Demographic, Geographic, and Temporal Trends in Co-Occurring Use Disorders and Mortality from Opioids, Other Drugs, and Alcohol among Middle-Age and Older Adults in the United States

Shannon Monnat, Associate Professor of Sociology, Syracuse University
Joseph Ditre, Associate Professor of Psychology, Syracuse University

Background: Opioid use disorders (OUD) and overdose death rates have grown to unprecedented levels. The U.S. has also experienced large increases in cocaine, methamphetamine, and non-opioid prescription (especially benzodiazepines) overdoses over the past decade. Deaths from alcohol use and use disorders (AUD) are also rising, especially among older adults, women, and low-SES individuals. These crises are costly, getting worse, and interdependent. Excessive alcohol use is common among individuals who misuse opioids, with more than half of individuals with OUD also meeting criteria for AUD; more than half of opioid-related deaths involve alcohol or another drug. Use disorders and overdose rates are also geographically patterned. Moreover, while drug and alcohol mortality rates have increased across many demographic groups over the past 20 years, increases in the middle-age cohort (35-64 years) have been startling. Thus, we focus on the relationship between drug- and alcohol- use disorders and between drug- and alcohol- related mortality among middle-aged and older adults. The specific aims of this study are:

Aim 1: Characterize demographic, geographic, and temporal trends (2000-2017) in the relationships between opioids, other drugs, and alcohol—in terms of use disorders and mortality—among middle-aged and older adults.
Aim 2: Identify typologies of counties based on use disorders and mortality from opioids, other drugs, and alcohol.
Aim 3: Compare the county groups found in Aim 2 by sociodemographic, economic, and other characteristics.