New research shows mortality tied to drug and alcohol abuse has been on the rise among older Americans, with the rate of death from drug overdoses more than tripling among those 65 and older over the past two decades and the rate of alcohol-induced deaths rising by more than 18% from 2019 to 2020.
Though drug overdoses account for only a small fraction of deaths among older adults, the overdose mortality rate rose from 2.4 deaths per 100,000 standard population in 2000 to 8.8 per 100,000 in 2020 among adults ages 65 and older, according to a report released Wednesday by the Centers for Disease Control and Prevention’s National Center for Health Statistics. Approximately 5,200 drug overdose deaths were recorded in 2020 out of more than 2.5 million deaths among older adults overall.
The report encompassed both unintentional and intentional drug overdoses, and showed wide variation in overdose mortality among older Americans by gender, as well as by race and ethnicity.
The overdose death rate among older men increased on average by 5% annually from 2.7 deaths per 100,000 in 2000 to 5.7 per 100,000 in 2014, but then increased each year by 14% on average to reach 12.3 deaths per 100,000 by 2020. Drug mortality among women 65 and older more than doubled over the past two decades, going from 2.3 deaths per 100,000 women in 2000 to 5.8 per 100,000 in 2020.
Among both older men and women, the overdose death rate in 2020 was higher among those 65 to 74 than among those 75 and older, at 19.2 per 100,000 for men and 7.9 per 100,000 for women in that younger group. The gap between overdose death rates among older men and women grew from being 1.2 times higher for men in 2000 to 2.1 times higher in 2020, according to the study.
Addiction Amid COVID-19
Black individuals also had the highest fatal overdose rate among men 75 and older in 2020, at 10.2 per 100,000. Among women, whites had the highest rate in that age group at 3.8 per 100,000.
The study points to synthetic opioids like fentanyl as a primary driver of the increase in overdose mortality among older Americans, as in the population overall. The mortality rate among those 65 and older involving such drugs increased 53% between 2019 and 2020, from 1.9 deaths per 100,000 to 2.9 per 100,000, according to the study.
The study was one of two released Wednesday that showed a worrying trend regarding substance use among older Americans. A second analysis showed that the mortality rate from alcohol-induced causes among those 65 and older increased from 17 per 100,000 in 2019 to 20.1 per 100,000 in 2020. Alcohol-induced issues were the underlying cause of death for 11,616 adults 65 and older in 2020.
Men between the ages of 65 and 74 had a higher rate than women of alcohol-induced death in 2020 at 43.4 per 100,000, compared with 12.9 deaths per 100,000 among women within that same age group. Among those 75 and older, men had a rate of 21.5 per 100,000 compared with 5.3 per 100,000 for women.
Among racial and ethnic groups, the highest rate of alcohol-induced death among those 65 and older was seen among American Indians or Alaska Natives at 55.1 deaths per 100,000 in 2020, representing a roughly 47% increase from 2019, according to the study.
The rate among older Hispanic adults increased by nearly 10% year over year to 23.1 per 100,000 in 2020, while rates among both Black and white older adults increased by close to 20% in 2020 over 2019.
Despite fatalities among older adults from drug overdose or alcohol accounting for small portions of deaths both in that demographic and among such deaths overall, the new studies’ findings raise concerns.
Ellen Kramarow, a health statistician at the NCHS and a co-author of both analyses, says the findings of the overdose study in particular highlight that the drug crisis is having as diverse an impact among older Americans as it’s had on the rest of the population, and that factors fueling fatal overdoses among older adults likely mirror those that have contributed to the rise in overdose deaths among younger Americans.
Notably, separate research has pointed to the lethality of the illicit drug supply as driving a dramatic rise in the overdose death rate among U.S. teens.
“The 65 and older population is not homogeneous, it is really heterogeneous,” Kramarow says. “You can surmise that some of the same forces affecting younger people are affecting older people.”
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