Nancy A West1, Stevan G Severtson2, Jody L Green2, Richard C Dart3. 1. Research Department, Rocky Mountain Poison and Drug Center, 990 Bannock Street, M/C 0180, Denver Health and Hospital Authority, Denver, CO 80204, USA. Electronic address: nancy.west@rmpdc.org. 2. Research Department, Rocky Mountain Poison and Drug Center, 990 Bannock Street, M/C 0180, Denver Health and Hospital Authority, Denver, CO 80204, USA. 3. Research Department, Rocky Mountain Poison and Drug Center, 990 Bannock Street, M/C 0180, Denver Health and Hospital Authority, Denver, CO 80204, USA; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA.
Abstract
BACKGROUND: Dramatic increases in the prescriptive use of opioid analgesics during the past two decades have been paralleled by alarming increases in rates of the abuse and intentional misuse of these drugs. We examined recent trends in the abuse and misuse and associated fatal outcomes among older adults (60+ years) and compared these to trends among younger adults (20-59 years). METHODS: Trend analysis using linear regression models was used to analyze 184,136 cases and 1149 deaths associated with abuse and misuse of the prescription opioids oxycodone, fentanyl, hydrocodone, morphine, oxymorphone, hydromorphone, methadone, buprenorphine, tramadol, and tapentadol that were reported to participating U.S. Poison Centers of the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS(®)) System between 2006-Q1 and 2013-Q4. RESULTS: Rates of abuse and misuse of prescription opioids were lower for older adults than for younger adults; however, mortality rates among the older ages followed an increasing linear trend (P < 0.0001) and surpassed rates for younger adults in 2012 and 2013. In contrast, mortality rates among younger adults rose and fell during the period, with recent rates trending downward (P = 0.0003 for quadratic trend). Sub-analysis revealed an increasing linear trend among older adults specifically for suicidal intent (P < 0.0001), whereas these rates increased and then decreased among younger adults (P < 0.0001 for quadratic trend). CONCLUSION: Recent linear increases in rates of death and use of prescription opioids with suicidal intent among older adults have important implications as the U.S. undergoes a rapid expansion of its elderly population.
BACKGROUND: Dramatic increases in the prescriptive use of opioid analgesics during the past two decades have been paralleled by alarming increases in rates of the abuse and intentional misuse of these drugs. We examined recent trends in the abuse and misuse and associated fatal outcomes among older adults (60+ years) and compared these to trends among younger adults (20-59 years). METHODS: Trend analysis using linear regression models was used to analyze 184,136 cases and 1149 deaths associated with abuse and misuse of the prescription opioids oxycodone, fentanyl, hydrocodone, morphine, oxymorphone, hydromorphone, methadone, buprenorphine, tramadol, and tapentadol that were reported to participating U.S. Poison Centers of the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS(®)) System between 2006-Q1 and 2013-Q4. RESULTS: Rates of abuse and misuse of prescription opioids were lower for older adults than for younger adults; however, mortality rates among the older ages followed an increasing linear trend (P < 0.0001) and surpassed rates for younger adults in 2012 and 2013. In contrast, mortality rates among younger adults rose and fell during the period, with recent rates trending downward (P = 0.0003 for quadratic trend). Sub-analysis revealed an increasing linear trend among older adults specifically for suicidal intent (P < 0.0001), whereas these rates increased and then decreased among younger adults (P < 0.0001 for quadratic trend). CONCLUSION: Recent linear increases in rates of death and use of prescription opioids with suicidal intent among older adults have important implications as the U.S. undergoes a rapid expansion of its elderly population.
Authors: Bradley T Kerridge; Tulshi D Saha; S Patricia Chou; Haitao Zhang; Jeesun Jung; W June Ruan; Sharon M Smith; Boji Huang; Deborah S Hasin Journal: Drug Alcohol Depend Date: 2015-09-02 Impact factor: 4.492
Authors: Jing Wang; Steven A Sumner; Thomas R Simon; Alex E Crosby; Francis B Annor; Elizabeth Gaylor; Likang Xu; Kristin M Holland Journal: JAMA Psychiatry Date: 2020-07-01 Impact factor: 21.596
Authors: Steven K Dobscha; Travis I Lovejoy; Benjamin J Morasco; Anne E Kovas; Dawn M Peters; Kyle Hart; J Lucas Williams; Bentson H McFarland Journal: J Pain Date: 2016-04-04 Impact factor: 5.820
Authors: Laura S Gold; Ryan N Hansen; Andrew L Avins; Zoya Bauer; Bryan A Comstock; Richard A Deyo; Patrick J Heagerty; Sean D Rundell; Pradeep Suri; Judith A Turner; Jeffrey G Jarvik Journal: Clin J Pain Date: 2018-04 Impact factor: 3.442
Authors: Eduardo Romano; Pedro A Torres-Saavedra; Hilda I Calderón Cartagena; Robert B Voas; Anthony Ramírez Journal: J Stud Alcohol Drugs Date: 2018-07 Impact factor: 2.582
Authors: Rachel D Maree; Zachary A Marcum; Ester Saghafi; Debra K Weiner; Jordan F Karp Journal: Am J Geriatr Psychiatry Date: 2016-06-07 Impact factor: 4.105