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Long-Term Consequences of Heroin and Cocaine Addiction

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

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  1. 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

  2. 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

  3. Overview • Long-term substance use trajectories • Mortality/morbidity • Mental health

  4. Sample Characteristics Baby boomers

  5. Average Ages at Key Events Over Lifespan

  6. Increase with Age Heroin Sample Has a Higher Mortality Rate Mortality Rates

  7. Cocaine Marijuana Heroin Alcohol Tobacco Amphetamine Cumulative Percent of Reporting Ever Used by Age at First Use

  8. Cocaine Marijuana Heroin Percent of Any Weekly Drug Use Over Time

  9. Still High among Older Addicts Past Year Use* *Based on self-report and urinalysis

  10. Rates of Abstinence(for 5 or More Years) Increase with Age

  11. Alcohol Dependence in the Past 12 Months

  12. Worse Health Functioning Older Ages Reporting Higher scores indicate better functioning and health

  13. 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

  14. 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)

  15. 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

  16. 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

  17. Increase Mental Health Problems with Age among Cocaine Sample Higher scores indicate greater problem severity

  18. Better Health Functioning Abstinence from Primary Drug Show Higher scores indicate better functioning and health

  19. 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

  20. Abstinence from Primary Drug Show Better Mental Health Higher scores indicate greater problem severity

  21. 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

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