{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:47:26Z","timestamp":1772779646535,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T00:00:00Z","timestamp":1628467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA042146"],"award-info":[{"award-number":["R01DA042146"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA031160"],"award-info":[{"award-number":["R01DA031160"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Substance use rates have increased in adults 50 years and older, and substance use in this population is associated with significant consequences. Given that little is known about their underlying substance use patterns, the objective was to identify latent classes of adults 50 years and older by past\u2010year substance use, past\u2010month substance use, and past\u2010year substance use disorder (SUD) diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The National Survey on Drug Use and Health is an annual nationwide cross\u2010sectional U.S. survey. Participants were 35,229 civilian, non\u2010institutionalized U.S. residents, 50 years and older. Past\u2010year and past\u2010month alcohol, tobacco, marijuana, heroin, cocaine, methamphetamine use, and opioid, stimulant, and tranquilizer\/sedative prescription drug misuse (PDM) were captured, as was past\u2010year DSM\u2010IV SUD from these substances. Correlates included mental health, physical health, and healthcare utilization variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Latent class analysis indicated four past\u2010year or past\u2010month substance use subgroups (Alcohol\u2010Only, Alcohol\u2010Tobacco\u2010Marijuana, Cocaine\u2010Polydrug, PDM\u2010Polydrug), with SUD prevalence rising from 3.2% to 17.3%, 68.8%, and 78.5% by past\u2010year subgroup; similarly, rates of past\u2010year suicidal ideation increased from 2.1%, to 4.8%, 12.0%, and 20.4% by past\u2010year subgroup. For SUD, there were three subgroups (Low Nicotine Dependence [ND], High Alcohol Use Disorder, Multiple SUDs). Over 90% of adults were in a low\u2010risk subgroup (i.e., Alcohol\u2010Only and Low ND), but members of Cocaine\u2010Polydrug, PDM\u2010Polydrug, or Multiple SUDs latent classes had high rates of mental and physical health concerns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most adults 50 and older have lower risk profiles, but those engaged in PDM or cocaine use are heavily substance\u2010involved and need screening and likely multi\u2010disciplinary intervention.<\/jats:p><\/jats:sec>","DOI":"10.1002\/gps.5605","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T02:31:38Z","timestamp":1627439498000},"page":"1867-1877","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The latent class structure of substance use in US adults 50 years and 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