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Treatment and Outcomes of Older Patients with Alcohol Use Disorders in Community Residential Programs
Sonne Lemke, Rudolf H. Moos
Objective: To determine whether older patients with alcohol use disorders receive equitable treatment in community residential facilities. Method: 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. Results: 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. Conclusions: 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. (J. Stud. Alcohol 64: 219-226, 2003)