Elsevier

Annals of Epidemiology

Volume 16, Issue 4, April 2006, Pages 257-265
Annals of Epidemiology

Projecting Drug Use Among Aging Baby Boomers in 2020

https://doi.org/10.1016/j.annepidem.2005.08.003Get rights and content

Purpose

Greater rates of lifetime drug use among the baby-boom generation, combined with the size of that generation, suggest that the number of elderly persons using drugs will increase in the next two decades. Given the potential public health demands implied by increasing numbers of elderly drug users, the goal is to project the numbers of current drug users aged 50 years and older in 2020.

Methods

Using the modeling and projection methods of Gfroerer et al (2003) applied to data from the 1999 to 2001 National Household Surveys on Drug Abuse, projections were developed for the use of marijuana, nonmedical use of any prescription-type psychotherapeutic drug, and any illicit drug use.

Results

From 1999 to 2001 to 2020, past-year marijuana use in persons 50 years and older is forecast to increase from 1.0% to 2.9%. The number of users is expected to increase from 719,000 to almost 3.3 million, reflecting the combined effects of the increase in rate of use and a projected 51.9% increase in the civilian noninstitutionalized population in this age group. Use of any illicit drug will increase from 2.2% (1.6 million) to 3.1% (3.5 million), and nonmedical use of psychotherapeutic drugs will increase from 1.2% (911,000) to 2.4% (almost 2.7 million).

Conclusions

These projections call attention to changes to be considered in planning and to the need for improved knowledge of the biomedical and psychosocial effects of nonmedical drug use on aging and elderly individuals.

Introduction

Illicit drug use in the United States increased in the 1970s, declined in the 1980s, rebounded to some extent from the early to mid-1990s, and subsequently has remained stable or, by some measures, declined (1). Trends such as these influence the need for treatment and prevention services, and being able to forecast future levels of drug use and dependence would benefit resource planning.

Previous efforts to predict the number of illicit drug users have met with limited success. In 1981, the National Institute on Drug Abuse forecast that the number of 18- to 25-year-olds using illicit drugs would decline from that time through 1995 as the last of the large baby-boom generation, those born from 1946 to 1964, who were 17 to 35 years old when the report was released, moved past young adulthood and gradually were replaced by the smaller “baby-bust” generation (2). Past-month marijuana users aged 18 to 25 years, for example, were predicted to number 8.7 million in 1985, 7.9 million in 1990, and 7.3 million in 1995. Subsequent cross-sectional surveys in those years estimated there were 7.1 million users in 1985, 3.7 million in 1990, and 3.3 million in 1995 3, 4, 5 (NIDA 1987; NIDA 1991; SAMHSA, 1996). The large discrepancy between predicted and concurrently estimated numbers reflects what we now know to have been a decline in the rate of drug use in adolescents and young adults that began around 1979 and ended in the early 1990s (6). The 1981 projections (2) were designed solely to forecast the impact of the anticipated population age shift. Perhaps because the limited number of population-based drug abuse epidemiologic studies available at that time did not provide a strong basis for modeling variations in prevalence rates, the projections were generated with the assumption that prevalence rates observed in 1977 would continue.

There is reason to believe that future trends and patterns in illicit drug use will be different as baby boomers, aged 41 to 59 years in 2005, enter older adulthood. The large size of this cohort, coupled with greater lifetime rates of drug use than in previous generations, might result in unprecedented high numbers of older drug users in the next 15 to 20 years.

This assumes, of course, that cohorts with greater lifetime rates of drug use also will have greater rates of current use despite the general tendency for drug use to decline with age 7, 8, 9. Within-individual changes in drug use occur against a backdrop of general secular trends and can be linked to cohort differences that may endure over time. Persons who reach the age of greatest vulnerability to drug use initiation during a period when drugs are popular and widely available in the society are at particularly high risk for trying drugs and, possibly, continuing to use them. As a preliminary indication of this shift, Compton et al. (10) reported that the rate of past-year marijuana use in the population aged 45 to 64 years increased from 0.6% in 1991 to 1992 to 1.6% in 2001 to 2002. The population aged 45 to 64 years in 1991 to 1992 included two birth years of baby boomers (1946 and 1947), whereas in 2001 to 2002, that age range included 12 birth years of baby boomers (1946 to 1957).

This study seeks to project the number of older adult drug users in the year 2020, when all of the baby-boom generation will be older than 50 years. Projections of the nature and extent of drug use in the large baby-boom generation as they enter their senior years are needed to determine the numbers of older adults at risk for adverse health consequences because of illicit drug use and the numbers who may need prevention and treatment services.

Section snippets

Methods

Because of secular trends and cohort differences in rates of lifetime drug use, it was necessary to model prevalence rates, as well as population dynamics. We adopted the method of Gfroerer et al. (11), who projected the number of adults 50 years and older needing treatment for substance abuse or dependence (including drugs and alcohol) in 2020.

Models for Current Drug Use in Persons Aged 50 Years and Older in 1999 to 2001

Independent variables and odds ratios (ORs) from logistic regression models developed for predicting past-year drug use in the population aged 50 years and older in 2000 are listed in Table 1. In low-risk models for past-year use of any illicit drug and marijuana (applied to data for persons > 50 years who had not used the respective drugs up to the age of 30 years), age, the sole independent variable considered, was related negatively to past-year use; for each year of age older than 50, the

Discussion

This study predicts that the number of drug users aged 50 years and older will increase significantly from 2000 to 2020 because of an anticipated 52% increase in population in that age group and a projected increase in the rate of past-year use as more persons from younger higher-drug-using cohorts reach the age of 50 years. The number of marijuana users is forecast to increase from 719,000 (1.0% of the population in that age group) to almost 3.3 million (2.9%). Use of any illicit drug is

References (24)

  • J.G. Bachman et al.

    The Decline of Substance Use in Young Adulthood: Changes in Social Activities, Roles, and Beliefs

    (2002)
  • C. Winick

    Maturing out of narcotic addiction

    Bull Narc

    (1962)
  • Cited by (0)

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