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The Prevalence of Mental and Physical Health Disorders Among Older Methadone Patients

https://doi.org/10.1097/JGP.0b013e31816ff35aGet rights and content

Objectives

The aging opioid-addicted cohort from the 1970s has begun to alter the demographic characteristics of individuals in need of services for heroin addiction. Yet, despite clear trends that indicate the population of older methadone patients is increasing, little is known about their well-being and service needs. The goal of this study was to assess the physical and mental health status of older methadone patients.

Design

Face-to-face interviews were conducted with study participants.

Setting

This study was conducted at a free-standing methadone clinic in a Midwestern industrial city.

Participants

A clinic sample of 140 adult methadone patients over the age of 50 was recruited for face-to-face interviews.

Measures

Mental health status was assessed by the Composite International Diagnostic Interview. The SF-12v2 was administered to measure a range of physical health issues. Participants were also asked about a variety of chronic conditions. In addition, respondents provided access to their drug screen results from monthly urine tests for illegal drug use for 1 year before and 1 year after the interview.

Results

Findings revealed that over half (57.1%) of respondents had at least one mental health disorder in the past year. In the year before the interview, the most prevalent mental health disorder experienced by older adult patients was major depressive episode (32.9%). The most prevalent anxiety disorders were posttraumatic stress disorder (27.8%) and generalized anxiety disorder (29.7%). Additionally, women experienced significantly higher levels of depression than males (43.8% versus 27.2%), and nearly twice the prevalence rate of agoraphobia and panic disorders. Regarding physical health, respondents reported high rates of health problems in the past year, including arthritis (54.3%) and hypertension (44.9%). The majority of respondents reported having fair to poor physical health (57.7%). When examining the entire 24-month period during which urine data were collected, three quarters (76.4%) of the respondents had at least 1 month where the urine screen detected illegal drug use.

Conclusions

In the next decade, the growing and aging substance abusing population will require clinicians trained in both geriatrics and substance abuse. Health and mental health professionals have the opportunity to address the specialized needs of this population and prepare for the shifting service needs these older patients will require.

Section snippets

Background

The data for this article were collected for a research project aimed at addressing the health and mental health service needs of older opioid-addicted individuals. Specifically, the study goals were to 1) document the prevalence and range of general medical and mental health disorders in a population of older methadone patients, and 2) evaluate a patient's ability to remain abstinent from illegal drug use in later-life.

Setting

Participants for this study were recruited from a free-standing methadone

RESULTS

The majority of older adult methadone clients in the study were male (64.3%, N = 92) and over half were African American (52.1%). Participants ranged in age from 50 to 67, with a mean age of 53.9 years (SD = 4.01). Nearly 17% were married and approximately 21% were widowers. Over a third of the respondents had been divorced (37.9%) or had never been married (26.4%). Over 30% lived alone; the remaining 70% lived with spouses, relatives, or friends. Less than one in five (17.9%) were currently

DISCUSSION

Our initial objective was to document the prevalence and range of health and mental health disorders in a sample of older adult methadone patients. The high rates of physical health problems and mental health disorders that were documented in the current study have expanded on previous studies by providing greater specificity on the needs of older individuals in an outpatient methadone maintenance program. This study also addresses the limited sample sizes found in many previous studies in this

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    The authors thank the John A. Hartford Social Work Faculty Scholars Program, the Advanced Center for Intervention Services and Services Research for Late-Life Mood Disorders, the John A. Hartford Center for Excellence in Geriatric Psychiatry, the UPMC Endowment in Geriatric Psychiatry, and the University of Pittsburgh Central Research Development Fund.

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