Drug overdose deaths -- both accidental and intentional -- have quadrupled over the past 20 years among older adults in the United States, a new study finds.
This increase in people ages 65 and older suggests the need for greater mental health and substance use policies, the authors said.
“The dramatic rise in overdose fatalities among adults over 65 years of age in the past two decades underscores how important it is for clinicians and policymakers to think of overdose as a problem across the life span,” said co-author Chelsea Shover, an assistant professor of medicine at the University of California, Los Angeles David Geffen School of Medicine.
“Updating Medicare to cover evidence-based treatment for substance use disorders is crucial, as is providing harm reduction supplies such as naloxone to older adults,” Shover said in a school news release.
About three-fourths of those who died accidentally were using illicit drugs, including synthetic opioids such as fentanyl, heroin, cocaine and methamphetamine. In 67% of intentional overdoses, seniors used prescription medication, including opioids, antidepressants, benzodiazepines, antiepileptics and sedatives.
The researchers calculated overdose deaths among seniors from 2002 to 2021, using a database from the U.S. Centers for Disease Control and Prevention. The investigators compared demographics, specific drugs, and whether the deaths were intentional, unintentional or undetermined.
They found that fatal overdoses quadrupled from 1,060 in 2002, which was 3 per 100,000, to 6,702 in 2021, or 12 per 100,000. Black seniors had the highest rates, at 30.9 per 100,000.
By 2021, 1 in 370 senior deaths was from an overdose, the report noted. About 57% of those involved opioids, 39% involved stimulants and 18% included a combination of the two types of drugs.
About 13% of overdoses in 2021 were intentional and 83% were unintentional. Another 4% were undetermined, and 0.7% -- five people -- were murdered.
Women comprised 57% of the intentional overdoses and 29% of the accidental overdoses, according to the study.
The researchers also determined that 37%, of overdoses among Asian-Americans were intentional compared to 17% among white people and 1% among Black people.
Deaths from alcohol poisoning rose from less than 0.03 per 100,000 to 0.5 per 100,000 during the study period.
“Even though drug overdose remains an uncommon cause of death among older adults in the U.S., the quadrupling of fatal overdoses among older adults should be considered in evolving policies focused on the overdose epidemic,” the researchers wrote. “Current proposals to improved mental health and substance use disorder coverage within Medicare, for example, applying mental health parity rules within Medicare, acquire greater urgency in light of this study's results.”
Study findings were published March 29 in JAMA Psychiatry.
The U.S. National Safety Council has more on drug overdoses.
SOURCE: UCLA, news release, March 29, 2023