[P]ainkiller addiction is not just a young person’s problem: Between one-third and one-half of prescription opioid overdose deaths in Vermont happen to people who are over the age of 50.
That’s according to data from the Vermont Department of Health, which compiled prescription opioid overdose deaths between 2010 and 2015 by older age cohorts for VTDigger.
In 2015, about 46 percent of people who overdosed on prescription opioids — including prescription fentanyl but not heroin — were over the age of 50. That’s the highest proportion of fatal overdoses by older Vermonters since 2010.
The data, which uses raw numbers among older people, offers a different perspective than what the Vermont Department of Health’s data tend to highlight: the percentage of people misusing who are age 12 to 17, 18 to 25, and 26 and older.
Experts and national data say painkiller abuse may be more pronounced among people over age 65. Between 1993 and 2012, hospital stays involving opioid overdoses—including heroin—increased five-fold for people over 45, compared to just three-fold for younger age groups, according to a report from the Agency for Healthcare Research and Quality.
An article in the September issue of JAMA Psychiatry, a medical journal, said people who use Medicare have “among the highest and most rapidly growing prevalence of opioid use disorder … with hospitalizations increasing 10 percent per year.”
“This has been really a hidden problem, and we need to stop that,” said Charles Gurney, the substance abuse and aging coordinator for both the Department of Aging and Independent Living and the Vermont Department of Health.
Gurney’s job is to go around the state to substance abuse centers and area agencies on aging to talk about substance abuse among seniors, and train home health workers to perform substance abuse screenings. He wants to make people aware of the problem, so that seniors can get treatment.
Gurney said prescription drug misuse among seniors “under-identified and undertreated” in Vermont and nationally. He said it often happens because seniors are prescribed so many opioids that they unintentionally become dependent on them.
“There’s just as many seniors with addiction problems as other adult age groups,’” he said. “I’ve literally never heard of seniors going to the addiction treatment rehabs. I think the perception was that not that many people needed it.”
According to the Vermont Department of Health, 28 percent of men and women over age 65 were given at least one prescription for an opioid in 2015. That is the highest percentage of people prescribed opioids among any age group in Vermont, and the statistic lines up with national trends.
“A lot of prescribed opiates are going to seniors, and they may need it, but they may not need as much of it or for as long,” Gurney said. “But I do know that there is a great deal of misuse of prescription medications by seniors that is mostly unintentional.”
At the same time, the Department of Health says substance abuse treatment tailored toward older adults is virtually non-existent. The Evergreen program in the Rutland area has a counselor who reaches out to seniors, and the Springfield Medical Health Center offers some traveling services that include substance abuse.
Barbara Cimaglio, the deputy commissioner for the Vermont Department of Health, said the state’s prevention efforts tend to focus on young people, and there’s a common misconception that addiction is only a young person’s problem.
“Older people who are on medications or who may have chronic pain definitely are at risk, and doctors are very uncomfortable with saying” that their older patients are using too many opioids, Cimaglio said.
“It’s a harder conversation to have with an older person than with a younger person,” she said.
