Treatment of Opioid Use Disorder in the Elderly

Abstract

With the increasing age of those born between 1946 and 1965, issues relating to the “baby boomer” generation are more relevant than ever. This review aims to both highlight the importance of screening for substance use disorders in the elderly (specifically in this case, opioid use disorder) and then summarize the available treatment options for this vulnerable population. A narrative review of the literature showed surprisingly little research on the treatment of substance use disorders, especially opioid use disorder, in the elderly. None of the three medications that are FDA approved for opioid use disorder in adults (methadone, buprenorphine, and naltrexone) is contraindicated in the elderly. All medications should be used cautiously, keeping in mind that the elderly often have more medical issues (which can include chronic pain) as well as are on multiple medications that can lead to medication interactions. Because there is very limited data on treatment of opioid use disorder in later life, current treatment generally follows recommendations for the general/mixed age population. More research into the topic is needed, especially with a larger percentage of the “baby boomer” generation entering the 65+ age range.