You’re Not Alone: Older Adults Are Facing a Hidden Opioid Crisis—and There’s Specialized Help

You’re reading this because you care—maybe for yourself, or a parent, or a friend. You worry about pain, prescriptions, aging, and the fine line between comfort and risk. That feeling matters. You’re not alone—and this story is for you.

Hospitals recorded a 34% increase in inpatient stays related to opioids among people 65 and older between 2010 and 2015, with emergency department visits up 74% in the same group. Overdose deaths in this age group increased about 10% from 2021 to 2022, and another 11.4% from 2022 to 2023.

These numbers show a quiet but growing crisis. You deserve clarity.

Why Seniors Face Unique Risks

You may be prescribed painkillers for surgery, arthritis, or cancer. They ease pain—but aging slows your body’s ability to process medications. Your liver and kidneys don’t work like they used to. That means even steady doses can build up, increasing risk.

Polypharmacy—taking many medications—is common and raises the chance of dangerous interactions. The 2023 Beers Criteria, which lists drugs to avoid in older adults, flags combinations like opioids with benzodiazepines or gabapentinoids as high risk for sedation, falls, and respiratory problems.

When Prescriptions Become the Problem

It’s less common now for older adults to “doctor shop”—most states require Prescription Drug Monitoring Program (PDMP) checks. Still, older patients often see multiple providers, and overlaps do happen. Asking for medical records and coordinating between specialists can help.

Signs pop up slowly: confusion, changes in routine, speech, or mood shifts. You or a loved one might chalk it up to aging. But it could be opioid misuse or withdrawal. Isolation makes recognition harder. Don’t ignore what feels “off.”

Care Must Match Seniors’ Needs

Breaking free from opioid dependence is harder when you're managing heart, kidney, or lung conditions. You need treatment that understands older bodies.

Medication-assisted treatment (MAT)—using buprenorphine or methadone—works for older adults. You should:

• Start low, go slow on dosing
• Monitor for interactions and heart rhythm risk, especially with methadone
• Prevent falls vigorously—risk is highest in the first month

Withdrawal requires more attention. Older adults can face delirium, dehydration, electrolyte issues, even heart complications. Slower tapers and close supervision are crucial.

Covering Treatment: What You Need to Know

If you’re on Medicare Part B, OTP (Opioid Treatment Program) services—including methadone, buprenorphine, naltrexone, and nalmefene—are covered when delivered by certified programs. But most non-hospital residential treatment (ASAM Level 3) is still not covered. Always check benefits carefully before committing.

Aftercare That Lasts

Recovery shouldn’t end when treatment ends. Many long-term care and assisted-living facilities aren’t equipped to continue MAT or understand opioid use disorder.

The availability of Medication-Assisted Treatment (MAT) in nursing homes and assisted living facilities is highly variable and depends on specific facility capabilities, policies, and state regulations. While many Skilled Nursing Facilities (SNFs) can and do provide MAT, assisted living facilities generally do not offer the same level of medical services since they are not medical providers and as such, they typically do not offer MAT on-site.

Medicare Part A provides temporary coverage for skilled nursing care, including up to 100 days in a skilled nursing facility after a qualifying hospital stay. During this period, the facility may offer access to medication-assisted treatment under Medicare. To administer MAT, the facility must be equipped to store controlled substances and employ practitioners with the required Drug Enforcement Administration registration.

After 100 days, unless you have Long-Term Care Insurance, or qualify for Medicaid because of limited financial resources, the cost of the extended care will be yoru responsibility.

If you have a Medicare Part D or Medicare Advantage (Part C) plan that includes prescription drug coverage, it will likely cover the cost of approved MAT prescription drugs.

When looking for an extended care facility to help with ongoing care, use the LTC News Caregiver Directory and search based on your zip code.

When you start calling facilities be sure to ask the right questions.

Ask: “Will you help continue my buprenorphine or methadone regimen?” and “Can you coordinate with outpatient providers?”

Warm handoffs to community programs or office-based providers are vital.

There are also treatment centers that are available. Treatment centers that specialize in serving older adults are making crucial contributions to addressing this hidden aspect of the opioid epidemic.

By providing age-appropriate, medically sophisticated care that addresses the complex needs of seniors, these facilities are helping to turn the tide on a crisis that has too often been overlooked.

There are several well-known treatment centers throughout the United States, like Seasons in Malibu, that recognize that older adults deserve specialized treatment that honors their life experience while providing the medical expertise necessary to achieve lasting recovery from opioid addiction.

Managing Pain Without New Addiction

You still deserve relief—without rekindling risk. The CDC advises that non-opioid methods should lead the way. Think:

• Physical therapy
• Non-opioid medications
• Mindfulness, acupuncture, gentle movement
• Inclusive pain plans work better long term for you.

Learn more: Rethinking Pain: Safer, Smarter Care Keeps You Moving - Even as You Age

Tech That Helps, Not Frustrates

You may worry about using apps or telehealth—but help is available. Simplified platforms can connect you to MAT prescribers from home. And federal rules still let you start buprenorphine via telehealth through Dec. 31, 2025. Just ask for training or have a caregiver assist.

Experts say that many older adults resent the idea of addiction— they think it’s a moral failure. Loved ones need to show them addiction is a medical condition. With tailored care, recovery is possible at any age.

What You Can Do—Right Now

• Review all medications with your doctor, including OTCs.
• Ask for PDMP checks when new prescriptions are written.
• Discuss fall-prevention and naloxone.
• Inquire whether your LTC facility or care provider continues MAT.
• Explore non-opioid pain control first.

Final Thought

You’re navigating tough decisions. It’s okay to feel uncertain. But you don’t walk this path alone. If an opioid problem is hiding behind pain, memory lapses, or mood shifts—help is out there. Geriatric-informed treatment matches your health, your life, and your recovery. You’ve earned that care.