Opioid Use Among Aging Persons with Criminal Justice Histories

• In Event: 30662 - Section on Crime, Law, and Deviance Roundtables
  In Refereed Roundtable (60 minute): Table 9: Violence, Pathways to Crime, Life Course

Abstract

Background/Objectives
Justice-impacted persons aged 40 and up with substance use disorder (SUD) demonstrate increased health risks and health disparities relative to general population peers. Propensity for premature mortality from overdose is startlingly high for at-risk groups (racial minorities, persons experiencing homelessness, etc.). We seek to better understand the forty and up adults in treatment for SUD with focusing on opioid use outcomes to identify patterns and risk factors that can inform policy.
Methods
Using a sample (N=357) of low-income justice-impacted adults in SUD treatment in the Midwest, USA, including a natural oversampling of Black and AIAN persons, we identify themes throughout the life course related to opioid use outcomes. We explore the extent to which persons in their 40s, 50s, and 60s report opioid use outcomes. We conceptualize life-course risk factors in developing an understanding of the 40 and up patients in SUD treatment. Logistic regression is used to assess overdose, opioid use, and opioid agonist use.
Results
Significant differences in opioid use by age were observed, with older persons less likely to report opioid use. Differences were not significant once controlling for user preferences, race, gender, family, childhood, and life course experiences. Overdose history was also significantly less likely for the forty and older SUD patient, though this was no longer significant when controlling for demographics. Opioid agonist use did not significantly differ by age.
Discussion
Justice-involved patients 40 and up in SUD treatment were less likely to have experienced overdose or report opioid use, relative to their younger peers, but this variation dissipated when considering demographic, family and/or life course factors. Targeted treatment services for gender and racial minorities may be beneficial for patients forty and up. We identify preference for one substance, versus two, as protective against overdose and opioid misuse among older persons who use drugs.

Authors

• Meghan M. O'Neil, Michigan State University

• Wayne Kepner, Stanford University

• Garland Gerber, Northeastern University

• Thomas Wojkiekowski, Michigan State University

• Debra Pinals, University of Michigan Medicine