Deadly Mix of Drugs Causes Staggering Rise in Overdose Deaths Among Seniors

America’s seniors are not immune to the current opioid epidemic.

Among adults 65 and older, deaths from overdoses of fentanyl mixed with stimulants (such as cocaine and methamphetamines) have increased 9,000% in the past eight years, matching the rates among younger adults.

That’s according to research from the American Society of Anesthesiologists, which was presented at the ANESTHESIOLOGY 2025 annual meeting this week in San Antonio.

A DEADLY DRUG STRONGER THAN FENTANYL IS SPREADING RAPIDLY IN AMERICA, EXPERTS WARN

Using data from the CDC, researchers analyzed 404,964 death certificates that listed fentanyl as a cause of death between 1999 and 2023.

Older adults accounted for 17,040 of the individuals, while younger adults, ages 25 to 64, accounted for 387,924.

Fentanyl-related deaths increased from 264 to 4,144 in older adults between 2015 and 2023, a 1,470% increase. Younger adults saw a 660% increase.

Among people aged 65 and older, deaths from fentanyl stimulants increased from 8.7% in 2015 to 49.9% in 2023, an increase of 9,000%.

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In younger adults, these deaths increased from 21.3% in 2015 to 59.3% in 2023, an increase of 2,115%.

The year 2015 marked the start of the fourth wave of the opioid crisis, when fentanyl stimulants began driving the rise in overdose deaths, data show.

Deaths of older adults began to increase sharply in 2020, the researchers highlighted. Among stimulants combined with fentanyl, cocaine and methamphetamines were the most common, surpassing alcohol, heroin, and benzodiazepines.

“There is no quality control. Today, many medications contain fentanyl.”

Older people are especially susceptible to these overdoses, as many live with chronic illnesses, take multiple medications and process drugs “more slowly due to age,” the researchers said.

It’s a common misconception that opioid overdoses primarily affect younger people, according to Gab Pasia, lead author of the study and a medical student at the University of Nevada, Reno School of Medicine.

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“Our analysis shows that older adults are also affected by fentanyl-related deaths, and that stimulant involvement has become much more common in this group,” he said in a statement. “This suggests that older adults are affected by the current fourth wave of the opioid crisis, following similar patterns seen in younger populations.”

The researchers could not determine the underlying reasons for these overdoses, since the analysis was a cross-sectional study of patterns over time, Pasia said.

“However, the findings underscore that fentanyl overdoses in older adults are often multi-substance deaths (not due to fentanyl alone) and the importance of sharing drug abuse prevention strategies with older patients,” he said.

Reduce risk

The study authors advised anesthesiologists and other pain medication specialists to recognize that polysubstance use can occur in all age groups and to use caution when prescribing opioids to adults over 65 years of age.

Study co-author Richard Wang, MD, an anesthesiology resident at Rush University Medical Center in Chicago, added that older adults prescribed opioids, or their caregivers, should be informed about overdose prevention strategies, such as having naloxone available and knowing the signs of an overdose.

Risk can also be reduced by simplifying medication routines and using clear labels and safe storage instructions.

“With these trends in mind, it is more important than ever to minimize opioid use in this vulnerable group and use other pain management methods when appropriate,” Wang said in the news release. “Proper patient education and regular review of medication lists could help flatten this terrible trend.”

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Dr. Larissa K. Laskowski, an emergency physician and medical toxicologist at NYU Langone Health, told News Digital that the findings of this study are “not surprising,” as illicitly manufactured fentanyl is “one of the deadliest substances known to man.”

“In recent years, it has proliferated throughout the illegal drug market,” said Laskowski, who was not involved in the study. “Fentanyl is commonly found in cocaine and methamphetamine supplies.”

Laskowski, a fentanyl risk educator in schools, emphasized that everyone, not just older people, should be aware of the drug’s potential harms.

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“Just a small amount (the equivalent of a few grains of salt) can stop breathing and cause death from overdose,” he warned. “Any substance sold illegally (not in a dispensary, pharmacy or licensed retail store) could contain anything.”

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“There is no quality control. Today, many medications contain fentanyl.”

The expert reiterated that doctors should talk to patients and caregivers about reversal agents, such as over-the-counter Narcan, which is often available for free in health departments, clinics and hospitals.