Abstract
Background and Objectives
In Maryland, fatalities due to opioid overdoses are highest among adults aged 55 and over a. This retrospective chart review evaluated 49 adults in outpatient opioid treatment in Baltimore as a function of age. Analyses: Intake characteristics and treatment outcomes were compared between 24 older (ages 55-70) and 25 younger (ages 23-35) adults using ANOVA and χ2 statistics (alpha=0.05).
Results
The cohort was 54% male, and most patients were prescribed methadone (84%). Older adults were more likely to be Black/African American (68% vs. 24%) and had longer histories of opioid (30 vs. 9 years) and tobacco use (45 vs. 14 years) (ps < 0.05). At intake, equal proportions of older and younger adults tested positive for cocaine (49%), fentanyl (61%), and benzodiazepines (27%); cannabis use was less common for older adults (17% vs. 56%; χ2 =8.15). While engaged in treatment, older adults were less likely to test positive for cocaine (26% vs. 77%) and cannabis (16% vs. 60%) (ps < 0.05), with no differences in fentanyl (66%) or benzodiazepine use (29%). Older adults remained in treatment longer (186 vs. 105 days, F=6.7) and had higher retention rates (21% vs. 0%) (χ2 =5.8).
Conclusion
Older adults showed less polysubstance use and longer retention in care. However, continued fentanyl and benzodiazepine use could put older adults at greater risk of overdose due to age-related vulnerabilities and prolonged substance use. These differences highlight the unique clinical characteristics of older adults at risk of overdose, which can inform age-friendly addiction treatment approaches.