How The Opioid Epidemic Affects Older Adults

In 2017, more than 5,500 North Carolinians went to the emergency room for an opioid overdose.

As the epidemic continues to grip the state and nation, older adults are being affected in unique ways.

WFDD's Bethany Chafin spoke with Winston-Salem State University Professor of Behavioral Sciences, Dr. Shannon Mathews, about how people 55 and older are experiencing the crisis.

Interview Highlights

On what's currently known about older adults and the opioid epidemic:

Generally we usually talk about opioid use in regards to older adults being victims. And what I mean by a victim is that their drugs or prescriptions that are opioid prescriptions, things like Vicodin or OxyContin or Fentanyl that they have been prescribed, have usually either been stolen or diverted by someone else or taken by other individuals and either used for their own illicit purposes or sold. And so we often really first think about them as victims.

But ... another side that's starting to really emerge in the discussion is really thinking about the fact that older adults themselves can actually use and misuse opioids in a way that's either non medically oriented or in relation to illicit drug use. And so we're starting to really say they're not only victimized in this opioid issue, they also are being impacted as abusers or users themselves.

On factors that might make older adults more susceptible to substance abuse disorder:

Older adults who are dealing with emotional or psychosocial issues, sometimes might be the loss of a spouse or an adult child, bereavement issues, isolation, prolonged insomnia, lack of sleeping, those kinds of issues can make them at risk. Social isolation we definitely know will make someone at risk. Any prior history with depression or anxiety will also add [risk]. The other issue in particular to psychoactive drugs is that they are very strong pharmaceuticals and as a result the aging body breaks them down very differently. And so older adults can be susceptible for that reason as well, that their body is just breaking it down a little bit differently and metabolizing it in different ways than a younger user.

On how opioid use and age is studied:

So some of the review of the literature would suggest that we're not yet at this stage of getting lots of direct information from users themselves but we're looking at data that gives us good indicators. So Medicare patients, we know that population is going to be 65 and older. If they're coming in for a hospitalization associated to an opioid, we can kind of see that and make those connections, so that data is there. And again substance abuse data is there. It's not always broken down by age, but I do think we have some good data to begin to really start to look at and tease out some of the cohort differences.

On resources available for older adults:

Substance Abuse Treatment programs are really not geared towards older adults. And I'll give you an example ... the group model or the group dynamic of a support group really works well in regards to substance abuse. And so we know that practice is appropriate. However, if you do an intergenerational group with an adult from an older cohort who is a bit more conservative, whose abuse is more associated to shame ... They may not feel as comfortable. So we have to really think about what's cohort appropriate for the older adult. And so oftentimes you will hear suggestions about making sure that it is an aggregated group of older adults in a support group. We might also need to look at gender because older adult males may not have talked openly about issues in the same way as women in all female groups. So I think gender dynamics will play out a little bit different. So I think there are ways we could customize programs for older adults, but there are very limited programs that have done that. And that is really a gap.