Lifetime drug use and health at and beyond midlife

Increased rates of lifetime drug use among older adults represents a new and potentially important dimension of health over the life course, particularly for the aging baby boomers and subsequent cohorts. Despite extensive data detailing differences in substance use across cohorts, few studies examine the empirical relationships between illicit drug use and health of mature and older adults. The purpose of the current study was to address this gap in the literature. Linear mixed models were used to explore whether lifetime drug use and four extent of use indicators were associated with self-rated health status at mid- and later life, accounting for individual level measures (demographics and other lifestyle factors) and neighborhood level context (neighborhood disadvantage). Data were drawn from community dwelling adults aged 45 and older who participated in wave one of the Healthy Aging in Neighborhoods of Diversity across the Life Span study. Separate analyses for physical health (PCS from the SF-12) and mental (MCS from the SF-12), were conducted in the total sample (N=1671) and the subsample who ever used drugs (N=1057). Results of the analyses show that the relationship between lifetime drug use and physical health differed by race and that lifetime drug use was not associated with mental health. Among those who reported ever using an illicit drug, two of the four extent of use indicators, recent use and types of drugs used, predicted PCS, but none of the indicators predicted MCS. Individual level predictors related differently to physical and mental health and neighborhood context was only associated with physical health in the total sample. Findings from this study inform future research in substance use over the life course and have implications for practice and policy.