The Impact of the Opioid Epidemic on the Aging Services Network and the Older Adults They Serve

To gain insight into how the opioid epidemic is affecting the aging services network and the older adults they serve, NCOA surveyed its aging services network of grantees and partners. The survey was intended to understand how older adults and their caregivers are affected by the opioid epidemic and identify new resources and tools needed for organizations to better serve their communities. This short online survey was administered in early 2019. Respondents represented a diverse group of organizations and agencies across the country. More than 200 CBOs responded from 40 states and Puerto Rico.

Primary survey results include:

• Organizations report spending more time addressing opioid-related problems in the last two years. Seven in 10 CBOs report an increased effort spent in addressing issues related to the opioid epidemic affecting their older adult clients or their caregivers, compared to two years ago. One in five organizations has increased their efforts by more than 25% due to the negative impact of opioid-related issues on their older adult clients or their caregivers.
• Opioid volume and lack of awareness and information fuel the opioid epidemic. Respondents identified the sheer volume of opioids available, lack of information about the potential for misuse or addiction, lack of awareness of alternative treatment options for chronic pain, poverty, and mental health challenges as fueling the opioid epidemic in their communities.
• Opioid addiction is a common reason why older adults must take on caregiving for their grandchildren or other young relatives. More than half of survey respondents indicate that up to 10% of their older adult clients are the primary caregivers for their grandchildren, many as a result of opioid addiction of their clients’ adult children or other family members.
• Health concerns related to the opioid crisis are common. Health concerns include lack of understanding and access to alternatives to reducing pain without opioid medications, challenges obtaining needed prescriptions or refills for opioid pain medication because of increased scrutiny and/or changing prescribing patterns, and difficulty managing the side effects of opioid pain medication with other medications.
• Older adult clients face financial concerns related to the opioid crisis. Common financial issues included increased reliance on federal benefits, theft of cash or other goods to sell in order to buy pain medication or other illicit drugs, using savings to pay for drug rehabilitation for themselves or adult children, and increased costs of obtaining opioid pain due to lack of access locally.
• Most organizations in the aging network do not routinely screen for opioid use issues. Despite the widespread problem of opioid misuse in the communities served by the organizations that responded to the survey, only 28% of survey respondents routinely screen for substance misuse and abuse using a variety of tools and approaches.
• Organizations serving older adults need more opioid-related resources. Respondents reported that resources most needed are best practices (case studies, tip sheets, issue briefs), referral sheets of local and national resources, webinars, online training modules, marketing materials, and substance use screening or assessment tools.

This 2019 NCOA issue brief provides a number of recommendations related to the survey findings:

• Improved health literacy among older adults toward the safe and appropriate use of opioids for chronic pain.
• Increased awareness, education, and access to non-drug approaches for managing chronic pain, including expanded insurance coverage for alternative therapies.
• Greater opportunities for the aging network to obtain reliable and easy-to-access training, validated screening tools, and other resources to adequately address the direct and indirect consequences of the opioid epidemic on older adults.
• State and local efforts focused on the opioid epidemic that take into account the needs of older adults and involve the aging network as key partners.
• Increased education about and access to assistance for public benefits and legal options that can help support and alleviate the added financial and other stresses of supporting family members in rehabilitation or new expenses of caring for grandchildren and other young relatives.