Treatment and outcomes of older patients with alcohol use disorders in community residential programs.

Abstract

To determine whether older patients with alcohol use disorders receive equitable treatment in community residential facilities. Older male veterans with alcohol use disorders who were treated in 63 community residential facilities (CRFs) were matched with young and middle-aged male veterans in these programs (n = 190 in each age group) on demographic variables and dual-diagnosis status. Patients were assessed at program intake and were followed 1 year and 4 years after treatment entry. Program staff provided information on use of services and on program characteristics. Although they had similar alcohol consumption and dependence symptoms at treatment entry, older patients experienced fewer alcohol-related problems and had fewer symptoms of psychological distress than did young and middle-aged patients. Controlling for initial differences, older patients did at least as well as young and middle-aged patients at both follow-ups. Older, middle-aged and young patients had equivalent treatment involvement in the CRF, participation in continuing outpatient care and involvement in self-help groups. Similar factors predicted better outcomes for older and younger patients, including a longer stay in the CRF, more counseling, involvement in supportive relationships with other residents, continuing outpatient substance abuse care and participation in self-help groups following residential treatment. Both older and younger patients showed similar benefits across varied treatment orientations. Older patients fare at least as well as younger patients in these age-integrated, community-based programs, and they respond in similar ways to treatment experiences and program factors.