Drug Deaths - Age 65+ in United States

United States

Drug overdoses are one of the leading causes of injury death in the United States and have skyrocketed in the last 20 years, destroying families and communities and placing an enormous burden on the health care system. Opioid-involved deaths increased among older adults between 2017 and 2018, despite a decrease in the overall rate. In 2019, 1 in 4 Medicare Part D beneficiaries received a prescription for an opioid. 

Drug abuse can be especially dangerous for older adults because age-related changes in the liver reduce the ability to metabolize medications, and most older adults take one or more prescription medications. They may also take non-prescription medications and dietary herbal supplements, which can further complicate drug interactions and lead to drug-induced death. Other risk factors that can lead to substance use among older adults include forced or unexpected retirement, social isolation, transitions in living situations, substance use earlier in life, physical and mental health issues, and deaths of loved ones.

A 2019 report estimated that the opioid crisis cost the U.S. at least $631 billion between 2015 and 2018. Mortality accounted for approximately 40% of these costs, while excess health care spending accounted for almost a third.

According to America’s Health Rankings analysis, the prevalence of drug deaths is higher among:

• Older men compared with older women.
• Black older adults, who have a prevalence nearly 12 times higher than Asian older adults.

Identifying addiction in older adults can be challenging because of similarities between symptoms of drug addiction and diseases such as diabetes, depression, dementia and other mental health disorders. Although limited addiction treatment programs exist specifically for older adults, the Substance Abuse and Mental Health Services Administration has a resource for locating treatment facilities and it can filter through specific populations such as seniors.

Strategies to prevent overdose deaths and reduce harm among older adults with opioid addiction include:

• Pain management techniques without the use of medications. Individuals can work with their doctors to safely and effectively manage their pain and avoid the risk of opioid abuse.
• State-based prescription drug monitoring programs. These programs track opioid prescription and dispensation and help reduce opioid addiction.
• Abuse-deterrent formulations (ADFs). These are promising medications that have been shown to reduce prescription drug abuse and its many consequences.
• Regular review of medication lists by health care providers, also referred to as medication reconciliation, to avoid adverse drug events.

The Centers for Disease Control and Prevention has updated their Guideline for Prescribing Opioids for Chronic Pain and created a prescription checklist to encourage safe prescribing practices for primary care providers. The National Institute on Drug Abuse offers resources and advice about what to do if someone you know has a problem with drugs.

Reducing drug overdose deaths is a Healthy People 2030 leading health indicator.

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