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Overdose deaths in adults age 65 and older from fentanyl blended with stimulants, resembling cocaine and methamphetamines, have surged 9,000% previously eight years, matching charges discovered amongst youthful adults, in keeping with analysis offered on the ANESTHESIOLOGY 2025 annual assembly.
The research is among the many first to make use of Facilities for Illness Management and Prevention (CDC) knowledge to indicate that older adults, a gaggle usually neglected in overdose analysis, are a part of the broader rise in fentanyl–stimulant overdose deaths. Adults 65 years and older are particularly susceptible to overdoses as a result of many reside with power well being situations, take a number of medicines and course of medicine extra slowly attributable to age.
The opioid epidemic has unfolded in 4 waves, every characterised by a distinct sort of opioid driving the rise in overdose deaths: prescription opioids within the Nineteen Nineties; heroin beginning in 2010; fentanyl beginning in 2013; and a mixture of fentanyl and stimulants beginning in 2015.
“A common misconception is that opioid overdoses primarily affect younger people,” mentioned Gab Pasia, M.A., lead writer of the research and a medical scholar on the College of Nevada, Reno Faculty of Drugs. “Our analysis shows that older adults are also impacted by fentanyl-related deaths and that stimulant involvement has become much more common in this group. This suggests older adults are affected by the current fourth wave of the opioid crisis, following similar patterns seen in younger populations.”
Researchers analyzed 404,964 dying certificates that listed fentanyl as a reason behind dying from 1999 to 2023, obtained from the CDC Large-ranging On-line Information for Epidemiologic Analysis (WONDER) system. Older adults (age 65+) represented 17,040 and youthful adults (ages 25–64) represented 387,924 of the dying certificates.
General, fentanyl-related deaths between 2015 and 2023 elevated from 264 to 4,144 in older adults (1,470% improve) and eight,513 to 64,694 in youthful adults (660% improve). The evaluation revealed a rising variety of fentanyl-stimulant associated deaths, notably amongst adults age 65 or older. Amongst this group, fentanyl-stimulant deaths rose from 8.7% (23 of 264 fentanyl deaths) in 2015 to 49.9% (2,070 of 4,144 fentanyl deaths) in 2023, a 9,000% improve.
For youthful adults, fentanyl-stimulant deaths elevated from 21.3% (1,812 of 8,513 fentanyl deaths) in 2015 to 59.3% (38,333 of 64,694 fentanyl deaths) in 2023, a 2,115% improve.
The researchers highlighted knowledge from these particular person years as a result of 2015 marked the onset of the fourth wave of the opioid epidemic and was additionally the 12 months fentanyl-stimulant deaths amongst older adults have been at their lowest, and 2023 because it was the newest 12 months of CDC knowledge accessible.
The researchers famous that the rise in fentanyl deaths involving stimulants in older adults started to sharply rise in 2020, whereas deaths linked to different substances stayed the identical or declined. Cocaine and methamphetamines have been the most typical stimulants paired with fentanyl among the many older adults studied, surpassing alcohol, heroin and benzodiazepines resembling Xanax and Valium.
“National data have shown rising fentanyl-stimulant use among all adults,” mentioned Mr. Pasia. “Because our analysis was a national, cross-sectional study, we were only able to describe patterns over time—not determine the underlying reasons why they are occurring. However, the findings underscore that fentanyl overdoses in older adults are often multi-substance deaths—not due to fentanyl alone—and the importance of sharing drug misuse prevention strategies to older patients.”
The authors famous anesthesiologists and different ache medication specialists ought to:
Acknowledge that polysubstance use can happen in all age teams, not solely in younger adults.
Be cautious when prescribing opioids to adults 65 or older by rigorously assessing treatment historical past, intently monitoring sufferers prescribed opioids who could have a historical past of stimulant use for potential negative effects, and contemplating non-opioid choices when doable.
Use harm-reduction approaches resembling involving caregivers in naloxone schooling, simplifying treatment routines, utilizing clear labeling and secure storage directions and ensuring directions are simple to know for these with reminiscence or imaginative and prescient challenges.
Display older sufferers for a broad vary of substance exposures, past prescribed opioids, to raised anticipate issues and regulate perioperative planning.
“Older adults who are prescribed opioids, or their caregivers, should ask their clinicians about overdose prevention strategies, such as having naloxone available and knowing the signs of an overdose,” mentioned Richard Wang, M.D., an anesthesiology resident at Rush College Medical Middle, Chicago and co-author of the research.
“With these trends in mind, it is more important than ever to minimize opioid use in this vulnerable group and use other pain control methods when appropriate. Proper patient education and regularly reviewing medication lists could help to flatten this terrible trend.”
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Adults 65 years and older not proof against the opioid epidemic, research finds (2025, October 11)
retrieved 11 October 2025
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