Drug Deaths - Age 65+ in United States

United States

Drug overdose deaths among older adults have risen in the United States over the past two decades. In 2024, nearly 8,200 Americans age 65 and older died of a drug overdose.

Drug abuse can be hazardous for older adults because age-related changes in the liver reduce the ability to metabolize medications, and most older adults take one or more prescription medications. They may also take nonprescription medications and dietary herbal supplements, which can further complicate drug interactions and lead to drug-induced death. Other risk factors that can lead to substance misuse among older adults include forced or unexpected retirement, social isolation, transitions in living situations, substance use earlier in life, physical and mental health issues, and deaths of loved ones.

A 2017 report estimated that the opioid crisis cost the U.S. at least $1.02 trillion in 2017. Mortality accounted for approximately 53.9% of these costs.

According to America’s Health Rankings analysis, the prevalence of drug deaths is higher among:

• Older men, who have a prevalence nearly three times that of older women.
• Black older adults, who have a prevalence 14 times that of Asian older adults.

Identifying addiction in older adults can be challenging because of similarities between symptoms of drug addiction and diseases such as diabetes, depression, dementia and other mental health disorders. Although limited addiction treatment programs exist specifically for older adults, the Substance Abuse and Mental Health Services Administration has a resource for locating treatment facilities that can be filtered for population-specific programs.

Strategies to prevent overdose deaths and reduce harm among older adults with opioid addiction include:

• Pain management techniques without the use of medication. Individuals can work with their doctors to safely and effectively manage their pain and avoid the risk of opioid abuse.
• State-based prescription drug monitoring programs. These programs track prescription and dispensation of controlled substances and help reduce opioid addiction.
• Abuse-deterrent formulations (ADFs). These are promising medications that have been shown to reduce prescription drug abuse and its many consequences.
• Regular reviews of medication lists by health care providers, also referred to as medication reconciliation, to avoid adverse drug events.

The Centers for Disease Control and Prevention has updated their Guideline for Prescribing Opioids for Chronic Pain and created a prescription checklist to encourage safe prescribing practices by providers.

Reducing drug overdose deaths is a Healthy People 2030 leading health indicator.

Dowell, Deborah, Kathleen R. Ragan, Christopher M. Jones, Grant T. Baldwin, and Roger Chou. “CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022.” MMWR. Recommendations and Reports 71, no. 3 (November 4, 2022): 1–95. https://doi.org/10.15585/mmwr.rr7103a1.

Florence, Curtis, Feijun Luo, and Ketra Rice. “The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017.” Drug and Alcohol Dependence 218 (January 2021): 108350. https://doi.org/10.1016/j.drugalcdep.2020.108350.

Garnett, Matthew, and Arialdi Miniño. Drug Overdose Deaths in the United States, 2023–2024. National Center for Health Statistics (U.S.), January 29, 2026. https://doi.org/10.15620/cdc/174639.

Kramarow, Ellen, and Betzaida Tejada-Vera. Drug Overdose Deaths Among Adults Aged 65 and Over: United States, 2000-2020. NCHS Data Brief No. 455. Hyattsville, MD: National Center for Health Statistics, November 30, 2022. https://doi.org/10.15620/cdc:121828.

Mallet, Louise, Anne Spinewine, and Allen Huang. “The Challenge of Managing Drug Interactions in Elderly People.” The Lancet 370, no. 9582 (July 2007): 185–91. https://doi.org/10.1016/S0140-6736(07)61092-7.

Marek, Karen Dorman, and Lisa Antle. “Medication Management of the Community-Dwelling Older Adult.” In Patient Safety and Quality: An Evidence-Based Handbook for Nurses, edited by Ronda G. Hughes. Rockville, MD: Agency for Healthcare Research and Quality, 2008. https://www.ncbi.nlm.nih.gov/books/NBK2670/.

Qato, Dima M., G. Caleb Alexander, Rena M. Conti, Michael Johnson, Phil Schumm, and Stacy Tessler Lindau. “Use of Prescription and Over-the-Counter Medications and Dietary Supplements Among Older Adults in the United States.” JAMA 300, no. 24 (December 24, 2008): 2867–78. https://doi.org/10.1001/jama.2008.892.

Skelly, Andrea C., Roger Chou, Joseph R. Dettori, Judith A. Turner, Janna L. Friedly, Sean D. Rundell, Rongwei Fu, et al. Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review. Comparative Effectiveness Review No. 209. Rockville, MD: Agency for Healthcare Research and Quality, June 11, 2018.https://www.ncbi.nlm.nih.gov/books/NBK519953/.