Substance use and health status among older adults: An examination of data from a local-level Behavioral Risk Factor Surveillance Survey (BRFSS)

Background: National data show the proportion of older adults using illicit or non-medical prescription drugs is growing and the number with substance use disorders is projected to double by 2020. Chronic health conditions common to an aging population may coexist with substance use, however few studies have examined associations between health status and substance use in older adults. This analysis used local-level BRFSS data to explore associations between substance use and indicators of health status among older adults. Methods: The 2008 Five Cities in Massachusetts BRFSS was conducted in 5 communities neighboring Boston, MA. The survey was a stratified, random sample of telephone-equipped households. The survey included demographic, physical and mental health, and substance use questions. All analyses were weighted to account for the sampling scheme. Results: The final sample size (N=2,171) represented over 86,000 individuals ages 45 and older (57% female, 82% white, and 40% college graduates). Overall, 5.7% were categorized as users of illicit and/or non-medical prescription drugs (use in prior year). Use was more frequent among those ages 45-64 (8.5%) compared those ages 65+ (1.4%). Marijuana was the most commonly used illicit substance (4.3%) followed by prescription drugs (2.2%). Multivariate models indicated users were significantly more likely to report poor/fair health status, feeling depressed all/most of the time, and chronic health conditions including hypertension, high cholesterol, and asthma. Conclusions: Understanding the magnitude of this trend and the correlates of substance use among older adults will help improve treatment effectiveness and access for this age group.