title: Trends in abuse and misuse of prescription opioids among older adults.
abstract: BACKGROUND
  Dramatic increases in the prescriptive use of opioid analgesics during the past two decades have been paralleled by alarming increases in rates of the abuse and intentional misuse of these drugs. We examined recent trends in the abuse and misuse and associated fatal outcomes among older adults (60+ years) and compared these to trends among younger adults (20-59 years).
  
  
  METHODS
  Trend analysis using linear regression models was used to analyze 184,136 cases and 1149 deaths associated with abuse and misuse of the prescription opioids oxycodone, fentanyl, hydrocodone, morphine, oxymorphone, hydromorphone, methadone, buprenorphine, tramadol, and tapentadol that were reported to participating U.S. Poison Centers of the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS(®)) System between 2006-Q1 and 2013-Q4.
  
  
  RESULTS
  Rates of abuse and misuse of prescription opioids were lower for older adults than for younger adults; however, mortality rates among the older ages followed an increasing linear trend (P < 0.0001) and surpassed rates for younger adults in 2012 and 2013. In contrast, mortality rates among younger adults rose and fell during the period, with recent rates trending downward (P = 0.0003 for quadratic trend). Sub-analysis revealed an increasing linear trend among older adults specifically for suicidal intent (P < 0.0001), whereas these rates increased and then decreased among younger adults (P < 0.0001 for quadratic trend).
  
  
  CONCLUSIONS
  Recent linear increases in rates of death and use of prescription opioids with suicidal intent among older adults have important implications as the U.S. undergoes a rapid expansion of its elderly population.
authors: Research Department, Rocky Mountain Poison and Drug Center, 990 Bannock Street, M/C 0180, Denver Health and Hospital Authority, Denver, CO 80204, USA. Electronic address: nancy.west@rmpdc.org.
authors: Nancy A
authors: NA
authors: West
authors: Research Department, Rocky Mountain Poison and Drug Center, 990 Bannock Street, M/C 0180, Denver Health and Hospital Authority, Denver, CO 80204, USA.
authors: Stevan G
authors: SG
authors: Severtson
authors: Research Department, Rocky Mountain Poison and Drug Center, 990 Bannock Street, M/C 0180, Denver Health and Hospital Authority, Denver, CO 80204, USA.
authors: Jody L
authors: JL
authors: Green
authors: Research Department, Rocky Mountain Poison and Drug Center, 990 Bannock Street, M/C 0180, Denver Health and Hospital Authority, Denver, CO 80204, USA; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA.
authors: Richard C
authors: RC
authors: Dart
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000701:Analgesics, Opioid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D063487:Prescription Drug Misuse / Q000639:trends*; D013406:Suicide, Attempted / Q000523:psychology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Abuse; Aging; Prescription opioid; Suicide; Surveillance