{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T16:04:19Z","timestamp":1789488259222,"version":"build-2803163510"},"reference-count":66,"publisher":"Department of Medicine, Warren Alpert Medical School at Brown University","issue":"4","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"introduction\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Substance use disorder (SUD) is frequently recognized in the literature as an epidemic in the United States, but less attention has been paid to the scale of the epidemic among people older than 60 years of age. As the cohort of individuals in this age group grows as a proportion of the population\u2014the so-called aging of the population\u2014the incidence of SUD in older adults will increase numerically as well. While most existing literature on SUD in the elderly has focused on alcohol, opioids, and prescription drugs, the number of users of stimulant drugs like cocaine and methamphetamine is also growing. We review literature on the use, effects, and diagnostic challenges of cocaine in adults in the so-called \u201cBaby Boomer generation\u201d (ages 59-77 in 2023), particularly those \u226565 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a literature review of PubMed and Web of Science databases, supplemented by Google Scholar using combinations of \u201ccocaine,\u201d \u201celderly,\u201d and \u201colder adults.\u201d We searched the reference sections of particularly salient articles and utilized PubMed\u2019s and Google Scholars\u2019 \u201cCited By\u201d and \u201cSimilar Articles\u201d functions to find additional materials to include. We produced an annotated bibliography containing title and author information for each paper along with its abstract to select the papers to include; each author reviewed this bibliography to determine if articles were relevant, and if so, in which section(s) the material should be included. A total of 66 references have been included in this review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both lifetime and current cocaine use appear to be more prevalent among members of the \u201cBaby Boomer generation\u201d than older cohorts. Though there has been limited research to inform clinical care for older adults who use cocaine, negative physical and psychosocial impacts have been noted in the literature. Cocaine use disorder may negatively affect the elderly more than younger users because of the increased vulnerability of their aging bodies to the physiological and cognitive effects of cocaine. Underdiagnosis of cocaine use in the elderly may be attributable to the assumption that any presenting symptoms are due to pre-existing medical conditions or that older adults are less likely to consume cocaine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is little information currently in the literature to help clinicians understand patterns and epidemiology of cocaine use, its effects on older adults and their common presentations after experiencing adverse events, and challenges of diagnosing and treating cocaine use in older adults. Additional research is needed to describe use and effects of cocaine on the elderly, particularly on age-related comorbid conditions and interactions with medications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.56305\/001c.87784","type":"journal-article","created":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T07:28:12Z","timestamp":1696145292000},"source":"Crossref","is-referenced-by-count":1,"title":["Use, Effects, and Diagnostic Challenges of Cocaine Use in \u201cBaby Boomers\u201d and Older Adults"],"prefix":"10.56305","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9561-6358","authenticated-orcid":false,"given":"Joyce","family":"Akwe","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03czfpz43","id-type":"ROR","asserted-by":"publisher"}],"name":"Emory University","department":["Department of Medicine, Division of Hospital Medicine"]},{"name":"VA Atlanta Healthcare System","department":["Hospital Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Moussa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03czfpz43","id-type":"ROR","asserted-by":"publisher"}],"name":"Emory University","department":["Department of Medicine, Division of Hospital Medicine"]},{"id":[{"id":"https:\/\/ror.org\/01gp9ja19","id-type":"ROR","asserted-by":"publisher"}],"name":"Emory Johns Creek Hospital","department":["Hospital Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4188-4768","authenticated-orcid":false,"given":"Mary Ann Kirkconnell","family":"Hall","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03czfpz43","id-type":"ROR","asserted-by":"publisher"}],"name":"Emory University","department":["Department of Medicine, Division of Hospital Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"35509","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"issue":"5","key":"ref1","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1001\/archpsyc.58.5.503","article-title":"A 33-year follow-up of narcotics addicts","volume":"58","author":"Yih-Ing Hser","year":"2001","journal-title":"Archives of General Psychiatry","ISSN":"https:\/\/id.crossref.org\/issn\/0003-990X","issn-type":"print"},{"issue":"jul01 1","key":"ref2","doi-asserted-by":"publisher","first-page":"c3172","DOI":"10.1136\/bmj.c3172","article-title":"Survival and cessation in injecting drug users: prospective observational study of outcomes and effect of opiate substitution treatment","volume":"341","author":"J. 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