Drug addiction deaths rose sharply among older Americans in 2020

Deaths from drug addiction, particularly alcohol and opioids, rose sharply among older Americans in 2020, the first year of the coronavirus pandemic, as shutdowns disrupted routines and isolation and fear has spread, federal health researchers reported Wednesday.

Alcohol and opioid-related deaths remained much less common among older people than among middle-aged and younger people, and rates had been rising in all groups for years. But the steep rise – another data point in the long list of pandemic miseries – surprised government researchers.

Deaths from opioids rose 53% among Americans age 65 and older in 2020 compared to the previous year, the National Center for Health Statistics found. Alcohol-related deaths, which had already been increasing for a decade in this age group, increased by 18%.

“The rate of alcohol-related deaths among older adults is much lower than among young adults, but the change caught our attention,” said Ellen Kramarow, health statistician at the center and lead author of the report, which analyzed death certificate data.

Synthetic opioid overdose deaths account for less than 1% of deaths in people over 65, Dr. Kramarow noted. “But the shape of the curve jumped out at us,” she said.

Physiological changes that occur with aging make older adults more vulnerable to the harmful effects of alcohol and drugs, as the metabolism and excretion of substances slows, increasing the risk of toxicity. Smaller amounts have larger effects, researchers have found.

Alcohol and opioids can interact badly with prescription medications that many seniors take for common conditions like high blood pressure, diabetes, and mood disorders. Misuse can lead to falls and injuries, exacerbate underlying medical conditions, and worsen cognitive decline.

Substance abuse in the elderly is often overlooked by health care providers, who rarely refer these patients to treatment. Many institutions that offer rehabilitation services are adapting their programs to younger populations. Older patients have different needs and may be uncomfortable receiving treatment with people who are only the age of their children or grandchildren.

Many baby boomers have struggled with addiction since they were young adults. Some fell off the wagon after retirement or during the pandemic, when they suddenly had more free time and little structure and lost access to treatment due to shutdowns and fear of infection.

Mortality rates indicate a widespread problem of substance abuse among the elderly. Although alcohol and drug use generally declines with age, nearly one million adults aged 65 and over suffer from a substance use disorder, according to government data. About 3% use marijuana, and one in 10 people binge drink, which is defined for men as having had five or more drinks on one occasion, and for women as having had four drinks or more.

“This is a hidden population that is often overlooked,” said Dr. Frederic Blow, professor of psychiatry and director of the University of Michigan Center for Addiction.

Dr Blow said relatively few older Americans are in treatment. Families and spouses are embarrassed and health care providers tend to be less aggressive when it comes to referring elderly patients to rehab, he added.

“Young people go for treatment because their family gives them an ultimatum or their employer has identified the problem, whereas the first way for older people to get treatment is through the criminal justice system,” often after a arrest for drunk driving, he said. .

Lochiel P., a 72-year-old man in Albany, NY, who asked that his last name be withheld, started drinking when he was 18 (which was then the legal drinking age) and started smoking marijuana and using psychedelic drugs in college.

He had been in and out of treatment his whole life. But he had been sober for eight years when his retirement triggered a relapse.

“I never smoked marijuana before going to work or during the work day – only when I got home,” he said. But after retiring he said, “I smoked marijuana all day and drank a pint of vodka every day, starting with a half pint at noon and the second in the evening.”

He was miserable and his wife was about to leave him, he said, when he was finally ordered into treatment after being arrested for driving under the influence.

He has now been sober for four years and has become a peer recovery advocate at Senior Hope, an outpatient clinic in Albany that serves people aged 50 and over struggling with substance abuse.

The program is the only one of its kind in New York to offer non-intensive treatment outside of a hospital for people in this age group, according to Nicole S. MacFarland, executive director of Senior Hope.

Treatment groups are smaller, which is preferred by older patients, and facilitators make sure to speak loudly and slowly to accommodate people with hearing and cognitive deficits, she said.

The new federal data offers granular information on who is most at risk. Men are more likely to suffer alcohol-related deaths: In 2020, rates for men aged 65 to 74 were more than three times higher than for women of the same age.

According to the new report, alcohol-related death rates among men aged 75 and over were four times higher than among women of the same age.

Native Americans and Alaska Natives ages 65 and older saw the largest increase in age-adjusted alcohol-related death rates in 2020, with the rate climbing nearly 50% from to 2019. The figure was more than twice as high as the rate among older Hispanics. Americans.

White Americans had the second highest death rate, with lower numbers for Black Americans and the lowest for Asian American seniors. A total of 11,616 Americans age 65 and older died of alcohol-induced causes in 2020.

About 5,000 seniors have died from drug overdoses. But that number represents a tripling of the drug-related death rate over the past two decades, with faster increases among men in recent years.

Drug overdose death rates for men ages 65 and older are highest among black men, compared to men of other racial and ethnic backgrounds. Among women, overdose death rates are highest among black women ages 65 to 74, while white women have the highest death rates among women ages 75 and older.

Aging baby boomers – the Woodstock generation – were more exposed to alcohol and drugs than previous generations, who viewed the use of these substances as a moral weakness and knew much less about marijuana, Dr Blow said.

The fraying of social media and shutdowns during the early part of the pandemic exacerbated drug addiction, as did access to cannabis and alcohol increased – one could order drinks or cannabis over the phone and have them home delivery, Dr. Blow said.

“When you add that to the feelings of loneliness and isolation, feeling like the end of the world in some ways, it caused people to start consuming more than they ever had in the past,” did he declare.