Sources of Misused Opioids in Older Adults

A man taking medication
A man taking medication
Recent physician-prescribed opioids represent the main source of provenance of the drug in individuals age ≥65 years who misuse them.

Recent physician-prescribed opioids represent the main source of provenance of the drug in individuals age ≥65 years who misuse them, according to a study published in Pain.

Investigators analyzed data from the 2009 to 2014 National Survey on Drug Use and Health to identify patients from 6 age groups who were taking opioids, including people 50 to 64 years old (n=24,384) and ≥50 years (n= 39,561).

Using computer-assisted self-interviews, individuals taking opioids provided information on opioid misuse during their lifetime and during the past year and past month, as well as information about the source(s) of those opioid medications (ie, obtained from a physician, friend/relative, or from another source; stolen/fake prescription; or other).

Physician-prescribed opioids that were misused were more prevalent in older vs younger individuals (≥65 years, 47.7%; 50-64 years, 39.2%; 12-17 years, 23.5%; 18-25 years, 21.8%). The percentage of individuals obtaining misused opioids through theft or fake prescriptions decreased with age, with the exception of the 50 to 64 age group (12-17 years, 13.6%; 18-25 years, 11.6%; 35-49 years, 7.2%; 50-64 years, 10.2%; ≥65 years, 5.3%). Adolescents and those age ≥65 years were less likely to obtain opioids for misuse from friends or relatives compared with young adults (18-25 years) and adults age 26 to 34 years (37.2% and 23.2% vs 56.8% and 56.7%, respectively).

In participants age ≥65 years, theft (5.3%), purchases (8.5%), and other (14.5%) were the least-used sources of past-month misused opioids, compared with physician- or friend/relative-obtained drugs (47.7% and 23.2%, respectively). Individuals ≥50 years who obtained misused opioids from 3 different sources vs physician only had higher rates of prescription opioid use disorder (P =.03).

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The cross-sectional design and self-reported nature of the analysis allows only associations and does not establish causality.

“These results suggest measures that can limit older adult prescription opioid misuse, including education on proper medication storage and disposal, education on the risks of prescription opioid medical misuse (ie, misusing one’s own prescription), heightened monitoring for signs of concurrent other substance and prescription opioid use, enhanced screening for potential [substance use disorders], and heightened monitoring for behaviors associated with prescription opioid misuse in older adults,” concluded the study authors.

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Schepis TS, McCabe SE, Teter CJ. Sources of opioid medication for misuse in older adults: Results from a nationally representative survey [published online April 5, 2018]. Pain. doi: 10.1097/j.pain.0000000000001241