Megan O'Grady, Kristyn Zajac, Alexandra DePalma, Yang Liu, Lisa C Barry
{"title":"老年人物质使用障碍的定制治疗：一项混合方法研究。","authors":"Megan O'Grady, Kristyn Zajac, Alexandra DePalma, Yang Liu, Lisa C Barry","doi":"10.1093/geroni/igaf027","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>The number of persons in mid-to-late life with substance use disorders (SUDs) in the United States has tripled over the past 2 decades, with opioid use disorder largely accounting for this increase. Older individuals with SUDs have unique medical, psychological, and social needs. Despite these needs and growing demand for SUD treatment within this age group, little is known regarding availability of specialized SUD treatment programs for older persons and barriers or facilitators to implementing these services.</p><p><strong>Research design and methods: </strong>We conducted a mixed-methods study, first conducting qualitative interviews with counselors at outpatient SUD treatment facilities in Connecticut (<i>N</i> = 10). We then used these qualitative interview findings to guide analysis of quantitative data from SAMHSA's National Substance Use and Mental Health Services Survey (N-SUMHSS) and the National Survey of Substance Abuse Treatment Services (N-SSATS) survey.</p><p><strong>Results: </strong>Using the Behavioral Model of Health Services Utilization for Vulnerable Populations and Framework Analysis, we identified predisposing (eg, treatment attitudes), enabling (eg, transportation), need-based (eg, comorbidities; integrated care), and healthcare system-related (eg, insurance) characteristics affecting older adults' SUD treatment engagement. SUD treatment facilities offering \"a tailored program for seniors or older adults\" increased steadily in Connecticut, and the United States overall, between 2010 and 2022. Of the 74 (43%) Connecticut facilities offering tailored older adult services, social, structural, and mental health services were offered at high rates (64%-86%), but medical services were offered at lower rates (39%-52%).</p><p><strong>Discussion and implications: </strong>Our findings indicate a gap between the treatment needs of older adults with SUDs and available services. Greater attention to integrated medical services, screening for geriatric-specific syndromes that could impede treatment access (eg, cognitive impairment; mobility), and appropriate workforce training is needed to optimize treatment for older adults with SUD, especially considering the opioid use disorder epidemic in the United States.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 6","pages":"igaf027"},"PeriodicalIF":4.9000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188435/pdf/","citationCount":"0","resultStr":"{\"title\":\"Tailoring Treatment for Substance Use Disorders in Older Adults: A Mixed-methods Study.\",\"authors\":\"Megan O'Grady, Kristyn Zajac, Alexandra DePalma, Yang Liu, Lisa C Barry\",\"doi\":\"10.1093/geroni/igaf027\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>The number of persons in mid-to-late life with substance use disorders (SUDs) in the United States has tripled over the past 2 decades, with opioid use disorder largely accounting for this increase. Older individuals with SUDs have unique medical, psychological, and social needs. Despite these needs and growing demand for SUD treatment within this age group, little is known regarding availability of specialized SUD treatment programs for older persons and barriers or facilitators to implementing these services.</p><p><strong>Research design and methods: </strong>We conducted a mixed-methods study, first conducting qualitative interviews with counselors at outpatient SUD treatment facilities in Connecticut (<i>N</i> = 10). We then used these qualitative interview findings to guide analysis of quantitative data from SAMHSA's National Substance Use and Mental Health Services Survey (N-SUMHSS) and the National Survey of Substance Abuse Treatment Services (N-SSATS) survey.</p><p><strong>Results: </strong>Using the Behavioral Model of Health Services Utilization for Vulnerable Populations and Framework Analysis, we identified predisposing (eg, treatment attitudes), enabling (eg, transportation), need-based (eg, comorbidities; integrated care), and healthcare system-related (eg, insurance) characteristics affecting older adults' SUD treatment engagement. SUD treatment facilities offering \\\"a tailored program for seniors or older adults\\\" increased steadily in Connecticut, and the United States overall, between 2010 and 2022. Of the 74 (43%) Connecticut facilities offering tailored older adult services, social, structural, and mental health services were offered at high rates (64%-86%), but medical services were offered at lower rates (39%-52%).</p><p><strong>Discussion and implications: </strong>Our findings indicate a gap between the treatment needs of older adults with SUDs and available services. Greater attention to integrated medical services, screening for geriatric-specific syndromes that could impede treatment access (eg, cognitive impairment; mobility), and appropriate workforce training is needed to optimize treatment for older adults with SUD, especially considering the opioid use disorder epidemic in the United States.</p>\",\"PeriodicalId\":13596,\"journal\":{\"name\":\"Innovation in Aging\",\"volume\":\"9 6\",\"pages\":\"igaf027\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2025-03-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188435/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Innovation in Aging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/geroni/igaf027\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Innovation in Aging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/geroni/igaf027","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Tailoring Treatment for Substance Use Disorders in Older Adults: A Mixed-methods Study.
Background and objectives: The number of persons in mid-to-late life with substance use disorders (SUDs) in the United States has tripled over the past 2 decades, with opioid use disorder largely accounting for this increase. Older individuals with SUDs have unique medical, psychological, and social needs. Despite these needs and growing demand for SUD treatment within this age group, little is known regarding availability of specialized SUD treatment programs for older persons and barriers or facilitators to implementing these services.
Research design and methods: We conducted a mixed-methods study, first conducting qualitative interviews with counselors at outpatient SUD treatment facilities in Connecticut (N = 10). We then used these qualitative interview findings to guide analysis of quantitative data from SAMHSA's National Substance Use and Mental Health Services Survey (N-SUMHSS) and the National Survey of Substance Abuse Treatment Services (N-SSATS) survey.
Results: Using the Behavioral Model of Health Services Utilization for Vulnerable Populations and Framework Analysis, we identified predisposing (eg, treatment attitudes), enabling (eg, transportation), need-based (eg, comorbidities; integrated care), and healthcare system-related (eg, insurance) characteristics affecting older adults' SUD treatment engagement. SUD treatment facilities offering "a tailored program for seniors or older adults" increased steadily in Connecticut, and the United States overall, between 2010 and 2022. Of the 74 (43%) Connecticut facilities offering tailored older adult services, social, structural, and mental health services were offered at high rates (64%-86%), but medical services were offered at lower rates (39%-52%).
Discussion and implications: Our findings indicate a gap between the treatment needs of older adults with SUDs and available services. Greater attention to integrated medical services, screening for geriatric-specific syndromes that could impede treatment access (eg, cognitive impairment; mobility), and appropriate workforce training is needed to optimize treatment for older adults with SUD, especially considering the opioid use disorder epidemic in the United States.
期刊介绍：
Innovation in Aging, an interdisciplinary Open Access journal of the Gerontological Society of America (GSA), is dedicated to publishing innovative, conceptually robust, and methodologically rigorous research focused on aging and the life course. The journal aims to present studies with the potential to significantly enhance the health, functionality, and overall well-being of older adults by translating scientific insights into practical applications. Research published in the journal spans a variety of settings, including community, clinical, and laboratory contexts, with a clear emphasis on issues that are directly pertinent to aging and the dynamics of life over time. The content of the journal mirrors the diverse research interests of GSA members and encompasses a range of study types. These include the validation of new conceptual or theoretical models, assessments of factors impacting the health and well-being of older adults, evaluations of interventions and policies, the implementation of groundbreaking research methodologies, interdisciplinary research that adapts concepts and methods from other fields to aging studies, and the use of modeling and simulations to understand factors and processes influencing aging outcomes. The journal welcomes contributions from scholars across various disciplines, such as technology, engineering, architecture, economics, business, law, political science, public policy, education, public health, social and psychological sciences, biomedical and health sciences, and the humanities and arts, reflecting a holistic approach to advancing knowledge in gerontology.
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