The pattern of substance abuse in Thai elderly: Ramathibodi Poison Center

Objective: To describe substances, clinical manifestations, treatment, and medical outcomes of substance abuse exposures among older adults in Thailand. Method: This is a retrospective study of individuals aged 60 years or older with intentional abuse exposures reported to the Ramathibodi Poison Center from 1 January 2010 to 31 December 2017. Results: Forty-four cases were reported. The most common manifestation was somnolence (20, 45.5%). The most common substance used was kratom. There were 12 severe and fatal cases. Only one died due to methadone abuse. The most frequent manifestation among severe cases was respiratory failure (8 of 12 cases, 66.7%). Two cases had severe metabolic acidosis and were treated with hemodialysis. Three cases received norepinephrine. Conclusion: Substance abuse in the elderly is a serious problem that is often overlooked. Health personnel should promptly recognize and address this issue in order to reduce morbidity and mortality in the elderly population.