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It has been called “most consequential preventable public health problem in the United States.” Indeed, the opioid epidemic is a national crisis with devastating consequences. The numbers are an eye-opener. Overdose deaths involving this highly addictive class of drugs — which includes natural opioids prescribed for pain, like morphine and codeine, plus synthetic versions, such as fentanyl and heroin — have increased over six times since 1999, according to the Centers for Disease Control and Prevention (CDC). There were an estimated 100,306 drug overdose deaths from opioids in the U.S. during the 12-month period from May 2020 through April 2021, an increase of 28.5 percent from the 78,056 deaths during the same period the year before.
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One surprising casualty: older adults. From 1999 tthrough 2019, 79,893 Americans age 55 and older died due to an opioid overdose, according to a new 21-year study published in JAMA Network Open. In 2019 alone, approximately 10,300 people age 55 and older died from opioid overdoses, compared to just over 500 in 1999. And ER visits for opioid misuse increased by nearly 220 percent from 2006 to 2014 for people 65 and older, researchers reported in a 2019 issue of Innovation in Aging.
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While the synthetic forms of opioids like fentanyl have been behind more overdose deaths in recent years, with older adults “it often takes the form of prescription opioid pain medication misuse,” says Robert G. Sise, M.D., a psychiatrist specializing in addiction in Billings, Montana.
The problem: Opioids are extremely addictive. The drugs trigger the release of endorphins, natural chemicals released by your body’s nervous system to deal with pain or stress. Repeated use can lead to tolerance, where the body begins to slow its own production of endorphins, according to the Mayo Clinic, and may cause users to seek higher dosages or more potent forms of the drug. (Opioids’ high addiction rate has led to thousands of lawsuits against opioid manufacturers, including Johnson & Johnson.)
Behind the problem
Screening for substance misuse among older adults is often lacking, says Maryann Mason, an associate professor of emergency medicine at Northwestern University’s Feinberg School of Medicine and lead author of the JAMA Network Open study. She says ageism is one reason: Simply put, people have a hard time believing that older adults could fall prey to substance abuse. “I think it goes back to how we see older adults, which is that they are Grandpa and Grandma, who bakes cookies,” says Mason. “Health care providers are saying, ‘Of course, they’re not into that. They’re older adults.’ But that’s what the study tells us: You can’t assume.”
A number of factors may be behind opioid use disorder among older adults. First, chronic medical conditions that plague many of us as we age — arthritis and cancer among them — may be treated with opioids.