Sources of Opioids for Non-medical Use Differ in Older Adults

Non-medical use of prescription opioid (NMUPO) patterns and sources of opioids have been widely described in adolescents and young adults; however, older adults are experiencing increasing rates of  NMUPO and overdose death. This study used combined data from the 2009–2014 National Survey on Drug Use and Health to examine patterns of NMUPO, prescription opioid use disorder (POUD) symptoms, and most recent source of opioids across age groups.

  • People aged ≥65 years were more likely to receive opioids from physicians (48%, with 39% from a single physician), compared with those 50–64 years (39%, with 33% from a single physician) and those in lower age groups (22–24% for those <25 years).
  • Compared with those <65 years, older adults were less likely to use theft (5%), purchase (9%), or friends/family for free (23%) to obtain opioids.
  • Among those >50 years with NMUPO, POUD symptoms were associated with obtaining opioids from purchase, a single physician, and multiple sources.

Comments: Older adults with NMUPO, especially those over 65 years, are much more likely to obtain opioids from a single physician, compared with younger people. Typical safety strategies such as prescription drug monitoring program checks or urine drug testing may be less effective in identifying these older patients with NMUPO or POUD. Although rates of NMUPO and POUD are lower in older people, increasing rates of opioid problems and the different opioid source patterns described here argue for innovative tactics to treat this population.

Joseph Merrill, MD, MPH

Reference: Schepis TS, McCabe SE, Teter CJ. Sources of opioid medication for misuse in older adults: results from a nationally representative survey. Pain. 2018;159(8):1543–1549.

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