Fentanyl-stimulant Overdose Deaths Surge Among Older Adults

Overdose deaths successful adults property 65 and older from fentanyl mixed pinch stimulants, specified arsenic cocaine and methamphetamines, person surged 9,000% successful nan past 8 years, matching rates recovered among younger adults, according to investigation presented astatine nan ANESTHESIOLOGY® 2025 yearly meeting.

The study is among nan first to usage Centers for Disease Control and Prevention (CDC) information to show that older adults, a group often overlooked successful overdose research, are portion of nan broader emergence successful fentanyl-stimulant overdose deaths. Adults 65 years and older are particularly susceptible to overdoses because galore unrecorded pinch chronic wellness conditions, return respective medications and process narcotics much slow owed to age. 

The opioid pandemic has unfolded successful 4 waves, each characterized by a different type of opioid driving nan summation successful overdose deaths: medicine opioids successful nan 1990s; heroin starting successful 2010; fentanyl starting successful 2013; and a operation of fentanyl and stimulants starting successful 2015.

A communal misconception is that opioid overdoses chiefly impact younger people. Our study shows that older adults are besides impacted by fentanyl-related deaths and that stimulant engagement has go overmuch much communal successful this group. This suggests older adults are affected by nan existent 4th activity of nan opioid crisis, pursuing akin patterns seen successful younger populations."

Gab Pasia, M.A., lead writer of nan study and medical student astatine nan University of Nevada, Reno School of Medicine

Researchers analyzed 404,964 decease certificates that listed fentanyl arsenic a origin of decease from 1999 to 2023, obtained from nan CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) system. Older adults (age 65+) represented 17,040 and younger adults (ages 25–64) represented 387,924 of nan decease certificates.

Overall, fentanyl-related deaths betwixt 2015 and 2023 accrued from 264 to 4,144 successful older adults (1,470% increase) and 8,513 to 64,694 successful younger adults (660% increase). The study revealed a increasing number of fentanyl-stimulant related deaths, peculiarly among adults property 65 aliases older. Among this group, fentanyl-stimulant deaths roseate from 8.7% (23 of 264 fentanyl deaths) successful 2015 to 49.9% (2,070 of 4,144 fentanyl deaths) successful 2023, a 9,000% increase. For younger adults, fentanyl-stimulant deaths accrued from 21.3% (1,812 of 8,513 fentanyl deaths) successful 2015 to 59.3% (38,333 of 64,694 fentanyl deaths) successful 2023, a 2,115% increase.

The researchers highlighted information from these individual years because 2015 marked nan onset of nan 4th activity of nan opioid pandemic and was besides nan twelvemonth fentanyl-stimulant deaths among older adults were astatine their lowest, and 2023 arsenic it was nan astir caller twelvemonth of CDC information available.

The researchers noted that nan emergence successful fentanyl deaths involving stimulants successful older adults began to sharply emergence successful 2020, while deaths linked to different substances stayed nan aforesaid aliases declined. Cocaine and methamphetamines were nan astir communal stimulants paired pinch fentanyl among nan older adults studied, surpassing alcohol, heroin and benzodiazepines specified arsenic Xanax and Valium.

"National information person shown rising fentanyl-stimulant usage among each adults," said Mr. Pasia. "Because our study was a national, cross-sectional study, we were only capable to picture patterns complete clip - not find nan underlying reasons why they are occurring. However, nan findings underscore that fentanyl overdoses successful older adults are often multi-substance deaths - not owed to fentanyl unsocial - and nan value of sharing supplier misuse prevention strategies to older patients."

The authors noted anesthesiologists and different symptom medicine specialists should:

• Recognize that polysubstance usage tin hap successful each property groups, not only successful young adults.
• Be cautious erstwhile prescribing opioids to adults 65 aliases older by cautiously assessing medicine history, intimately monitoring patients prescribed opioids who whitethorn person a history of stimulant usage for imaginable broadside effects, and considering non-opioid options erstwhile possible.
• Use harm-reduction approaches specified arsenic involving caregivers successful naloxone education, simplifying medicine routines, utilizing clear labeling and safe retention instructions and making judge instructions are easy to understand for those pinch representation aliases imagination challenges.
• Screen older patients for a wide scope of constituent exposures, beyond prescribed opioids, to amended expect complications and set perioperative planning.

"Older adults who are prescribed opioids, aliases their caregivers, should inquire their clinicians astir overdose prevention strategies, specified arsenic having naloxone disposable and knowing nan signs of an overdose," said Richard Wang, M.D., an anesthesiology resident astatine Rush University Medical Center, Chicago and co-author of nan study. "With these trends successful mind, it is much important than ever to minimize opioid usage successful this susceptible group and usage different symptom power methods erstwhile appropriate. Proper diligent acquisition and regularly reviewing medicine lists could thief to flatten this unspeakable trend."