“My family was celebrating the graduation of one of our loved ones when the festivities were cut short by a devastating call. We were told that one of our grandmothers was being rushed to the hospital with life saving measures in progress. She had recently had a medically necessary surgery and was given opioids for pain relief following the surgery. Suddenly, we faced the possibility of losing our healthy grandmother to an unintentional drug overdose.”
Distinct Challenges for Older Adults
Older adults are a unique subset of the population when it comes to drug overdoses. For starters, adults over 60 are the most common users of opioid prescriptions in the United States, and they are also more likely to take multiple medications daily. As of 2020, each adult 65 and older, on average, takes 4.3 medications daily. Older people are also more likely to be hospitalized . They’re often prescribed new medications when in the hospital and released without adequate medication reconciliation or consideration of cognitive abilities. In addition to the higher use of medications, there are other physical and psychosocial factors that put older adults at an increased risk of overdose such as the following:
- Vision impairment that commonly accompanies aging makes it harder to see the medication instructions, labels, and doses. In one study, 39% of older adults reported that they were unable to read their prescription labels.
- Liver and kidney function slows as people age. Because the liver and kidneys are responsible for clearing medications from the body, medications stay in the body longer in these patients causing a build up in the system and increasing dangerous side effects.
- Due to chronic conditions, prolonged use of some medicines can lead to lung problems and brain damage. This can cause or worsen cognitive decline creating a cycle of riskier drug use and worsened cognitive decline.
- Older adults are also more likely to be taking multiple different medications that can interact with opioids putting them at higher risk of dangerous side effects. For example, taking opioids for chronic pain with anti-anxiety medications such as benzodiazepine can slow respirations to the point of death.
- It is estimated that between 40% and 75% of adults over 65 are taking their medications incorrectly. One study of 325 older persons found that 67% did not understand the medication information given to them contributing to their unintentional misuse.
- Adults over 65 who have a substance use disorder often experience symptoms similar to depression or dementia. They are often misdiagnosed with one of these conditions, leaving the substance use disorder untreated.
- Several psychosocial factors that are common in adults over 65 years old can contribute to substance use disorders such as: living alone, loss of loved ones, feeling isolated, living in care facilities, changes or transitions in their living arrangements, and having certain coping styles.
Understanding these risks is the first step in building a safety net to protect our elders.
A Growing Need for Proactive Safety Planning
Fortunately for my family, someone happened to find our grandma shortly after she stopped breathing. They began CPR in time, and this beloved grandmother was able to make a full recovery. Unfortunately, there are many who are not as lucky. According to a recent CDC report, age-adjusted rates of drug overdose deaths for adults aged 65 and over increased from 2.4 per 100,000 in 2000 to 8.8 deaths per 100,000 in 2020. Another study reports that by 2021,1 out of every 370 senior deaths were from overdoses, and at least 83% were unintentional.
At Zero Overdose, our goal is to proactively implement overdose prevention strategies. Whether someone lives or dies should not solely depend on someone being in the right place at the right time. The Zero Overdose safety planning tool is easy and accessible. It does not require licensure allowing caretakers from many different roles the ability to learn and implement safety plans. This can include familial caretakers, nursing home staff, physicians, therapists, and virtually anyone who cares for older adults. Overdose can happen when you least expect it, and action steps should be taken to keep people safe.
If you work with older adults in any capacity, reach out to Zero Overdose to schedule a safety plan training for your family or team .
