PMID- 30384321
OWN - NLM
STAT- MEDLINE
DCOM- 20190315
LR  - 20191201
IS  - 1879-0046 (Electronic)
IS  - 0376-8716 (Print)
IS  - 0376-8716 (Linking)
VI  - 193
DP  - 2018 Dec 1
TI  - A hidden aspect of the U.S. opioid crisis: Rise in first-time treatment 
      admissions for older adults with opioid use disorder.
PG  - 142-147
LID - S0376-8716(18)30542-8 [pii]
LID - 10.1016/j.drugalcdep.2018.10.002 [doi]
AB  - BACKGROUND: Older adults with opioid use disorder (OUD) are a medically complex 
      population. The current study evaluated trends in older adults seeking treatment 
      for OUD, with a focus on primary heroin versus prescription opioid use. This 
      study also compared older adults with OUD to the younger OUD population on 
      demographics and drug use behaviors. METHODS: Publicly available data from 
      state-certified addiction treatment centers were collected via the Treatment 
      Episode Data Set - Admissions (TEDS-A) between 2004-2015. This study utilized 
      Joinpoint Regression to conduct a cross-sectional, longitudinal analysis of 
      trends in first-time treatment admissions for OUD in adults 55 and older (older 
      adults; n = 400,421) versus adults under the age of 55 (n = 7,795,839). Given the 
      rapid increase in older adults seeking treatment for OUD between 2013-2015, 
      secondary outcomes include changes in demographics and drug use between 2012 (as 
      a baseline year) and 2015. RESULTS: The proportion of older adults seeking 
      treatment for OUD rose steadily between 2004-2013 (41.2% increase; 
      p-trend = 0.046), then rapidly between 2013-2015 (53.5% increase; 
      p-trend = 0.009). The proportion of older adults with primary heroin use more 
      than doubled between 2012-2015 (p < 0.001); these individuals were increasingly 
      male (p < 0.001), African American (p < 0.001), and using via the intranasal 
      route of administration (p < 0.001). CONCLUSIONS: There has been a recent surge 
      in older adults seeking treatment for OUD, particularly those with primary heroin 
      use. Specialized treatment options for this population are critically needed, and 
      capacity for tailored elder care OUD treatments will need to increase if these 
      trends continue.
CI  - Copyright (c) 2018 Elsevier B.V. All rights reserved.
FAU - Huhn, Andrew S
AU  - Huhn AS
AD  - Johns Hopkins University School of Medicine, Department of Psychiatry and 
      Behavioral Sciences, Baltimore, MD, USA. Electronic address: ahuhn1@jhu.edu.
FAU - Strain, Eric C
AU  - Strain EC
AD  - Johns Hopkins University School of Medicine, Department of Psychiatry and 
      Behavioral Sciences, Baltimore, MD, USA.
FAU - Tompkins, D Andrew
AU  - Tompkins DA
AD  - Johns Hopkins University School of Medicine, Department of Psychiatry and 
      Behavioral Sciences, Baltimore, MD, USA; UCSF School of Medicine, Department of 
      Psychiatry, San Francisco, CA, USA.
FAU - Dunn, Kelly E
AU  - Dunn KE
AD  - Johns Hopkins University School of Medicine, Department of Psychiatry and 
      Behavioral Sciences, Baltimore, MD, USA.
LA  - eng
GR  - R21 DA035327/DA/NIDA NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20181018
PL  - Ireland
TA  - Drug Alcohol Depend
JT  - Drug and alcohol dependence
JID - 7513587
RN  - 70D95007SX (Heroin)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Cross-Sectional Studies
MH  - Female
MH  - Heroin
MH  - *Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Opioid-Related Disorders/*therapy
MH  - Sex Factors
PMC - PMC6242338
MID - NIHMS1510781
OTO - NOTNLM
OT  - Heroin
OT  - Older adults
OT  - Opioid use disorder
OT  - Prescription opioids
OT  - Treatment
OT  - Trend analysis
COIS- Conflict of Interest Statement Author DAT has received medication supplies from 
      Indivior for an investigator initiated study, was site PI for a clinical trial 
      sponsored by Alkermes, and is on a scientific advisory board for Alkermes. Author 
      ECS has served as a consultant or served on advisory boards for Analgesic 
      Solutions, Indivior, The Oak Group, Egalet Pharmaceuticals, Caron, Innocoll, and 
      Pinney Associates, and has received research funding through his university from 
      Alkermes. All opinions expressed and implied in this paper are solely those of 
      the authors and do not represent or reflect the views of the Johns Hopkins 
      University or the Johns Hopkins Health System. Authors ASH and KED report no 
      conflicts.
EDAT- 2018/11/02 06:00
MHDA- 2019/03/16 06:00
PMCR- 2019/12/01
CRDT- 2018/11/02 06:00
PHST- 2018/09/11 00:00 [received]
PHST- 2018/10/11 00:00 [revised]
PHST- 2018/10/16 00:00 [accepted]
PHST- 2018/11/02 06:00 [pubmed]
PHST- 2019/03/16 06:00 [medline]
PHST- 2018/11/02 06:00 [entrez]
PHST- 2019/12/01 00:00 [pmc-release]
AID - S0376-8716(18)30542-8 [pii]
AID - 10.1016/j.drugalcdep.2018.10.002 [doi]
PST - ppublish
SO  - Drug Alcohol Depend. 2018 Dec 1;193:142-147. doi: 
      10.1016/j.drugalcdep.2018.10.002. Epub 2018 Oct 18.