Çağatay ÇAVUŞOĞLU, Mehmet Emin DEMİRKOL

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Yaşlılarda Bağımlılık

Yaşlı bireylerde madde kullanımı ile ilişkili bozukluklar, son yıllarda dikkat çeken sorunlardan biri olarak göze çarpmaktadır. Madde kullanımı ile ilgili 2015 yılında yapılan bir çalışmada hastaneye madde kullanımı ile ilişkili bozukluklar nedeniyle tedavi amaçlı başvuran yaklaşık 1,500,000 hastanın %17.3’ünü 50 yaş ve üzeri bireylerin oluşturduğu saptanmıştır. Özellikle yaşlı bireylerde bir çok kronik hastalığın bir arada olması, çoklu ilaç kullanımı, böbrek ve karaciğer fonksiyonlarında değişiklik gibi bir çok neden madde kullanımının zararlı etkilerini önemli ölçüde arttırmakta ve sorunu çok daha karmaşık bir hale getirmektedir. Genç bireylerde madde ile ilişkili bozuklukları saptamak için bir çok tarama testi olmasına rağmen, aynı testlerin bir çoğu yaşlı bireyler için valide değildir. Alkol, şu an için en çok kullanılan madde olmakla birlikte, benzodiazepin, opiat grubu ilaçlar, marihuana kullanımı da gün geçtikçe artmaktadır. Yaşlı bireylerde sorunun saptanması kadar tedavi de önemli bir konudur ve dikkatle değerlendirilmesi gerekmektedir. Bir çalışmada yaşlı bireylerde madde kullanımına bağlı tedavinin %250 oranında artarak 2020 yılında 4.4 milyon kişiyi etkileyeceği öngörülmüştür. Dolayısıyla yaşlı bireylerde madde ile ilişkili bozukluklar detaylı bir şekilde irdelenmelidir ve bu konu ile ilgili yeni araştırmalara ihtiyaç vardır.

Dependence in the Elderly

Disorders related to substance use in elderly individuals are one of the most noticeable problems in recent years. In a study about substance use conducted in 2015, 17.3% of the approximately 1,500,000 patients who applied for treatment due to substance use disorders were found to be 50 years of age or older. Many causes, such as the combination of many chronic diseases in elderly people, the use of multiple drugs, changes in kidney and liver functions, significantly increase the deleterious effects of substance use and make the problem much more complicated. Although there are many screening tests to detect substance-related disorders in young individuals, many of the same tests are not valid for elderly individuals. Alcohol is currently the most commonly used substance, benzodiazepine, opiate group drugs, marijuana use is increasing day by day. Treatment is also an important issue and needs to be assessed carefully as well as the detection of a problem in elderly individuals. In a study it was predicted that treatment related to substance use in elderly individuals would increase by 250% and affect 4.4 million people by 2020. Therefore, substance-related disorders in elderly individuals should be investigated in detail and new researches on this subject are needed.
Keywords:

dependence, elderly alcohol use disorder, substance use disorder,

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  • West LA, Cole S, Goodkind D, et al. 65+ in the United States: 2010. US Census Bureau 2014; 23-212.
  • Micheal G, Rudolf M. Substance misuse among older adults: a neglected but treatable problem. Addiction 2008; 103:347-8.
  • Dowling GJ, Weiss SRB, Condon TP. Drugs of Abuse and the Aging Brain. Neuropsychopharmacology 2007; 33:209.
  • Gfroerer J, Penne M, Pemberton M, et al. Substance abuse treatment need among older adults in 2020: the impact of the aging baby-boom cohort. Drug and Alcohol Dependence 2003; 69:127-135.
  • Crome I, Wu L-T (editors). Substance use and older people. 1.Baskı, Oxford: John Wiley & Sons, 2015; 11-15.
  • Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. https://www.samhsa.gov/data/sites/default/files/NSDUHNationalFindingsResults2010-web/2k10ResultsRev/NSDUHresultsRev2010.pdf ( 12 Temmuz 2018'de ulaşıldı).
  • Cho J, Bhimani J, Patel M, et al. Substance Abuse among Older Adults: A Growing Problem: Maintaining Vigilance Is the Key to Effective Recognition and Treatment. Current Psychiatry 2018; 17:14.
  • Beynon CM. Drug use and ageing: older people do take drugs! Age and Ageing 2009; 38:8-10.
  • Halter J, Ouslander J (editors). Hazzard's geriatric medicine and gerontology 7th Edition: 2017. General Topics in Geriatric Psychiatry. 7.Baskı ,United States: McGraw-Hill Prof Med/Tech, 2017.
  • Substance use dısorders https://geriatricscareonline.org/FullText/B026/B026_VOL001_PART001_CH034/ (17 Temmuz 2018'de ulaşıldı).
  • A day ın the lıfe of older adults: substance use factshttps://www.samhsa.gov/data/sites/default/files/report_2792/ShortReport-2792.html.( 16 Temmuz 2018'de ulaşıldı).
  • Degenhardt L, Peacock A, Colledge S, et al. Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. The Lancet Global Health 2017; 5:1192-1207.
  • Barrio G, Montanari L, Bravo MJ, et al. Trends of heroin use and heroin injection epidemics in Europe: findings from the EMCDDA treatment demand indicator (TDI). Journal of substance abuse treatment 2013; 45:19-30.
  • Carew AM, Comiskey C. Treatment for opioid use and outcomes in older adults: a systematic literature review. Drug and alcohol dependence 2018; 182:48-57.
  • Mokdad AH, Marks JS, Stroup DF, et al. Actual causes of death in the United States, 2000. Jama 2004; 291:1238-45.
  • Kuerbis A, Sacco P, Blazer DG, et al. Substance abuse among older adults. Clinics in geriatric medicine 2014; 30:629-54.
  • Blazer DG, Wu L-T. The epidemiology of substance use and disorders among middle aged and elderly community adults: national survey on drug use and health. The American Journal of Geriatric Psychiatry 2009; 17:237-45.
  • Dua T, Barbui C, Clark N, et al. Evidence-based guidelines for mental, neurological, and substance use disorders in low-and middle-income countries: summary of WHO recommendations. PLoS Medicine 2011; 8:e1001122.
  • Minority Serving Institutions (MSI) Partnerships with Community-Based Organizations (CBO). https://www.samhsa.gov/grants/grant-announcements/sp-14-005 (10 Temmuz 2018'de ulaşıldı).
  • Le Roux C, Tang Y, Drexler K. Alcohol and opioid use disorder in older adults: neglected and treatable illnesses. Current psychiatry reports 2016; 18:87.
  • Blazer DG, Wu L-T. The epidemiology of alcohol use disorders and subthreshold dependence in a middle-aged and elderly community sample. The American Journal of Geriatric Psychiatry 2011; 19:685-694.
  • Bommersbach TJ, Lapid MI, Rummans TA, et al. Geriatric alcohol use disorder: a review for primary care physicians. Mayo Clin Proc. 2015; 90(5):659-666.
  • Rosen D, Engel RJ, Hunsaker AE, et al. Just say know: an examination of substance use disorders among older adults in gerontological and substance abuse journals. Social work in public health 2013; 28:377-387.
  • Grohol JM. Top 25 psychiatric prescriptions for 2009. Bipolar Disord 2010; 15:88.
  • Kan CC, Hilberink SR, Breteler MH. Determination of the main risk factors for benzodiazepine dependence using a multivariate and multidimensional approach. Comprehensive Psychiatry 2004; 45:88-94.
  • Beauchamp GA, Winstanley EL, Ryan SA, et al. Moving beyond misuse and diversion: the urgent need to consider the role of iatrogenic addiction in the current opioid epidemic. American journal of public health 2014; 104:2023-2029.
  • Volkow ND, McLellan AT. Opioid abuse in chronic pain—misconceptions and mitigation strategies. New England Journal of Medicine 2016; 374:1253-1263.
  • Compton WM, Boyle M, Wargo E. Prescription opioid abuse: problems and responses. Preventive medicine 2015; 80:5-9.
  • Results from the 2005 National Survey on Drug Use and Health: National Findings http://www.dpft.org/resources/NSDUHresults2005.pdf (8 Temmuz 2018'de ulaşıldı).
  • Subramanian N. Treatment and care for older drug users, European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), 2010. Irish Journal of Psychological Medicine, 2011; 28:234.
  • European Drug Report 2014: Data and statistics http://www.emcdda.europa.eu/data/2014/methods-hrdu (19 Temmuz 2018'de ulaşıldı).
  • Taylor MH, Grossberg GT. The growing problem of illicit substance abuse in the elderly: a review. The primary care companion for CNS disorders 2012; 14.
  • King CJ, Van Hasselt VB, Segal DL, et al. Diagnosis and assessment of substance abuse in older adults: Current strategies and issues. Addictive Behaviors 1994; 19:41-55.
  • Kampman K, Jarvis M. American Society of Addiction Medicine (ASAM) national practice guideline for the use of medications in the treatment of addiction involving opioid use. Journal of addiction medicine 2015; 9:358.
  • Diagnostic and Statistical Manual of Mental Disorders(DSM–5) https://www.psychiatry.org/psychiatrists/practice/dsm (14 Temmuz 2018'de ulaşıldı).
  • Jonas DE, Garbutt JC, Amick HR, et al. Behavioral counseling after screening for alcohol misuse in primary care: a systematic review and meta-analysis for the US Preventive Services Task Force. Annals of internal medicine 2012; 157:645-654.
  • Wilsey B, Marcotte T, Deutsch R, et al. Low-dose vaporized cannabis significantly improves neuropathic pain. The Journal of Pain 2013; 14:136-148.
  • Gupta S. Medical marijuana: Do the benefits outweigh the risks? Current Psychiatry 2018; 17:34.
  • Smith LA, Azariah F, Lavender VT, et al Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Cochrane Database of Systematic Reviews 2015; 100-101.
  • Minozzi S, Amato L, Vecchi S, et al. Oral naltrexone maintenance treatment for opioid dependence. Cochrane Database of Systematic Reviews 2011, Issue 2. Art. No.: CD001333.
  • Krupitsky E, Zvartau E, Blokhina E, et al. Naltrexone with or without guanfacine for preventing relapse to opiate addiction in St.-Petersburg, Russia. Drug and alcohol dependence 2013; 132:674-80.
  • Results from the 2004 National Survey on Drug Use and Health: National Findings https://medicalmarijuana.procon.org/sourcefiles/2k4results.pdf (11 Temmuz 2018'de ulaşıldı).
  • Kalapatapu RK, Vadhan NP, Rubin E, et al. A pilot study of neurocognitive function in older and younger cocaine abusers and controls. The American journal on addictions 2011; 20:228-239.
  • Edelman EJ, Cheng DM, Krupitsky EM, et al. Heroin use and HIV disease progression: results from a Pilot Study of a Russian Cohort. AIDS and Behavior 2015; 19:1089-97.
  • Hser Y-i, Hoffman V, Grella CE,et al. A 33-year follow-up of narcotics addicts. Archives of general psychiatry 2001; 58:503-508.
  • Ögel K. Madde kullanım bozuklukları epidemiyolojisi. Türkiye Klinikleri Dahili Tıp Bilimleri Dergisi Psikiyatri 2005; 1:61-64.
  • Buzrul S. Türkiye’de Alkollü İçki Tüketimi. Journal of Food and Health Science 2016; 2:112-122.
  • Organization WH. The Selection and Use of Essential Medicines: Report of the WHO Expert Committee, 2015 (including the 19th WHO Model List of Essential Medicines and the 5th WHO Model List of Essential Medicines for Children): World Health Organization; 2015.
  • Yılmaz N. Alkol ve Madde Bağımlılığı: Bireysel ve Toplumsal Sonuçları.Yüksek Lisans Tezi. İstanbul. Beykent üniversitesi Sosyal bilimler enstitüsü İşletme yönetimi anabilim dali, 2015.
  • Doğan YB. Madde kullanımı ve bağımlılığı. Sosyal Politika Çalışmaları Dergisi 2001; 4.
  • Akvardar Y, Demiral Y, Ergör G, et al. Substance use in a sample of Turkish medical students. Drug and alcohol dependence 2003; 72:117-21.
  • Akgoz S, Akkaya C, Berkay F, et al. Trends in the annual incidence rates of narcotics felons arrested over the last 30 years in metropolitan Bursa, Turkey. The Tohoku journal of experimental medicine 2007; 212:253-263.
  • Mutlu E, Alaei A, Tracy M, et al. Correlates of injection drug use among individuals admitted to public and private drug treatment facilities in Turkey. Drug and alcohol dependence 2016; 164:71-81.
  • sıklı S, Iraklı M. Türkiye’de madde kullanımı ve bağımlılığı pro li araştırması: 2002 yılı madde kullanımı geniş alan araştırması [Investigation of substance use and addiction profile in Turkey: Year of 2002, broad region research of substance use] Turkish Psychological Association. 2002; 4:55–65.
  • Ebert MH, Loosen PT (editors). Current diagnosis & treatment in psychiatry 2e: Lange Medical Books/McGraw-Hill; 2008.
Bağımlılık Dergisi-Cover
  • ISSN: 1302-5570
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2000
  • Yayıncı: Galenos Yayınevi
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