Substance use disorder among older adults in the United States in 2020.

Aims This study aimed to project the number of people aged 50 years or older with substance use disorder (alcohol/ illicit drug dependence or abuse) in the United States in 2020. Design Logistic regression models were applied to estimate parameters predicting past-year substance use disorder using the 2002–06 National Survey on Drug Use and Health data. We applied these parameters to the projected US 2020 population to estimate the number of adults aged 50 or older with substance use disorder in 2020. Setting Non-institutionalized US residences. Participants Representative sample of the US civilian, non-institutionalized population. Measurements Substance use disorder is classified based on criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Findings Due to the large population size and high substance use rate of the baby-boom cohort, the number of adults aged 50 or older with substance use disorder is projected to double from 2.8 million (annual average) in 2002–06 to 5.7 million in 2020. Increases are projected for all examined gender, race/ethnicity and age groups. Conclusions Our estimates provide critical information for policymakers to allocate resources and develop prevention and treatment approaches to address future needs of the US older adult population with substance use disorder.