Maine's elderly population increasingly affected by drugs amidst opioid crisis

In September, Megan Harrigan moved quickly through the Union Street Brick Church in Bangor, guiding clients to a makeshift clinic tucked in a back corner. Folding tables and metal chairs formed a temporary setup where each client, many of whom were homeless and battling opioid addiction, received care. Harrigan knew each person by name.

Between helping clients access medication-assisted treatment, treating wounds related to opioid use, checking on those she hadnt seen recently, and exchanging light-hearted moments with the street medicine team, Harrigan shared with a Maine Monitor reporter a trend she has observed: older adults increasingly using stronger illicit drugs.

Harrigan, a mental health and rehabilitation technician, has worked with people struggling with addiction for over two decades. Initially, her older patients primarily dealt with prescription opioids. However, stricter prescribing rules have pushed many to illicit substances, largely fentanyl. She now sees more older adults using these substancesa surprising development given that drug use typically declines after young adulthood.

While opioid use remains most common among younger populations, Maine Monitor analysis of Medicare claims data shows that the number of Maine patients aged 65 and older receiving buprenorphine increased nearly 70% between 2019 and 2023. This growth represents roughly 450 additional individuals across the state, a small but noticeable rise for healthcare providers. Some practitioners worry this may signal a developing trend.

Eventually theyre going to age, and our drugs are not stopping, Harrigan said, referencing her role with OPTIONS, a state program for overdose prevention.

Some Maine doctors and addiction specialists have noticed more older adults with opioid issues, suggesting the emergence of a hidden problem. However, organizations like MaineHealth Behavioral Health and Bangor Area Recovery Network report no significant change in their older patient numbers. Overall, total overdoses in the state are decreasing, with older adults accounting for a smaller share. Last year, Mainers 65 and older made up 23% of the population but only 12% of nonfatal overdoses.

State opioid response director Gordon Smith noted that while all age groups require attention, limited resources mean focusing on younger populations where the highest risks exist. Opioid use disorder often begins in adolescence, making preventive efforts in younger age groups critical.

Still, as Maines population ages, experts emphasize preparing for potential growth in older adults with opioid use disorders. Kaylie Smith, a licensed counselor at Northern Light Acadia Hospital, observed that her patients aged 65 and older, though a small fraction of her caseload, have doubled over ten years. She predicts this trend will continue.

Walt Bresnahan, 68, who developed an opioid addiction in his 30s, highlighted the challenge older adults face in seeking help due to stigma and pride. Pastor Leon Licata of Union Street Brick Church echoed this, noting a rise in older individuals using street drugs at his center, even if they initially deny it.

Clinical advisor Dr. Rachel Solotaroff described older patients with opioid use disorders as mostly women who smoke rather than inject drugs. Many began with prescriptions and transitioned to fentanyl. She called for interventions designed specifically for older adults, emphasizing population-focused strategies distinct from younger age groups.

While Maines initiatives have expanded access to buprenorphine and harm reduction services, gaps remain, particularly in nursing homes and assisted living facilities, which often lack resources to manage opioid addiction. Physician assistants and counselors report challenges in maintaining continuity of care when older adults require higher-level medical support.

Data shows a sharp rise in opioid treatment among Medicare recipients aged 65 and older, from 638 in 2019 to 1,087 in 2023a 70% increase. Despite this, treatment quality and accessibility remain concerns. Primary care doctors report difficulties addressing opioid dependence in older patients, who may have multiple health conditions or fear stigma. Distinguishing between physiological and pathological dependence is particularly complex.

Nationally, older adults are experiencing significant increases in opioid-related overdoses, especially involving fentanyl mixed with stimulants. Maine reflects this broader trend, prompting calls from doctors and public health experts to adapt treatment strategies and expand services tailored for aging populations.

Despite the small percentage of older Mainers affected, healthcare providers stress vigilance. Many overdoses among seniors involve fentanyl, highlighting the need for targeted interventions. While prescriptions for traditional opioids have declined, buprenorphine use has surged, underscoring a shift in treatment approaches. Experts urge a coordinated effort to ensure older adults have access to effective care and harm reduction resources.

Efforts to update nursing home policies for residents with addiction have faced resistance, with few facilities able to implement meaningful changes. Staff limitations, high turnover, and regulatory hurdles continue to impede progress. Nevertheless, providers emphasize the importance of integrating addiction care into all healthcare settings to stabilize patients and prevent relapse.

As Maine continues to age, experts stress the importance of preparing for the evolving landscape of opioid use, ensuring older adults are not overlooked in treatment and prevention strategies.

Author: Sophia Brooks