Rising Trends in Fentanyl-Related Deaths Among Adults Over 65

The issue of substance use among older adults is more pressing than ever. As the population of adults aged 65 and older continues to rise, there is a stark increase in substance use and concerningly high rates of fentanyl-related deaths in this age group. This post examines the underlying factors driving these trends and presents compelling statistics to illustrate the urgency of the situation.

Understanding the Demographic Shift

Aging is a global phenomenon. The World Health Organization (WHO) predicts that by 2050, there will be around 2 billion people aged 60 and older. With this shift comes several challenges, including increased healthcare needs and a heightened risk of substance use disorders. Research from the National Institute on Aging (2023) indicates that life transitions, such as retirement and the loss of loved ones, can lead to feelings of loneliness and stress, prompting some older adults to engage in substance use as a coping mechanism just like those younger than them.

Older adults often take multiple medications for various health conditions, a phenomenon known as polypharmacy. This increases the risk of adverse drug interactions, exacerbating existing vulnerabilities.

The Rise of Substance Use Among Older Adults

Recent studies show a significant uptick in substance use among older adults, particularly concerning prescription medications and alcohol. According to the National Institute on Drug Abuse (NIDA, 2023), nearly 50% of older adults reported using prescription opioids for pain management, with many misusing these medications without even realizing it.

The misuse leads to dependence, with the Centers for Disease Control and Prevention (CDC, 2023) highlighting that older adults face a higher risk of opioid overdose due to factors like decreased metabolism and coexisting health issues. For instance, 30% of older adults with chronic pain are prescribed opioids, making it critical to monitor their use closely.

Fentanyl: A Growing Threat

Fentanyl is a synthetic opioid that is 50 to 100 times stronger than morphine, which makes it extremely dangerous, especially for older adults. The CDC (2023) estimates that fentanyl-related deaths have dramatically increased, particularly among those aged 65 and older. In 2021 alone, this demographic accounted for approximately 25% of opioid overdose-related deaths, with fentanyl being cited as a major contributing factor.

Fentanyl's proliferation in the drug market poses significant risks. It is often mixed with other substances, sometimes without consumers' knowledge. Consequently, older adults may inadvertently consume fentanyl-laced drugs, leading to fatal outcomes.

Within the older population, deaths involving both fentanyl and stimulants grew from 8.7% (23 of 264 fentanyl deaths) in 2015 to 49.9% (2,070 of 4,144) in 2023 -- a staggering 9,000% rise (American Society of Anesthesiologists, 2025).

Factors Contributing to Increased Substance Use

Several key factors are driving the trends in substance use and fentanyl-related deaths among older adults.

Mental Health Issues

Mental health disorders like depression and anxiety are common in older adults. According to the National Institute of Mental Health (2023), nearly 15% of older adults experience depression. Many may resort to substances as a form of self-medication. For example, a substantial portion of those experiencing loneliness or isolation—particularly after the loss of a partner—report increased alcohol use as a coping mechanism.

Chronic Pain Management

Chronic pain is prevalent among older adults, often leading to the prescription of opioids. While effective, these medications come with significant risks. According to the CDC (2023), nearly 50% of opioids prescribed are given to adults over 65. This emphasizes the urgent need to monitor prescriptions to curb potential dependency and overdose.

Social Isolation

Social isolation significantly contributes to the rising trends in substance use. Many older adults live alone, lacking robust social support systems. This isolation often leads to increased substance use as a way to cope with loneliness. Statistics show that about 1 in 4 older adults report feelings of isolation, which only heightens the risk for substance misuse.

The Impact of COVID-19

The COVID-19 pandemic has intensified the challenges older adults face, amplifying substance use issues. Social distancing and lockdown measures have led to greater feelings of isolation and anxiety. A study in the Journal of the American Geriatrics Society (2023) discovered that older adults increased their alcohol consumption during the pandemic. With some, the alcohol consumption extended beyond the lockdown and has persisted as long term substance issues.

The Rise of Cutting Agents and Synthetic Drugs

In recent decades, the trend of cutting drugs has escalated. Cocaine, once celebrated

for its purity in the 70s and 80s, is now frequently mixed with harmful substances such as fentanyl, levamisole, and other synthetic agents. This practice not only increases the risk of overdose but also complicates the user’s experience, as they are often unaware of the true composition of the drugs they consume. Additionally, the emergence of synthetic drugs has further transformed the drug culture. Substances like synthetic cannabinoids and opioids have flooded the market, often with unpredictable effects and higher risks of addiction. These drugs are frequently manufactured in clandestine labs, making them even more dangerous due to the lack of regulation and quality control.

...they may not anticipate the changes in potency and composition that have occurred over the decades.

Impact on Older Adults

The shift in drug culture poses significant risks, particularly for adults over 65. Many older individuals may have experimented with drugs in their youth, during a time when substances were more predictable in their effects. As they return to drug use, they may not anticipate the changes in potency and composition that have occurred over the decades. This generational gap in drug experience can lead to several issues:

• Increased Vulnerability: Older adults may not be aware of the prevalence of cutting agents and synthetic drugs, leading them to underestimate the risks associated with their use.

  
  

• Higher Addiction Rates: The combination of unfamiliar substances and altered effects can make it easier for older adults to become addicted, as they may seek the euphoric experiences they remember from their youth.

  
  

• Severe Health Consequences: The unexpected potency of modern drugs can result in more severe health complications, including overdose, which can be particularly dangerous for older individuals with pre-existing health conditions.

The Role of Healthcare Providers

Healthcare providers play a crucial role in combating substance use among older adults. However, many may not recognize the signs of substance misuse or may overlook it due to age-related biases. According to the National Institute on Drug Abuse (2023), comprehensive assessments and open communication are vital in identifying substance use issues. Building trust can empower healthcare providers to help older patients better manage their health and well-being.

More communication between pharmacies and doctors is crucial to prevent "doctor shopping", where a person goes to multiple providers and care facilities to gather pain medication. Because many offices do not share information unless explicitly given consent by the patient, there is a large gap in information that could help manage substance abuse. This is even more valid with the polypharmacy older adults already experience.

Final Thoughts

The rising trends in substance use and fentanyl-related deaths among adults over 65 demand urgent attention. A 9000% increase since 2017 is a rapid, dangerous path that shows an uptick in substance abuse, especially with hard drugs like fentanyl and stimulants (cocaine, methamphetamines, etc).

Providers and family members need to be aware of the signs and symptoms of drug abuse, which can be found here: Signs of Drug Abuse.

Adults who use these substances need to be aware that purchasing or acquiring unprescribed medication is extremely dangerous. Many of the once "pure" substances are being cut with additional cheaper drugs that heavily increase the likelihood of overdose. With increasing adulteration of substances and the rise of synthetic drugs, side effects are becoming more intense, and dangerous. Even without the risk of overdose, combining substances can cause severe mental and physical concerns including psychosis and seizures, even stroke.

If you or a loved one are struggling with addiction, some options are FindTreatment.gov or call the National Rehab Hotline at 866-210-1303.

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References

American Society of Anesthesiologists. "Fentanyl overdoses among seniors surge 9,000% — A hidden crisis few saw coming." ScienceDaily. ScienceDaily, 13 October 2025. <www.sciencedaily.com/releases/2025/10/251012054606.htm>.

Centers for Disease Control and Prevention. (2023). Opioid Overdose. Retrieved from CDC

Journal of the American Geriatrics Society. (2023). Alcohol Use Among Older Adults During the COVID-19 Pandemic. Retrieved from JAGS

National Institute on Aging. (2023). Substance Use and Older Adults. Retrieved from NIA

National Institute on Drug Abuse. (2023). Trends in Substance Use Among Older Adults. Retrieved from NIDA

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