Drug overdose deaths have quadrupled among older US adults

Fatal drug overdoses among older adults in the US have quadrupled over the past two decades, indicating that the problem isn’t only affecting young people.

Drug overdose deaths have steadily increased in the US since 1999, largely due to the proliferation of prescription and illicit opioids like morphine, oxycodone and fentanyl.

“There’s been a lot of focus on overdose among younger people,” says Chelsea Shover at the University of California, Los Angeles. “We wanted to understand to what degree is that happening among older adults.”

She and her colleagues collected data on overdose deaths in adults 65 years and older from the US Centers for Disease Control and Prevention’s WONDER database. The database tracks every fatality recorded in the country, including the person’s age, race, gender and cause of death.

The researchers found that between 2002 and 2021, rates of fatal overdoses quadrupled among older adults. In 2002, three out of every 100,000 adults 65 years and older in the US died from a drug overdose. In 2021, that number increased to 12 out of every 100,000. Rates were highest among non-Hispanic Black people and Native Americans, though Asian and non-Hispanic white people had higher rates of intentional overdose deaths. For reference, 62 out of every 100,000 adults between 35 and 44 years old in the US died from drug overdose in 2021.

Most fatal drug overdoses among older adults in 2021 involved illicit drugs, but 37 per cent involved prescription medications. Opioids, including prescription opioids, played a role in 57 per cent of overdose deaths.

“Compared to other portions of the population, older adults are generally prescribed more things, including more drugs that can lead to overdose, whether alone or combined,” says Shover. They also don’t metabolise drugs as efficiently, which increases overdose risk, says Alexis Kuerbis at Hunter College in New York, who wasn’t involved in the study

“Understanding the scope of this problem is important to enact better policies to provide more equitable healthcare for older adults,” says Shover. For example, Medicare – the federal health insurance programme for older adults in the US – isn’t required to cover mental health and substance use disorder treatment to the same degree as other health conditions, she says.