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Brazilian Journal of Psychiatry

Print version ISSN 1516-4446On-line version ISSN 1809-452X

Rev. Bras. Psiquiatr. vol.40 no.4 São Paulo Oct./Dec. 2018

http://dx.doi.org/10.1590/1516-4446-2018-0109 

LETTERS TO THE EDITORS

Cocaine use by older populations, sleep quality, and associated risks

Vinícius Dokkedal-Silva1 

Lenise J. Kim1 

JoséC. Galduróz1 

Sergio Tufik1 

Monica L. Andersen1 

1Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.

Reports of cocaine use by older populations have risen in recent years. The abuse of illicit substances by older adults was once considered unlikely, and aging was commonly seen as a protective factor against use of these substances. However, new cases of drug abuse by aging individuals are being reported through admissions for inpatient treatment.1 In some cases, onset of cocaine consumption might occur after 50 years of age, contradicting previous assumptions. Yarnell2 reported on this trend and highlighted that it is a growing health concern that has been underestimated and under-analyzed to date. Projections warn that approximately 5.7 million people over the age of 60 years will have substance-use disorder by 2020.3

Several demographic aspects should be considered when assessing this population. A great number of these older cocaine users are male and unmarried. The profile for these substance abusers seems to be developing into one of predominantly white people with a secondary or higher education. Possible factors involved in the seeking of illicit psychoactive substances by older adults include emotional problems related to loneliness and stressful situations in later life, loss of productivity or a social role, and chronic pain. A high frequency of depression is also observed in these individuals. It is noteworthy that alcohol consumption may be an associated factor.2 Regarding age, higher rates of cocaine use were reported in adults aged 50 to 64 than in those over 65 years old.3

Elderly people frequently experience neurologic, cognitive, and behavioral impairments that can be worsened by cocaine use. Attention and working and visual memory are the cognitive functions most prominently impaired in cocaine users.4 Andersen et al.5 reported a decrease in birth of new cells in the hippocampal dentate gyrus in experiments involving acute administration of cocaine in adult rats.

Cocaine is also known to disrupt the sleep pattern of its users severely, affecting sleep maintenance, causing sleep fragmentation, and altering sleep architecture,6,7 all effects that warrant special attention in the elderly.

It is safe to assume that cocaine use can have an amplifying impact on several health problems associated with advanced age. Illicit drug use is on the rise, while life expectancy has increased. Substance abuse by older adults is an observed and ongoing trend that may represent a social and health concern of considerable proportions in the future. Specifically, we highlight the relevance of qualitative and quantitative evaluations of this trend and its possible implications.

Acknowledgements

This study was supported by grants from Associação Fundo de Incentivo à Pesquisa (AFIP), Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP; grant 2015/ 19136-5 to LJK), and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq; grant number 133397/2017).

References

1. Fahmy V, Hatch SL, Hotopf M, Stewart R. Prevalences of illicit drug use in people aged 50 years and over from two surveys. Age Ageing. 2012;41:553-6. [ Links ]

2. Yarnell SC. Cocaine abuse in later life: a case series and review of the literature. Prim Care Companion CNS Disord. 2015;17. doi: 10.4088/PCC.14r01727. [ Links ]

3. Wu LT, Blazer DG. Illicit and nonmedical drug use among older adults: a review. J Aging Health. 2011;23:481-504. [ Links ]

4. Jovanovski D, Erb S, Zakzanis KK. Neurocognitive deficits in cocaine users: a quantitative review of the evidence. J Clin Exp Neuropsychol. 2005;27:189-204 [ Links ]

5. Andersen ML, Perry JC, Bignotto M, Perez-Mendes P, Cinini SM, Mello LE, et al. Influence of chronic cocaine treatment and sleep deprivation on sexual behavior and neurogenesis of the male rat. Prog Neuropsychopharmacol Biol Psychiatry. 2007;31:1224-9. [ Links ]

6. Irwin MR, Bjurstrom MF, Olmstead R. Polysomnographic measures of sleep in cocaine dependence and alcohol dependence: implications for age-related loss of slow wave, stage 3 sleep. Addiction. 2016;111:1084-92. [ Links ]

7. Angarita GA, Canavan SV, Forselius E, Bessette A, Morgan PT. Correlates of polysomnographic sleep changes in cocaine dependence: self-administration and clinical outcomes. Drug Alcohol Depend. 2014;143:173-80. [ Links ]

Received: March 26, 2018; Accepted: April 04, 2018

Disclosure The authors report no conflicts of interest.

Creative Commons License This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.