Seniors Impacted by Dual Health Crises: COVID & Opioid Misuse

Elderly people are facing a confluence of health crises right now: COVID-19 and opioid misuse.

Seniors are already the most heavily impacted population for COVID-19 hospitalizations and death rates, and a concurrent acceleration of opioid misuse places additional stress on vulnerable seniors.

In 2018, Medicare recipients were given an average of 5 opioid prescriptions and more than 350,000 of them were dosed higher than the equivalent of 90 mg of morphine, which is the threshold recommendation by the Centers of Disease Control and Prevention (CDC) to avoid the risk of overdose.

Deaths from opioid and other drug overdoses jumped 38% in the 12 months ending in May 2020, according to recently released data from the CDC. All but one of the 38 U.S. jurisdictions that track synthetic opioid data reported higher overdose deaths over the past year from synthetic opioids such as fentanyl.

Opioid misuse and overdose deaths are straining the health care system at a time when COVID-19 has claimed nearly 500,000 lives in the United States — more than the number of fatalities among U.S. troops during World War II.

Of all the COVID-19 related deaths in the United States, more than 80% have been in people who are age 65 or older.

Although COVID-19 cases have been declining in recent weeks as more people get vaccinated and the early benefits of herd immunity emerge, many hospitals are still at or near capacity for treating patients with the worst symptoms.

Seniors who are taking opioid drugs may also experience conditions that make them more susceptible to COVID-19, such as respiratory depression, delirium and immunosuppression.

“The numbers are clear — COVID-19 has greatly exacerbated an already dire situation. No single entity is capable of resolving the opioid epidemic on its own. There needs to be a collaborative effort to fight the opioid crisis during and beyond the COVID-19 pandemic,” Scott Greenwell, PharmD, who is the president of Humana Pharmacy Solutions, wrote in an article in Pharmacy Times.

COVID related quarantines, shelter-in-place mandates and restricted in-person health care visits may be inadvertently exacerbating the risks to seniors who are taking opioids because there aren’t as many opportunities for health care providers and pain management providers to monitor patients face-to-face and spot potential problems, Greenwell wrote.

It’s critical that health insurers, prescribing physicians, other health care practitioners and patients communicate more seamlessly and also closely monitor data so they can make better informed decisions about therapeutic management of opioids in the era of COVID-19, he said. Broader distribution of overdose reversal drugs like naloxone is also important.

“The resolution of the opioid crisis is one of the top health care challenges of our time and should be made an even higher priority due to the increased devastation caused by the COVID-19 pandemic,” Greenwell wrote. “Although it may feel like individual actions aren’t making enough of an impact against an issue of this magnitude, all these efforts are synergistic.”

Hall Booth Smith’s (HBS) Opioid Task Force was created to defend physicians, surgeons, pain management specialists and other health care providers as well as physician groups, hospitals, surgical centers, urgent care clinics and other organizations on the full range of opioid and prescription-related claims they may face. For more information about HBS’s Opioid Task Force, please contact Partner J. Brent Allen.