Increasing Rates of Opioid Misuse Among Older Adults Visiting Emergency Departments

Objective: This study sought to investigate factors associated with opioid misuse-related emergency department (ED) visits among older adults and changes in outcomes associated with these visits, using multiple years of nationally representative data. Methods: A retrospective analysis of the Nationwide Emergency Department Sample was conducted. Study inclusion was limited to adults aged 65 years and older. Diagnostic codes were used to identify opioid misuse disorder; sampling weights were used to adjust standard estimates of the errors. Descriptive and multivariate procedures were used to describe risk and visit outcomes. Results: ED visits by older adults with opioid misuse identified in the ED increased sharply from 2006 to 2014, representing a nearly 220% increase over the study period. Opioid misuse was associated with an increased number of chronic conditions, greater injury risk, and higher rates of alcohol dependence and mental health diagnoses. Conclusion: The steep increase in opioid misuse observed among older adult ED visits underscores the critical need for additional research to better understand the national scope and impact of opioid misuse on older adults, as well as to better inform policy responses to meet the needs of this particular age group. Translational Significance: Findings demonstrate the breadth and scope of opioid misuse and dependence among older adults visiting emergency departments and indicate that targeted programs aimed at screening, intervention, and treatment specifically geared toward older adults are warranted. Results from this study also highlight the complexity of treating opioid dependence in this population, which reflect in part, high rates of coexisting mental health and other substance abuse disorders. When considered together, these findings underscore the pressing need for policy changes to increase access to long-term substance misuse treatment and support needs.