# Novel methods for estimating the prevalence of drug use among older adults

> **NIH NIH R21** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2024 · $480,348

## Abstract

Drug use among older adults has increased sharply over the past decade. The combination of the aging and
increasing use of psychoactive drugs, including misuse of prescription psychotropic medications, creates a
growing public health problem with rising numbers of older adults at risk for experiencing harm from drug use.
This problem is exacerbated by the fact that older adults are more susceptible to the harms of drug use due to
age-associated physiological changes, social factors such as increased isolation, increases in comorbidity, and
use of medications that may interact with other drugs. There is a lack of reliable estimates of drug use among
older adults that may contribute to the perception that they do not engage in use, making them less likely to be
screened for use. As such, we believe the prevalence of drug use among older adults is underestimated. More
focused surveys assessing drug use aimed at older adults are needed. Additionally, intentional and
unintentional underreporting of drug use remains common across populations. Combining surveys with
biological testing could detect underreporting and unintentional exposure to drugs, and this combination can
also be used to adjust estimates of use. Thus, assessing drug use through surveys plus biological testing will
provide important information that informs how both researchers and clinicians screen and address drug use in
this population. Our multidisciplinary team has extensive expertise in drug use epidemiology among older
adults, survey design, population sampling, and advanced toxicology testing. We will administer a rapid drug
survey to query use of ~100 illegal drugs and a variety of prescription psychoactive drugs in 300 adults aged
≥65 in New York City. We will calculate the prevalence of use of a wide variety of drugs and assess the value
of adding saliva testing and hair testing to the survey. We will apply a targeted street intercept sampling
approach to reach diverse older populations often overlooked by national surveys, including people
experiencing homelessness. We can test exposure to >1,000 drugs including over 100 fentanyl analogs. The
aims of this project are to: 1) determine if and to what extent saliva and hair testing add to the prevalence of
self-reported drug use, 2) delineate risk factors for testing positive for exposure after not reporting use
(discordant report) and deduce the extent to which discordant report is from unknown adulterant exposure vs.
misreporting, and 3) characterize use of cannabis and other illegal drugs in terms of reasons for use, route(s)
of administration, and whether adverse effects (including substance use disorder) have resulted from use. This
interdisciplinary research spanning aging research and drug use epidemiology will inform public health
responses and improve age-friendly health systems to address the increase in psychoactive drug use and its
adverse health effects among older adults. This study will not only inform how resear...

## Key facts

- **NIH application ID:** 10864137
- **Project number:** 1R21DA060362-01
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** Joseph J Palamar
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $480,348
- **Award type:** 1
- **Project period:** 2024-09-15 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10864137

## Citation

> US National Institutes of Health, RePORTER application 10864137, Novel methods for estimating the prevalence of drug use among older adults (1R21DA060362-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10864137. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*