of alternatives available Abuse was accidental, in that patients were taking prescribed dosages Frequent falls associated with fentanyl use

14 So What Did We Do? Integrated Knowledge Mobilization Gives stakeholders a voice and a contributing role in developing the product; Informs the development of the report; Ensures product has relevance to the field; and Maximizes impact by ensuring product meets actual needs;

15 Thank you Zachary Patterson, PhD Knowledge Broker rue Albert Street, Ottawa, ON K1P 5E