PATTERNS OF DIAGNOSIS AND TREATMENT AMONG LATE-MIDDLE-AGED AND OLDER SUBSTANCE-ABUSE PATIENTS

This study examines the diagnoses and treatment received by a cohort ( N = 22,678) of late-middle-aged and older substance abuse patients. Mo re than 23% of substance abuse inpatients admitted to Department of Ve terans Affairs (VA) Medical Centers in fiscal year 1987 were 55 years of age or older. Most of these patients had multiple health problems. More than 90% had an alcohol-related diagnosis; almost 30% were diagno sed with a psychiatric disorder; and more than 80% had a medical disor der Compared with their younger counterparts, older substance abuse pa tients were less likely to receive specialized inpatient or outpatient treatment specifically directed toward their substance abuse or psych iatric problems. In general, older substance abuse patients received s ervices oriented more toward medical management than toward rehabilita tive substance abuse or psychiatric care. These findings imply a need to develop treatment programs tailored to the characteristics and subs tance abuse problems of older patients, and to encourage more use of s pecialized outpatient aftercare services by these individuals.