Project Summary/Abstract
Older adults with substance use disorders are at high risk for associated adverse outcomes due to co-existing
chronic diseases and functional impairments. This is also a population that has experienced a profound loss of
their social networks and is therefore also at risk for social isolation and loneliness. Additionally, older adults
with substance use disorder also experience a high level of stigma related to drug use, drug use treatment,
and ageism. Recently, there has been increasing interest in the relationship between lack of social
connectedness and stigma with health outcomes. Yet, very little research in this area has focused on older
adults with substance use disorders. To address this, the objective of this research is to use the national
expertise of the Principal Investigators (Drs. Han and Inagaki) to measure social isolation, loneliness, and
intersectional stigma longitudinally among older adults who receive care in opioid treatment programs and
examine how this may influence health outcomes. Aim 1 of this study is to characterize trajectories of social
isolation and loneliness longitudinally. 150 older adults (age ³55) living with opioid use disorder who receive
treatment in San Diego County’s opioid treatment programs will be recruited to complete validated measures of
social isolation and loneliness at three-time points (baseline, 6 months, and 12 months later). Aim 2 will
examine whether trajectories of social isolation and loneliness predict 12-month opioid use disorder treatment
outcomes, non-opioid psychoactive substance use, and acute healthcare utilization. Finally, Aim 3, through
qualitative interviews with a subset of enrolled participants (n=40), will explore patient perspectives on how
social isolation and loneliness influence substance use, recovery, and treatment and elicit perspectives on
strategies to address social connectedness through opioid treatment programs. As an exploratory aim, this
study will measure the experienced stigma of this population through validated scales. During qualitative
interviews, perspectives regarding stigma related to opioid use disorder, ageism, and other potentially related
factors will also be assessed. Results from this research will ultimately inform future interventions to address
isolation and disconnection among older adults with opioid use disorder. This will have additional public health
implications for the efficacy of improving addiction treatment and health outcomes.