Fatal drug overdoses have quadrupled in US seniors

older white woman with grey hair being loaded into ambulance by two paramedics, at night as the ambulance lights flash
U.S. seniors are facing a higher risk of fatal drug overdose than in previous decades. (Image credit: Cavan Images via Getty Images)

Fatal drug overdoses aren't just a problem for the young — increasingly, overdoses deaths are involving America's senior population, according to a new study.

The study found that the annual rate of drug overdose deaths among adults ages 65 and older in the U.S. has quadrupled over the last two decades.

The findings mean that it's "important to think of and plan for overdose as a problem that affects people across the life course," study co-author Chelsea Shover, an assistant professor at the David Geffen School of Medicine at UCLA, told Live Science in an email.

Fatal drug overdoses have been on the rise in the U.S. since 1999, largely driven by the country's opioid epidemic. Most overdose deaths occur among working-age adults, with the highest rates reported among those ages 35 to 44 years old, according to the Centers for Disease Control and Prevention (CDC). 

But older adults may be increasingly at risk of fatal overdose, relative to their past risk, the authors wrote in their paper, published March 29 in the journal JAMA Psychiatry

Related: Opioids are the most common cause of fatal poisonings in kids under 5 

Many older adults are prescribed multiple drugs that they take every day, a factor that can increase the risk of drug overdose, the authors said. In addition, the use of illicit drugs has increased in the older population in recent years, according to the National Institute on Drug Abuse. This may in part be due to an aging population of people who use drugs, Shover said. (For example, some people in the baby boomer generation began using drugs in their youth and continued to use them as they aged, according to Northwestern University.)

For the new study, the researchers analyzed information from the CDC's public health database known as WONDER (Wide-ranging Online Data for Epidemiologic Research), which includes information on all deaths in the United States and their underlying causes. This data is drawn from death certificates.

They found that the rate of fatal drug overdoses among U.S. adults ages 65 and older increased from 3 per 100,000 in 2002 to 12 per 100,000 in 2021. Rates were highest among Black seniors, at nearly 31 deaths per 100,000 people ages 65 and older.

In 2021, the most recent year for which data is available, 6,702 people ages 65 and older died from drug overdose, nationwide. Most of these deaths, 57%, were due to opioids; 39% were due to stimulants; and 18% were due to a combination of both.

Of the 6,702 deaths, the majority — 83% — were classified as unintentional, while 13% were classified as intentional and 4% were undetermined. Three-quarters of the unintentional deaths were due to illicitly manufactured drugs, including synthetic opioids like fentanyl, heroin, cocaine and methamphetamines; and 20% involved a combination of both prescription and illegal drugs.

In contrast, more than two-thirds of the intentional deaths were due to prescription opioids, antidepressants, benzodiazepines, antiepileptics and sedatives, the authors wrote.

Overall in 2021, one out of every 370 deaths among seniors was due to a drug overdose.

"The quadrupling of fatal overdoses among older adults should be considered in evolving policies focused on the overdose epidemic," the researchers wrote. 

"These findings increase [the] urgency of Medicare parity — that is, requiring Medicare to cover evidence-based treatment for substance use disorder the same way Medicaid and other public and private insurance providers are [covering it]," Shover said. 

Other strategies to reduce the rate of overdose among older adults include providing the overdose rescue drug naloxone to patients judged as high risk for an overdose; and expanding the use of nonpharmacological interventions (like psychological treatments and physical therapy) for health problems common in older adults, such as insomnia and pain, the authors said.

Rachael Rettner

Rachael is a Live Science contributor, and was a former channel editor and senior writer for Live Science between 2010 and 2022. She has a master's degree in journalism from New York University's Science, Health and Environmental Reporting Program. She also holds a B.S. in molecular biology and an M.S. in biology from the University of California, San Diego. Her work has appeared in Scienceline, The Washington Post and Scientific American.