Substance Use Disorders (SUD) are increasing among older adults in the US. Compared to younger groups, older adults have an increased risk of overdose, falls, drug interactions, cognitive and psychomotor impairment, as well as an increased risk of mortality. Medication-Assisted Treatment (MAT) is an effective treatment for Opioid Use Disorders (OUD), but it is especially underused among older adults with an estimated 7.9-9.8% of older adults used MAT as part of their treatment.
It can be challenging treating older populations for OUD, as there can be physical limitations, comorbidities, and negative interactions with other medications. Methadone maintenance treatment requires counseling sessions, toxicology screens, and same-day screening which can be challenging for older adults with physical limitations and transportation issues. Methadone, in particular, may interact with other drugs that are common for older adults. Insurance coverage of MAT services is also a significant barrier for older adults, as Medicare does not cover methadone use for OUD. Primary care providers, and other physicians that treat older adults, should be trained on how to screen for OUD and refer them to treatment.
Joshi, P., Shah, N. K., & Kirane, H. D. (April 01, 2019). Medication-Assisted Treatment for Opioid Use Disorder in Older Adults: An Emerging Role for the Geriatric Psychiatrist. The American Journal of Geriatric Psychiatry, 27, 4, 455-457.