By Kathy Ritchie and John Skelton
The number of drug and alcohol deaths among people 65 and older is on the rise. It’s a concerning trend, but substance abuse treatment centers are mostly out of reach for older adults on Medicare.
Throughout the pandemic, KJZZ News reported on the increased use of alcohol and drugs among people 65 and older. Now, the Centers for Disease Control and Prevention issued a report saying that deaths resulting from these substances are on the rise.
More than 5,000 older adults nationwide died from a drug overdose in 2020. And more than twice as many died from alcohol-related causes, according to the CDC.
"This was not surprising to me at all," said Paige LeForte, she’s with Spectrum Healthcare, which provides behavioral healthcare across Yavapai and Maricopa counties.
"I think we're finally in a place where we're really getting to dive deep into the data that was 2020 and getting to see the impact that the pandemic really had," she said.
Something else in the CDC report: The death rate from synthetic opioids like fentanyl is on the rise.
"What we have noticed over the last several years is with the constraint that pain management clinics are being put under by different guidelines that they have to follow individuals in the older community that suffer from chronic pain conditions or being dismissed from their pain management program."
And it's creating a pipeline of older adults looking for substances that will help with pain.
"When you prevent an individual from accessing pain management through a licensed provider and a health clinic, they're going to seek that pain relief elsewhere. And most often we see that with alcohol, but now we're starting to see that happened through fentanyl, which is readily available in our communities."
In rural communities, like the ones LeForte serves, it's even more challenging.
"The most common social determinant of health for an older individual is social isolation and unmanaged chronic health conditions. And those are almost all always the contributing factors to their substance abuse or any type of crisis that they're experiencing," LeForte said. "And given that we are in a rural area, it is significantly harder for us to change their social isolation because their doctor could be two and a half hours away, and they have no car and no family to get them there."
Dr. Tiffany Panko is the vice president chief of caregiver wellness and patient experience and a physician with HonorHealth in Phoenix. She’s also seeing more and more older adults struggling with substance abuse disorder.
"So this is very concerning," she said. "If this is the trend that continues that we may be seeing more and more problems in the future, if this is not something that we're routinely screening for and offering assistance to patients that have drug or alcohol misuse."
Panko echoed what LeForte said about the increased use of opioids among this population.
"As folks get older, they do have more pain, things like arthritis, some back pain, other chronic conditions that can cause pain, neuropathy, those kinds of things can really create a burden on our elderly patients," said Panko. "Some of the other medications either are not helpful for them, things like anti inflammatories. Or they may have other reasons they can't take them. So, opioids sometimes are used to treat this pain. And then there is that addictive potential that can impact our older patients just as much as it can our younger patients."
Paige LeForte is a clinical director with Spectrum Healthcare, which provides behavioral health care across Yavapai and Maricopa counties. LeForte says alcohol is a common substance used by older adults; so are synthetic opioids like fentanyl.
Yet, despite the uptick substance abuse disorder, treatment remains mostly out of reach.
"Prescott Arizona is one of the most popular rehab cities in America. And not a single one of those facilities accepts Medicare as an insurance and Medicare will not credential them to provide care," LeForte said.
And unless this changes, LeForte says we’ll continue to see a disparity in terms of who can access treatment.
"On a crisis call, I had an individual with Medicare primary who called 180 treatment facilities in Arizona and all 180 treatment facilities did not accept Medicare," LeForte said.