Fentanyl Abuse Among Elderly Citizens

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

Elderly citizens are often prescribed pain relievers like opioids to help manage chronic pain in older age. Fentanyl is one of the most common of these prescribed. Due to its effects on the brain, it is highly addictive and may be misused by those with or without a prescription. This includes the patch form of fentanyl, most often sold under the brand name, Duragesic.

People of older age may deal with a number of issues that can make them vulnerable to substance abuse. It is never too late to develop an addiction, yet elderly citizens with a substance problem often go undiagnosed.

Elderly citizens who do develop a problem with fentanyl abuse may need to seek inpatient treatment to overcome their drug abuse. Depending on the needs of the patient, treatment may be personalized to treat all co-occurring mental and medical conditions.

What Is Fentanyl?

Fentanyl is a synthetic opioid (narcotic) that can provide effective pain relief. When prescribed, fentanyl may be come in the form of a patch, lozenge, or lollipop. It may also be injected as a shot.

Fentanyl is a powerful drug known to be 50 to 100 times more potent than the natural opiate, morphine. This can make it effective for treating severe pain following surgery, or to relieve chronic pain.

Common uses among elderly adults include:

• chronic back pain
• arthritis
• fibromyalgia
• headaches or migraines

Fentanyl’s high potency makes it capable of providing effective pain relief. This can also be dangerous. Fentanyl has a high risk for misuse, often for its euphoric effects. Taking fentanyl in larger or more frequent doses than directed can lead to dependence and increases risk for overdose.

Although fentanyl is a common narcotic that may be prescribed by the doctor, it is also sold illegally on the street.

The patch form of fentanyl (Duragesic) is commonly prescribed to treat chronic pain in elderly adults. These patches can provide around-the-clock pain relief for people who may not respond well to other medications.

While effective for acute purposes, long-term use of fentanyl poses a greater risk for addiction.

Effects Of Fentanyl In Senior Citizens

Like other opioids, fentanyl works by binding to opioid receptors in the brain that control pain levels and emotion. Fentanyl patches come in varying dosage strengths and are usually changed every 72 hours.

Fentanyl can have powerful effects on the brain even in small doses. This includes a feeling of extreme happiness referred to by some as a fentanyl ‘high’.

It may also cause some uncomfortable symptoms, including nausea, drowsiness, and constipation.

Additional fentanyl patch side effects in elderly may include:

• headache
• confusion
• difficulty breathing
• insomnia
• depression
• dry mouth
• stomach or back pain
• feeling cold
• skin irritation
• itching
• difficulty urinating
• burning, tingling, or numbness of the hands or feet

When using a fentanyl patch, it is also important to apply it as directed. Touching the sticky side of a Duragesic patch can cause immediate absorption of fentanyl into the bloodstream. This can be dangerous for people with a low tolerance for narcotics.

Risks For Elderly Citizens

While fentanyl abuse among any age group is dangerous, senior citizens may face additional risks. Fentanyl abuse may result in severe health consequences and can be life-threatening.

Under-diagnosis Among Elderly

According to experts, opioid addiction among the elderly may often go undetected. While many signs of fentanyl addiction in seniors can be the same as those in younger people, health conditions that arise in old age can sometimes complicate diagnosis. This is in part because conditions like dementia and depression have symptoms that overlap with substance use disorders.

Thus, doctors may be less likely to connect the dots between symptoms of drug addiction and the fentanyl they are prescribing. This can put some older patients who aren’t aware of the severity of their drug misuse at risk for serious health problems.

Dangers To Health

The dangers of fentanyl misuse may be elevated among the elderly, whose bodies are more fragile. They may be more susceptible to complications of fentanyl abuse, which can include:

• difficulty breathing
• hypoxia (too little oxygen reaching the brain)
• brain damage
• coma

Overdose

Ingesting too much fentanyl in any of its forms may lead to overdose. This can lead to slowed or stopped breathing, and can be fatal.

According to recent statistics, fentanyl and other synthetic opioids are the most common drugs involved in drug overdose deaths in the United States. The number of fatal fentanyl overdoses has been on the rise and is not exclusive to those who acquire it illegally.

In fact, many opioid overdose deaths in older populations are among those who have received a legitimate prescription.

While doctors may be hesitant to prescribe powerful opioids to younger patients, they tend to be more likely to prescribe to elderly patients with age-related health conditions. This can make it easier for the elderly to access potent opioid medications.

Elderly people have decreased sensitivity in general to the powerful effects of opioids and metabolize them slower. This may cause the drug to build up in an older person’s system faster, and have more harmful effects in smaller doses. This includes an increased risk for overdosing.

Symptoms of fentanyl overdose:

• small, pinpoint pupils
• extreme sleepiness
• slowed or stopped breathing
• dizziness
• decreased coordination
• trouble speaking
• confusion and memory troubles
• loss of consciousness or coma

Fentanyl Abuse And Addiction Among Elderly Citizen

Elderly patients who experience a great deal of pain may be more likely to take more of the drug than prescribed, or more often than directed. Some signs of fentanyl abuse can also depend on the form in which it’s prescribed.

Fentanyl patches, for instance, can be abused in several different ways:

• applying multiple patches at once
• chewing the patches instead of applying to the skin
• boiling them in water to drink as a liquid
• heating the gel inside the patch and smoking its vapors

Causes of Addiction in Senior Citizens

Drug addiction is a complex problem that can have emotional, biological, and environmental roots. Certain events or traumatic experiences may also lead someone to abuse fentanyl as a way to ease or numb emotional pain.

There are several events and situations that occur in older age that can have a serious emotional toll. If elderly citizens lack support or any additional means of coping, they may be more likely to turn to substances to manage physical or emotional pain.

Common triggers among the elderly:

• retirement
• death of a friend, spouse, or family member
• insomnia
• age-related health conditions
• depression

Drug abuse and addiction can be isolating and may increase feelings of depression or loneliness in the elderly. Recovery from fentanyl addiction is possible in people of all ages, including those who may have co-occurring mental or medical conditions. An effective way for the elderly to overcome fentanyl addiction is to seek treatment.

Treatment For Fentanyl Abuse Among Elderly

Despite age-related needs some elderly patients may have, older individuals may often benefit from the same drug rehab programs available to younger adults.

People addicted to fentanyl first need medical detox to help them safely withdraw from the substance. Fentanyl withdrawal can trigger several physical and psychological symptoms that may be best monitored under medical supervision. These symptoms can appear within hours after someone’s last dose, and may be difficult or even dangerous to undergo alone.

Doctors may also recommend inpatient treatment within a rehab facility or hospital. Inpatient programs for opioid addiction typically offer several treatments that can be effective for overcoming substance abuse.

Inpatient programs may include:

• cognitive behavioral therapy (CBT)
• contingency management
• motivational interviewing
• dual-diagnosis (for co-occurring mental disorders)
• medication-assisted treatment (MAT)

People struggling with fentanyl addiction later in life are not alone and do not have to suffer in silence.

If you believe you or a family member is struggling with fentanyl abuse or addiction, contact one of our treatment specialists today to learn more.