Seniors With Opioid Use Disorder Receive Substandard Care

Older Adults And Opioid Addiction

Seniors 65 and older, also referred to as Baby Boomers, are encountering a growing problem in the addiction world: they are receiving substandard care for their opioid use disorder (OUD). According to a new study in Health Affairs, more than 60% of Medicare enrollees with an OUD are getting subpar treatment.

A common misperception is that illicit drug use and abuse end in early adulthood, but this is far from reality. Data shows that nearly 1 million adults, 65 years or older, struggle with a substance use disorder (SUD). Older adults struggle with more health problems, which can lead to more prescription medications, increasing their exposure to addictive prescription medications, and mixing prescription medications.

Older age also often comes with loneliness, depression, and chronic pain, which can lead to an increase in prescribed antidepressants, benzodiazepines, and opioids. Whether it is advanced cancer, cardiac pain, or arthritis, opioids are often prescribed in older patients because they are effective for treating pain and may be considered a compassionate form of treatment.

In 2020 – 2021, 12.8% of adults aged 65 and older, on average, filled at least one outpatient opioid prescription, and 4.4% had four or more prescription fills during the year. Unfortunately, age does not negate the chances of developing a substance use disorder, and older adults are still prone to addiction to opioids.

Studies show that the number of adults in mid-to-late life with substance use disorders in the United States has tripled over the past two decades, rising from 1.7 million to 5.7 million. This increase is largely driven by opioid use disorder, and the prevalence of SUDs among older adults is expected to continue rising sharply.

Risk Factors For Addiction In Older Adults

There are two main groups of 65+ seniors who struggle with substance use disorder:

• Those with a history of substance misuse that has progressed into their senior years.
• Those who are newly diagnosed with health conditions that require addictive prescription medications.

Substance misuse in older adults is often influenced by co-occurring mental health conditions, such as depression, as well as later-life challenges like the loss of loved ones or declining independence. The use of addictive prescription medications can further contribute to a downward spiral, particularly when compounded by additional stressors such as loneliness or the loss of a spouse.

Additionally, older adults typically have slower metabolisms, meaning that addictive prescription drugs are not cleared at the same rate compared to younger people. These drugs can build up in the system, resulting in greater potency and toxicity. Not only do older adults metabolize opioids more slowly and are more susceptible to the side effects of opioids, but they also tend to mix other prescription drugs with opioids and alcohol, since the older population generally takes more prescription medications compared to younger adults.

What Happens When Seniors Seek Treatment For Opioid Addiction?

Older adults with OUDs who want to seek treatment admit to having increased social isolation and declining medical health problems. They may not have a strong social network that can offer support during their treatment process, nor may they be mobile enough to attend community addiction treatment meetings or even drive to their treatment programs.

Unfortunately, most opioid addiction treatment programs are not integrated with a patient’s primary care medical office. Therefore, there is no way of incorporating care between their medical needs and their opioid addiction needs. This is an important matter, as many opioid treatment medications and supportive medications may interact with other prescription medications.

The decrease in mobility, lack of social support, and limited knowledge about opioid treatment for seniors tends to create a buildup of stigma and shame among people with an opioid addiction within the aging community.

Treatment centers generally do not have integrated approaches that involve transportation, physical therapy, and managing geriatric chronic medical conditions while also addressing OUDs. As a result of the lack of understanding about geriatric care and the lack of integrated services, this population is receiving substandard treatment for their opioid use disorder.

Fragmented care for older people receiving treatment for opioid addiction is not age-friendly and can increase the chance of multiple drug interactions, especially when this population is on many medications and has a multitude of chronic health conditions. This fragmented care can make people feel they are tossed off to the wayside and are not important, and when it comes to addiction, it can be a big risk for relapse.

What Can We Do To Fix The Problem?

Unfortunately, many strict state and federal regulations require patients to come into the office for in-person methadone treatment, and many opioid programs are based on a fee-for-service model, meaning that people must go into an office or clinic for treatment. This can be difficult for older adults, who often already face mobility and transportation barriers. In response, integrated and coordinated care that takes place at home with addiction staff, in skilled nursing facilities, assisted living centers, and adult day programs, can help address this barrier.

The older community also needs access to social support within their community, such as Narcotics Anonymous or Alcoholics Anonymous meetings. These meetings can help individuals stay strong in their recovery, especially if they lack a social support system at home.

Get Help Today

If you are an older adult struggling with opioid misuse, help is available. Some treatment centers have age-specific treatment plans that can provide the support you need to overcome OUD. To learn more about your rehab options, explore our rehab directory or contact a treatment provider today.