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Long-Term Consequences of Heroin and Cocaine Addiction. Yih-Ing Hser, Ph.D. UCLA Integrated Substance Abuse Programs Drug Abuse in the 21st Century: What Problems Lie Ahead for the Baby Boomers? September 2004. Background 33-year follow-up of a heroin sample
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Long-Term Consequences of Heroin and Cocaine Addiction Yih-Ing Hser, Ph.D. UCLA Integrated Substance Abuse Programs Drug Abuse in the 21st Century: What Problems Lie Ahead for the Baby Boomers? September 2004
Background • 33-year follow-up of a heroin sample • 12-year follow-up of a cocaine sample Relevance • Many in old ages • Natural history data
Overview • Long-term substance use trajectories • Mortality/morbidity • Mental health
Sample Characteristics Baby boomers
Increase with Age Heroin Sample Has a Higher Mortality Rate Mortality Rates
Cocaine Marijuana Heroin Alcohol Tobacco Amphetamine Cumulative Percent of Reporting Ever Used by Age at First Use
Cocaine Marijuana Heroin Percent of Any Weekly Drug Use Over Time
Still High among Older Addicts Past Year Use* *Based on self-report and urinalysis
Rates of Abstinence(for 5 or More Years) Increase with Age
Worse Health Functioning Older Ages Reporting Higher scores indicate better functioning and health
More Health/Medical Conditions Older Ages Reporting 1Hypertension, Hardening of arteries/heart attack, Other 2Asthma, Emphysema/Lung Cancer, TB 3Cirrhosis, Hepatitis, Ulcer, Hernia rapture, Spastic colon 4AIDS/HIV, Gonorrhea, Syphilis, Herpes, Others
Medical Testing Results Show* High Levels of Cardiovascular Risk • Over half (58.3%) had hypertension • One-fifth (22.4%) had high total cholesterol • Over half (54.6%) were overweight (using body/mass index) *Heroin subsample Source: Hser et al., Journal of Behavioral Medicine (in press)
Medical Testing Results Show* High LevelsofInfectiousDiseases • Four-fifths (85.6%) tested positive for Hepatitis B • Nearly all (94.2%) tested positive for Hepatitis C • Over one-quarter (27.3%) had a positive TB skin test • Nearly one-quarter (23.8%) tested positive for syphillis • HIV rate was very low (1.8%) *Heroin subsample
Medical Testing Results Show* High Levels of Abnormal Functions • More than half had abnormal liver function by at least one indicator (ALT, AST, billirubin) • 18.8% had diabetes • 27-35% had abnormal pulmonary function *Heroin subsample
Increase Mental Health Problems with Age among Cocaine Sample Higher scores indicate greater problem severity
Better Health Functioning Abstinence from Primary Drug Show Higher scores indicate better functioning and health
Better Health/Medical Conditions Abstinence from Primary Drug Show 1Hypertension, Hardening of arteries/heart attack, Other 2Asthma, Emphysema/Lung Cancer, TB 3Cirrhosis, Hepatitis, Ulcer, Hernia rapture, Spastic colon 4AIDS/HIV, Gonorrhea, Syphilis, Herpes, Others
Abstinence from Primary Drug Show Better Mental Health Higher scores indicate greater problem severity
Conclusions Overall • Chronicity of addiction • Adverse consequences • elevated mortality, particularly heroin • health/medical problems • mental health problems Older ages • Substance use (heroin, alcohol) persist in older ages • Greater health and mental health problems Abstinence • Increases with age • Less health and mental health problems