Administration for Community Living - Opioids and Older Adults

About the Administration for Community 

Living (ACL)

The mission of the ACL is to maximize the independence, 

well-being, and health of older adults, people with 

disabilities across the lifespan, and their families and 

caregivers.

ACL’s role in addressing the opioid crisis includes:

 Reaching people impacted by these conditions in the 

community (i.e., older adults, caregivers, 

grandparents raising grandchildren)

 Offering resources to professionals and volunteers 

touching the lives of older people and caregivers

 Aligning partnerships with CMS, SAMHSA, and other 

federal agencies to address this issue

"The Opioid Public Health Emergency and Older Adults" is 

an ACL-authored issue brief. It explains how the opioid 

crisis is affecting older adults and what stakeholders 

might be able to do to address it. 

Opioids & Older Adults - Data

 Older adults are among the groups affected by the 

opioid public health emergency because they often 

use prescription opioids to cope with painful chronic 

conditions, like arthritis, or procedures, such as 

surgery. 

Like anyone else, if older adults use prescription 

opioids for a long time, they risk developing an opioid 

use disorder (OUD) (Dowell et al., 2016).

 Opioids have a stronger impact on older adults 

because bodily processes slow as people age. Older 

adults also tend to be using multiple medications, 

which can interact with opioids and cause serious 

side effects. Complicating this situation is that older 

adults with a substance use disorder, such as an OUD, 

may have symptoms similar to those of depression, 

delirium or dementia (Maree et al., 2016).

 Prescription opioids are more readily available and 

more often used in older adults than in younger 

adults (Frenk, Porter, & Paulozzi, 2015). 

We saw an almost 9-fold increase in opioid 

prescriptions in office-based medical visits by older 

adults between 1995 and 2010 (Olfson, et al., 2013).

 Medicare beneficiaries (aged and disabled) have 

among the highest and fastest-growing rates of 

diagnosed OUD at more than 6 of every 1,000 

beneficiaries (CMS, 2017). 

 Other consequences of OUD may include elder abuse 

and grandparents raising grandchildren whose 

parents have OUD or died as a result of OUD (ACL, 

2018).

Local Resources

The Eldercare Locator (www.eldercare.gov or 

800.677.1116) is a nationwide service that connects older 

adults and their caregivers with trustworthy local support 

resources. 

Contact them on-line or via phone to find a local agency 

that can explain what resources may be available for 

older adults, including caregivers and grandparents 

raising grandchildren, in any location in the country.
Prevention & Evidence-Based Resources

There are evidence-based practices and programs 

designed to help older adults manage their physical and 

behavioral health. Practices include Screening, Brief 

Intervention, and Referral to Treatment (SBIRT), which is 

used to identify, reduce, and prevent problematic use, 

abuse, and dependence on alcohol and illicit drugs and

the Chronic Pain Self-Management Program, which 

provides information and teaches practical skills for 

managing the challenges of living with chronic pain – a

portion of this program explores strategies for 

management of medications, including opioids. 

Program availability varies. Contact the Eldercare 

Locator (800.677.1116) to find local programs that serve 

older adults, to get more information about communitybased resources, and for various tip sheets, such as Older 

Adults and Medication Safety.

Elder Abuse & Adult Protective Services

Resources

At the Elder Justice Coordinating Council meeting held 

June 5, 2018, U.S. Secretary of Health and Human 

Services, Alex Azar stated:

"We know that some older adults abuse opioids 

themselves and that many others also experience abuse, 

neglect, and exploitation by others as a result of opioid 

addiction. 

Across HHS, we're looking at approaches to help 

communities across our country that are suffering from 

addiction, including ways to support (Adult Protective 

Services) as they develop effective ways to prevent, detect 

and remediate the harm caused by opioid abuse."

Adult Protective Services (APS) programs are provided by 

state and local governments serving older adults and 

adults with disabilities who need assistance because of 

abuse, neglect, self-neglect, or financial exploitation 

(adult maltreatment). In all states, APS programs are

charged with receiving and responding to reports of adult 

maltreatment and working closely with clients and a wide 

variety of allied professionals to maximize client safety 

and independence.

Contact the National Center on Elder Abuse for a 

directory listing of state-by-state reporting contacts and 

other information.

Other Resources

 "Summary of ACL Stakeholder Discussion: Opioid 

Public Health Emergency" highlights themes from a 

discussion on opioids and the impact on older adults 

and people with disabilities, including areas where 

more information is needed and how Aging and 

Disability Networks may be involved with providing 

supports to address the opioid epidemic. 

 "Summary of Responses from a Request for 

Information (RFI): People with Disabilities and Opioid 

Use Disorder (OUD)" is issued by the National 

Institute on Disability, Independent Living, and 

Rehabilitation Research (NIDILRR) at ACL. The RFI 

yielded comments from 50 respondents, including 

consumers, community and national organizations, 

research teams, and federal partners resulting in a 

funding opportunity to conduct research on OUD

among people with disabilities.

 To subscribe to ACL email updates: 

https://public.govdelivery.com/accounts/USACL/subs

criber/new

For More Information, contact:

Shannon Skowronski, MPW, MSW

Administration for Community Living

U.S. Department of Health and Human Services

Email: shannon.skowronski@acl.hhs.gov

Web: https://www.acl.gov