Geriatric drug overdose deaths in US quadrupled over 20 years

Key takeaways:

• Drug overdose fatalities have quadrupled among people aged 65 years or older in the past 20 years.
• Most unintentional overdoses involved illegal drugs and most intentional overdoses involved prescription drugs.

From 2002 to 2021, the rate of drug overdose death among people aged 65 years or older quadrupled, according to data published in JAMA Psychiatry.

The study was conducted by Keith Humphreys, PhD, the Esther Ting Memorial Professor in the department of psychiatry and behavioral sciences at Stanford University, and Chelsea L. Shover, PhD, an assistant professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA.

Humphreys and Shover evaluated the annual overdose mortality rate among U.S. adults aged 65 years and older using data from the CDC WONDER database. For 2021 data, the researchers also evaluated characteristics of intentional and unintentional overdose death, drug type and decedent demographics.

Over the study period, the rate of overdose deaths among adults aged 65 years and older grew from three to 12 deaths per 100,000 people (P < .001). Rates were highest among non-Hispanic African Americans (30.9 per 100,000 people) and lowest among non-Hispanic Asian or Pacific Islander people (2.8 per 100,000 people).

Drug overdose deaths accounted for 0.06% of all-cause mortalities in 2002 and for 0.27% of all-cause mortalities in 2021, an increase of 359% (P < .001). In 2021, this amounted to one overdose for every 370 deaths among adults aged 65 years or older.

Analyses of 2021 data revealed 3,814 (57%) of 6,702 overdose deaths involved an opioid, 2,587 (39%) involved a stimulant and 1,204 (18%) involved both, the researchers wrote. More than half (57%) of intentional overdoses were among female decedents, while only 29% of unintentional overdoses were among female decedents. A greater proportion of non-Hispanic Asian or Pacific Islander adults intended to overdose (38%) compared with non-Hispanic whites (18%) and non-Hispanic African Americans (2%) in 2021.

Humphreys and Shover noted that illicit drugs were involved in most (74%) unintentional overdoses, and 19% of unintentional overdoses involved both prescription and illicit drugs. More than half (68%) of intentional overdoses involved prescription drugs including opioids, antidepressants, benzodiazepines or antiepileptics and sedative-hypnotics.

“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 lifespan,” Shover said in a press release. “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.”

References:

• Drug overdose fatalities among US older adults has quadrupled over 20 years, UCLA research finds. https://www.eurekalert.org/news-releases/984302. Published March 29, 2023. Accessed March 29, 2023.
• Humphreys K, et al. JAMA Psychiatry. 2023;doi:10.1001/jamapsychiatry.2022.5159.