Understanding Substance Abuse Across Generations: A Comparative Analysis of Adolescents and Older Adults in the U.S.
DOI:
https://doi.org/10.61173/jytgdb10Keywords:
Substance abuse, adolescent, older adultsAbstract
Substance abuse remains a critical public health issue in the U.S., with rising overdose rates affecting both adolescents and older adults. Despite the growing impact on these age groups, there is a gap in research exploring the distinct factors that drive substance abuse across generations, particularly among older adults, who remain underrepresented in clinical studies. This essay aims to compare the current situation and psychological, social, and policy-related drivers of substance abuse between adolescents and older adults, while proposing age-specific interventions to address these issues. Using a literature review and data analysis from national health surveys and clinical research, key findings suggest that adolescents are increasingly vulnerable to synthetic opioids like fentanyl, while older adults face challenges related to polypharmacy, chronic pain, and inadequate healthcare access. Consequently, this essay emphasizes the need for distinct prevention and treatment methods, calling for more inclusive research on older adults though advancing public health policies, improved access to addiction treatment by expanding practitioner workforce, and the use of digital health tools to provide age-appropriate care in the future.References
[1] West, N. A., Severtson, S. G., Green, J. L., & Dart, R. C. Trends in abuse and misuse of prescription opioids among older adults. Drug and Alcohol Dependence, 2015,149: 117-121.
[2] Schepis, T. S., McCabe, S. E. Prescription Opioid Misuse in US Older Adults: Associated Comorbidities and Reduced Quality of Life in the National Epidemiologic Survey of Alcohol and Related Conditions-III. The Journal of Clinical Psychiatry, 2019,80(6).
[3] Hall, W. D., Patton, G., Stockings, E., Weier, M., Lynskey, M., Morley, K. I., & Degenhardt, L. Why young people’s substance use matters for global health. The Lancet Psychiatry, 2016,3(3): 265-279.
[4] Miech, R. A., Johnston, L. D., Patrick, M. E., O’Malley, P. M., & Bachman, J. G. Monitoring the Future national survey results on drug use, 1975-2023: Secondary school students. Monitoring the Future Monograph Series. Ann Arbor, MI: Institute for Dean&Francis Jiayin Wen Social Research, University of Michigan. Available at https:// monitoringthefuture.org/results/annual-reports/.
[5] NIDA. Reported drug use among adolescents continued to hold below pre-pandemic levels in 2023. Retrieved from https:// nida.nih.gov/news-events/news-releases/2023/12/reported-druguse-among-adolescents-continued-to-hold-below-pre-pandemiclevels-in-2023.
[6] Friedman, J., Godvin, M., Shover, C. L., Gone, J. P., Hansen, H., & Schriger, D. L. Trends in Drug Overdose Deaths Among US Adolescents, January 2010 to June 2021. JAMA, 2022,327(14): 1398.
[7] Culberson, J. W., & Ziska, M. Prescription drug misuse/ abuse in the elderly. Geriatrics, 2008,63(9): 22-31.
[8] Humphreys, K., & Shover, C. L. Twenty-Year Trends in Drug Overdose Fatalities Among Older Adults in the US. JAMA Psychiatry, 2023,80(5): 518.
[9] Heneghan, A., Stein, R. E. K., Hurlburt, M. S., Zhang, J., Rolls-Reutz, J., Fisher, E., Landsverk, J., & Horwitz, S. M. Mental Health Problems in Teens Investigated by U.S. Child Welfare Agencies. Journal of Adolescent Health, 2013,52(5): 634-640.
[10] Harstad, E., Wisk, L. E., Ziemnik, R., Huang, Q., Salimian, P., Weitzman, E. R., & Levy, S. Substance Use Among Adolescents with Attention-Deficit/Hyperactivity Disorder: Reasons for Use, Knowledge of Risks, and Provider Messaging/ Education. Journal of Developmental & Behavioral Pediatrics, 2017,38(6): 417-423.
[11] Chuang, C.-W. I., Sussman, S., Stone, M. D., Pang, R. D., Chou, C.-P., Leventhal, A. M., & Kirkpatrick, M. G. Impulsivity and history of behavioral addictions are associated with drug use in adolescents. Addictive Behaviors, 2017,74: 41-47.
[12] Volkow, N. D., & McLellan, A. T. Opioid Abuse in Chronic Pain--Misconceptions and Mitigation Strategies. New England Journal of Medicine, 2016,374(13): 1253-1263.
[13] Gabrielli, J., Jackson, Y., & Brown, S. Associations Between Maltreatment History and Severity of Substance Use Behavior in Youth in Foster Care. Child Maltreatment, 2016,21(4): 298-307.
[14] Maxwell, K. A. Friends: The Role of Peer Influence Across Adolescent Risk Behaviors. Journal of Youth and Adolescence, 2002,31(4): 267-277.
[15] Doggett, A., Qian, W., Godin, K., De Groh, M., & Leatherdale, S. T. Examining the association between exposure to various screen time sedentary behaviours and cannabis use among youth in the COMPASS study. SSM - Population Health, 2019,9: 100487.
[16] Desai, R., Karim, S., Freeborn, J., Trivedi, C., Husain, K., & Jain, S. Contextualizing the Relationship Between Social Isolation and Substance Abuse. The Primary Care Companion For CNS Disorders, 2024,26(5).
[17] Farmer, A. Y., Wang, Y., Peterson, N. A., Borys, S., & Hallcom, D. K. Social Isolation Profiles and Older Adult Substance Use: A Latent Profile Analysis. The Journals of Gerontology: Series B, 2022,77(5): 919-929.
[18] Friedman, J., & Hadland, S. E. The Overdose Crisis among U.S. Adolescents. New England Journal of Medicine, 2024,390(2): 97-100.
[19] Herrera, A. P., Snipes, S. A., King, D. W., Torres-Vigil, I., Goldberg, D. S., Weinberg, A. D. Disparate Inclusion of Older Adults in Clinical Trials: Priorities and Opportunities for Policy and Practice Change. American Journal of Public Health, 2010,100(S1): S105-S112.
[20] The mental health and substance use workforce for older adults. (n.d.). Google Books. Retrieved from https://books.google.com/books?id=p6A7XtK_cEQ C&lpg=PR1&ots=cSz_2a8BpM&dq=substance%20 abuse%20policy%20gaps%20and%20healthcare%20 deficiencies%20for%20older%20adults%20in%20the%20 US&lr&pg=PR15#v=onepage&q&f=false.
[21] Robison, J., Shugrue, N., Porter, M., Fortinsky, R. H., & Curry, L. A. Transition from Home Care to Nursing Home: Unmet Needs in a Home- and Community-Based Program for Older Adults. Journal of Aging & Social Policy, 2012,24(3): 251-270.
[22] Das, J. K., Salam, R. A., Arshad, A., Finkelstein, Y., & Bhutta, Z. A. Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews. Journal of Adolescent Health, 2016,59(4): S61-S75.
[23] Ennett, S. T., Ringwalt, C. L., Thorne, J., Rohrbach, L. A., Vincus, A., Simons-Rudolph, A., & Jones, S. A Comparison of Current Practice in School-Based Substance Use Prevention Programs with Meta-Analysis Findings. Prevention Science, 2003,4(1): 1-14.
[24] Horigian, V. E., Anderson, A. R., & Szapocznik, J. Family- Based Treatments for Adolescent Substance Use. Child and Adolescent Psychiatric Clinics of North America, 2016,25(4): 603-628.
[25] Merchant, R. C., & Beaudoin, F. L. Brief Interventions for Substance-Use Disorder in Older Patients. Oxford University Press, 2016.
[26] Lin, J., Arnovitz, M., Kotbi, N., & Francois, D. Substance Use Disorders in the Geriatric Population: A Review and Synthesis of the Literature of a Growing Problem in a Growing Population. Current Treatment Options in Psychiatry, 2023,10(3): 313-332.
[27] Miller-Rosales, C., Morden, N. E., Brunette, M. F., Busch, S. H., Torous, J. B., & Meara, E. R. Provision of Digital Health Technologies for Opioid Use Disorder Treatment by US Health Care Organizations. JAMA Network Open, 2023,6(7): e2323741.
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