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Older Offenders, Substance Abuse, and Treatment

Received February 14, 2002; revised March 6, April 9, 2002; accepted April 12, 2002. From the Department of Psychiatry, College of Medicine, University of Iowa, Iowa City, IA (SA,CT,MF); the Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA (SA); the Iowa Consortium for Substance Abuse Research, University of Iowa, Iowa City, IA (SA), and the Iowa Department of Corrections, Iowa Medical and Classification Center, Oakdale, IA (MF). Address correspondence to Dr. Arndt, Iowa Consortium for Substance Abuse Research, 100 Oakdale Campus M308 OH, University of Iowa, Iowa City, IA 52242. e-mail: stephan-arndt{at}uiowa.edu

OBJECTIVE: The adoption of more stringent truth-in-sentencing laws and the aging of the United States population in general has led to an increase in the proportion of prison inmates age 55 years and older. Recent judicial rulings require prisoners to receive adequate medical and mental health care. Care for substance abuse is often included to reduce recidivism. However, little systematic research has been conducted on the mental health and substance abuse treatment needs of older prisoners. METHODS: The authors examined age differences in substance abuse history provided by 10,952 offenders as part of their orientation and evaluation on entry into prison. Trained substance abuse counselors interviewed each offender and recorded data in an institutional database. RESULTS: Seventy-one percent of older inmates reported a substance abuse problem. When compared with younger inmates, older offenders were more likely to abuse alcohol only. Those older inmates with abuse problems had used substances for over 40 years, yet more than one-third had never received treatment. CONCLUSION: Like younger inmates, most older offenders would benefit from substance abuse treatment. The treatment may need to be tailored to age and lack of previous treatment experience and should be sensitive to this high-risk group's additional medical needs.

Key Words: Alcohol • Other Addictive Disorders

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