Abstract
Introduction The ageing of baby boomers is expected to confront addiction care with new challenges. This cohort had greater exposure to psychoactive substances in youth than earlier cohorts. In this study, we aimed to investigate whether Berlin addiction care is confronted with a sustained change in its clientele initiated by the baby boomers. Methods Using data from Berlin outpatient addiction care facilities, we contrasted type of primary substance use disorder and number of comorbid substance use disorders in baby boomers with an earlier and a later cohort. To isolate cohort effects, two-level random intercept regression models were applied in the overlapping age groups of the baby boomer cohort with each of the other cohorts. Results Compared with the earlier cohort, alcohol use disorder lost importance whereas illicit substance use disorder gained importance in the baby boomers. Baby boomers presented a higher number of comorbid substance use disorders than the earlier cohort. Comparing baby boomers with the later cohort, these relationships pointed in the opposite direction. Discussion and conclusions Outpatient addiction care faces a sustained change to more illicit and comorbid substance use disorders. With increasing life expectancy and the ageing of baby boomers marked by higher substance use than previous cohorts, older clients, who had been under-represented in outpatient addiction care, will gain relevance. Hence, addiction care has to adapt its offers to appropriately meet the changing needs of its clientele.
Highlights
The ageing of baby boomers is expected to confront addiction care with new challenges
To close the knowledge gap on whether there had been a shift in cohort characteristics in German outpatient addiction care this study aims to examine: (i) whether outpatient addiction care seekers from the baby boomer cohort are less likely to be diagnosed with primary alcohol use disorder (AUD) and (ii) more likely to be diagnosed with illicit substance use disorder (ISUD) than an earlier cohort; (iii) whether cohort effects in the likelihood of being diagnosed with AUD or ISUD differ by sex; (iv) whether baby boomers have more comorbid substance use disorders (CUD) than an earlier cohort; and (v) whether characteristics observed in the baby boomers continue in a later cohort
AUD was the most frequent primary diagnosis presented in 61.9% of the baby boomers and 48.4% of the later cohort
Summary
The ageing of baby boomers is expected to confront addiction care with new challenges. Baby boomers had greater exposure to alcohol, tobacco and illicit substances in youth [5], developed a higher acceptance towards drug consumption [6] and, as a result, are more susceptible to substance use [5]. Overall, these historical conditions have the potential to influence members of a cohort, which could play a part in social changing processes [7,8]. Individuals seeking help in addiction care primary for alcohol problems differ substantially
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