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Improving Treatment for Medicaid Beneficiaries with Co-occurring Disorders

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Project Summary:

The cohorts currently approaching late adulthood are believed to have consumed more alcohol and other substances during their early and middle years than previous or current cohorts of older persons and, as a result, may be more likely to continue to use or to turn to alcohol as a coping mechanism in their later years than the current older generation. Late life also tends to be characterized by the use of multiple pharmacologic agents, generally to treat the myriad chronic diseases and conditions that tend to manifest at this stage of life. Many drugs, such as analgesics, antihypertensives, anticoagulants, diuretics, and psychoactive agents, can produce adverse reactions when used in conjunction with alcohol. An obvious consequence of such effects might be the higher utilization of treatment for substance abuse. We know relatively little, however, about the relationships between substance abuse and prescription drug use in this age group or the medical consequences of risky drug use. In this supplement, I propose the use of claims data from Medicaid beneficiaries in the 6 states (Arkansas, Colorado, Georgia, Indiana, New Jersey, and Washington) of the parent grant to study, 1) prescription medication use (especially analgesics and psychoactive agents) 2) specialty substance abuse care for persons aged 65 and older with evidence of alcohol abuse (and other substance use disorders) and concomitant illness. My examination will focus primarily on: i) painting a descriptive portrait of the elderly Medicaid alcohol (and other substance) abuse population in regard to their characteristics and their use of services, ii) piecing together the role that the Medicaid program plays in providing treatment. This grant is a supplement to the parent grant titled, “Improving Treatment for Medicaid Beneficiaries with Co-Occurring Disorders”.

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