Cannabis
People in older age groups continue to be less likely to use cannabis than the general population aged 14 and over (AIHW 2020). However, the proportion of older people who have recently used cannabis has increased over time. Specifically, the 2019 NDSHS showed that:
- Recent use of cannabis has been increasing since 2001 among people in their 50s and those aged 60 and over, reaching its highest level in 18 years in 2019 (Figure OLDER2).
- Between 2016 and 2019, recent use of cannabis significantly increased among people in their 50s (from 7.2% to 9.2%) and those aged 60 and over (1.9% to 2.9%). This rise was driven by increased cannabis use among females, both in their 50s (up from 4.7% to 6.7%) and aged 60 and over (1.0% to 2.1%) (Table S3.45).
Data from the NDSHS suggest that older people are also more likely to use cannabis for medical purposes than people in younger age groups. In 2019, 43% of people who had recently used cannabis for medical purposes only were aged 50 and over, while 16% of people who used cannabis for non-medical reasons were aged 50 and over (AIHW 2020).
Non-medical use of pharmaceutical drugs
Similar to cannabis, non-medical use of pharmaceutical drugs is generally lower among older age groups than the general population aged 14 and over. However, pharmaceuticals are the second most common drug used by older people.
- In 2019, 3.4% of people in their 50s and 3.7% of those aged 60 and over reported recent use of a pharmaceutical for non-medical purposes, compared with 4.2% of all people aged 14 and over.
- From 2016 to 2019, recent non-medical use of pharmaceutical drugs fell slightly for people in their 50s (from 4.1% to 3.4%) and significantly decreased for those aged 60 and over (from 4.5% to 3.7%) (AIHW 2020) (Table S3.46).
Health and harms
For related content on health and harms, see also:
Drug-related hospitalisations
National Drug and Alcohol Research Centre (NDARC) analysis of the National Hospital Morbidity Database of drug-related hospitalisations (excluding alcohol) showed that, in 2018–19, people aged 20–29 and 30–39 had the highest rates of drug-related hospitalisations of any age group. However, this rate has been increasing among older age groups. From 1999–2000 to 2018–19:
- The rate of drug-related hospitalisations increased for people aged 50–59 (from 94.3 to 183.7 hospitalisations per 100,000 population), 60–69 (from 51.3 to 98 per 100,000) and people aged 70 and over (from 52.7 to 73.5 per 100,000).
- Males aged 40–49 and 50–59 had the greatest increase in the rate of hospitalisations of any group (Man et al. 2021).
Deaths due to harmful alcohol consumption
Alcohol-induced deaths are defined as those that can be directly attributable to alcohol use, as determined by toxicology and pathology reports (for example, alcoholic liver cirrhosis or alcohol poisoning). Alcohol-related deaths include deaths directly attributable to alcohol use and deaths where alcohol was listed as an associated cause of death (for example, a motor vehicle accident where a person recorded a high blood alcohol concentration) (ABS 2018).
Australian Institute of Health and Welfare (AIHW) analysis of the AIHW National Mortality Database showed that of the reported 1,452 alcohol-induced deaths in 2020, the highest age-specific rates for alcohol-induced deaths were for older people:
- 16.0 per 100,000 population for those aged 60–64 years
- 13.2 per 100,000 population for those 55–59
- 12.3 per 100,000 population for those aged 50–54 (Table S1.1e).
In comparison, the lowest rates of alcohol-induced deaths were for young people aged 15–24 years—there were no alcohol-induced deaths for people aged 15–19 and the rate was 0.1 per 100,000 population for those aged 20–24 years.
Higher rates of alcohol-related deaths were also recorded for the older age groups (ranging from 32.2 deaths per 100,000 population for those aged 50–54 to 37.1 per 100,000 population for those aged 60–64) (Table S1.1e). This compares with the lowest rate of 1.0 per 100,000 population for people aged 15–19 years.
ABS Causes of Death data 2020 reported:
- The highest age-specific rates for males were for those aged 55–64 years (22.4 per 100,000 population), followed by those 65 and over (16.9 per 100,000 population).
- The highest age-specific rates for females were also those aged 55–64 years, (7.1 per 100,000 population), followed by those 45–54 years (6.8 per 100,000).
- The median age at death was higher for males than females (59.3 and 56.7 years, respectively) (ABS 2021).
Drug-induced deaths
Drug-induced deaths are defined as those that can be directly attributable to drug use and includes both those due to acute toxicity for example, drug overdose) and chronic use (for example, drug-induced cardiac conditions) as determined by toxicology and pathology reports (ABS 2021).
In 2020, ABS Causes of Death data reported 1,842 drug-induced deaths. Of these deaths, 28% were in people aged 55 years and over (512 deaths). Overall, the highest rates were in the 35–44 and 45–54 year age groups, both with an age-specific rate of 13.5 deaths per 100,000 population. For the older age groups:
- Males aged 55–64 years reported an age-specific death rate of 11.7 per 100,000 population (170 deaths), while males aged 65 and over reported a lower age-specific death rate of 5.8 per 100,000 population (113 deaths).
- Females aged 55–64 years reported an age-specific death rate of 8.0 per 100,000 population (123 deaths), while females aged 65 and over reported a lower age-specific death rate of 4.8 per 100,000 population (106 deaths).
- Almost half (46%, or 198 deaths) of intentional drug-induced deaths were for those aged 55 and over (ABS 2021).
AIHW analysis of the National Mortality database shows that in 2020, people aged 65 years and over were the only age group to not have personal history of self-harm as the most frequently occurring psychosocial risk factor. Personal history of self-harm was second most frequently occurring risk factor, behind limitation of activities due to disability (17.4% of drug-induced deaths in this age group) (Table 2.71b).
Data analysis on causes of death in Australia show that the age profile of people with drug-induced deaths has changed over the last 2 decades:
- Between 1997 and 2005, the highest rate of drug-induced deaths was recorded for people aged 25–34 years. However, the rate decreased substantially from a peak of 22.0 per 100,000 population in 1999 to 10.4 per 100,000 in 2001. The rate has fluctuated between 2001 and 2019, with 8.0 deaths per 100,000 population in 2019.
- Conversely, the rate for people aged 45–54 years increased substantially from 5.6 deaths per 100,000 population in 1997 to 15.1 in 2019—the highest rate recorded across all age groups.
- The rate for people aged 55–64 years also increased between 1997 (3.2 per 100,000 population) and 2019 (9.5 per 100,000 population)—the third highest rate recorded in 2019 (Chrzanowska et al. 2021).
In 2019, the highest rate of opioid-induced deaths was for people aged 45–54 years (9.7 per 100,000 population compared with 2.1 per 100,000 population for those aged under 25 years). However, much lower rates were recorded for people aged 65–74 years (1.9 per 100,000 population) and 75–84 years (1.5 per 100,000) (Chrzanowska et al. 2021). There has been a recent increase in the rate of deaths involving amphetamine for those aged 45–54 years, increasing from 0.9 deaths per 100,000 population in 2013 to 4.4 in 2019—the second highest rate across age groups in 2019 (Chrzanowska et al. 2021).
Treatment
The 2020–21 Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) Early Insights report shows that 11% of clients seeking treatment were aged 50–59 and 4.7% were aged 60+ (AIHW 2022a).
Data collected for the AODTS NMDS are released twice each year—a key findings report in April and a detailed report in June. Detailed information will be updated in July 2022.
The Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) provides information on treatment provided to clients by publicly funded AOD treatment services, including government and non-government organisations. Data from AIHW’s AODTS NMDS and National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collections indicate that, in the last 11 years, an ageing cohort of Australians receiving drug and alcohol treatment has emerged.
NOPSAD data indicate that:
- On a snapshot day in 2021, 22% of clients who received opioid pharmacotherapy treatment were aged 50–59 (excluding data for Queensland). This has increased from 15% in 2011.
- The median age of clients who received opioid pharmacotherapy treatment has increased from 38 years in 2011 to 44 in 2021 (AIHW 2022b).
Data from the AODTS NMDS show that 14% of clients who received treatment for their own or someone else’s alcohol or other drug use in 2019–20 were aged 50 and over. This has increased from 13% in 2014–15 (AIHW 2021a).
In 2019–20, among clients who sought treatment for their own AOD use:
- The most common principal drug of concern among clients aged 50–59 was alcohol (58% of clients), followed by amphetamines (13%).
- Alcohol was also the most common principal drug of concern for those aged 60 and over (74% of clients), followed by cannabis (5%) (Table S3.49).
- Counselling was the most common treatment type for clients aged 50–59 (40% of clients) and those aged 60 and over (37%), followed by assessment only (20% of clients aged 50–59 and 23% of those aged 60 and over) (Table S3.50).
The AODTS data were matched with the Specialist Homelessness Services (SHS) collection to identify clients who use both services (matched clients) and compared characteristics between the groups (AIHW 2016). Older clients were identified as 1 of 4 vulnerable cohorts in the analysis (along with clients with a current mental health issue, clients who experienced family and domestic violence and young clients aged 15–24). The analysis found that matched clients aged 50 and over (when compared to the other vulnerable cohorts) were more likely to be:
- male (68%) and living alone (69%)
- receiving treatment for alcohol (68%)
- Indigenous (17%).
Older clients had similar patterns of alcohol and other drug treatment types, regardless of whether they were in the matched group or AODT-only group, with counselling being the most commonly provided treatment type for all older clients (AIHW 2016).