Opioid and Methamphetamine Use Among Older Adults

As the baby boomer generation ages, substance use among these older adults is increasingly common, though it’s often overlooked and understudied. In recent years, Sacramento County has witnessed an alarming but often invisible crisis: the growing misuse of opioids and methamphetamine among adults 60+ years of age. As our population ages – the  California Department of Aging projects a 187% increase in people 60+ living in Sacramento County by 2060 – addressing substance use within this demographic becomes increasingly critical. It’s a challenge that demands compassion, community awareness, targeted resources, and supportive, stigma-free environments.

A Closer Look

In Sacramento County, the misuse of opioids and methamphetamine among those aged 65+ has quietly risen with increases in overdose deaths and a troubling upward trend in hospitalizations and treatment cases involving older adults. Opioids, commonly prescribed for chronic pain, arthritis, or following surgeries, can quickly become problematic due to heightened sensitivity to medications in older adults. Increased drowsiness, cognitive impairment, and a higher rate of falls and fractures are some of the problems connected to opioid use for older folks. Fentanyl, an illicit opioid, contributed to 14% of overall overdose deaths for those ages 60-74 in 2024, according to the Sacramento County Coroner’s Office. While the rate of older adults diagnosed with an opioid use disorder (OUD) is rising (it’s the most common substance use disorder among this population in Sacramento County), research shows that few receive medication as part of comprehensive treatment.

Methamphetamine misuse among the older adult population, though less publicized, is also concerning. In 2024, meth was the number one drug of choice in Sacramento County, accounting for 35% of overdose deaths among those ages 60-74. Factors driving this include social isolation, past substance use, mental health struggles, and economic pressures that are further complicated by Sacramento's diverse urban and rural communities.

Why Older Adults Are Particularly Vulnerable

Older adults' susceptibility to substance misuse involves both physical and psychosocial elements. Age-related physiological changes mean medications like opioids are metabolized differently, heightening risks of addiction. Opioids can also accelerate age-related issues that impact physical and cognitive functioning. 

In many cases, individuals may be just now seeking treatment after struggling with a substance use disorder for years, even decades. This is often the case with methamphetamine addiction, as the long-term effects of meth – high blood pressure, liver and brain damage, mood disorders, can worsen with age.  

Additionally, issues such as cognitive decline, financial stress, grief and trauma, and the difficulty of managing multiple medications (polypharmacy) further increase the risk for misuse or accidental overdoses. Older adults struggling with loneliness, depression, or seeking to manage fatigue and isolation may turn to substances as a coping strategy.

Recognizing Signs and Symptoms

Awareness of substance misuse signs is crucial for caregivers, family members, and professionals working with older adults. Typical indicators include:

• Opioids: Sedation, confusion, increased falls, frequent mood swings, and unexplained withdrawal or isolation

• Methamphetamine: Rapid weight loss, dental deterioration, increased agitation, paranoia, irregular sleep patterns, and erratic behavior

Early detection by family, friends, or caregivers can significantly enhance outcomes by ensuring timely intervention and support.

Unfortunately, detection and treatment face substantial hurdles. Stigma, embarrassment, or denial frequently prevent older adults from seeking help. Many older adults fear judgment or worry about losing independence, particularly in communities where drug misuse remains stigmatized.

Local Solutions and Effective Strategies

Sacramento County offers several promising solutions and strategies as part of prevention, treatment, and the continuum of care:

• Treatment and Prevention Programs: Initiatives tailored explicitly to older adults can effectively address both substance misuse and underlying mental health concerns. Treatment options include intensive outpatient care, withdrawal management, medication-assisted treatment (MAT), residential treatment, recovery residences, as well as both court and DUII programs. 

• Safe Prescribing: Local healthcare providers increasingly emphasize safer opioid prescribing practices, supplemented by alternative pain management therapies like physical therapy, acupuncture, and cognitive-behavioral strategies.

• Community Outreach and Resources: Programs that specifically educate older populations about methamphetamine risks, opioid addiction, and harm-reduction techniques have shown promise. The Sacramento County Aging Resources Directory provides a curated list of local, state, and national services and resources available to older adults and caregivers. 

Families and Community Support

Families and caregivers play essential roles in recognizing and addressing substance misuse compassionately. Regular, open dialogues help reduce stigma and encourage honesty and trust. Sacramento County offers caregiver education programs and support groups to provide guidance, resources, and encouragement.

Policy and Community Action in Sacramento

Sacramento County has actively responded with targeted public health campaigns and policy initiatives aimed at older adults. Collaborations between local governments, healthcare providers, and community organizations have successfully raised awareness and improved access to care. The county offers substance use prevention and treatment services, which begin with free screenings and referrals to providers. Successful community-based programs demonstrate the value of local involvement. 

Moving Forward with Compassion and Action

Addressing opioid and methamphetamine misuse among older adults in Sacramento County requires empathy, informed action, and community engagement. By raising awareness, increasing access to treatment, and empowering families and caregivers, we can work together to ensure our older adults can thrive in their later years.

• References

  • California Department of Public Health. (n.d.). CA overdose surveillance dashboard. Skylab.cdph.ca.gov. Retrieved 5, 2025, from https://skylab.cdph.ca.gov/ODdash/?tab=CTY

  • Dufort, A., & Samaan, Z. (2021). Problematic opioid use among older adults: Epidemiology, adverse outcomes and treatment considerations. Drugs & Aging, 38(12). https://doi.org/10.1007/s40266-021-00893-z

  • Kuo, Y.-F., Westra, J., Harvey, E. P., & Raji, M. A. (2025). Use of medications for opioid use disorder in older adults. American Journal of Preventive Medicine, 68(5). https://doi.org/10.1016/j.amepre.2025.01.019

  • National Institute on Drug Abuse. (2022). Opioids. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/opioids

  • Sacramento County Coroner. (2025). Drug deaths. Arcgis.com. https://experience.arcgis.com/experience/8fbbafb14a464bc79bdee22543f0b760/page/Drug-Deaths

  • SAMHSA. (n.d.). Too many prescription drugs can be dangerous, especially for older adults who is most at risk of harm from polypharmacy? https://publichealth.hsc.wvu.edu/media/3331/polypharmacy_pire_2_web_no-samhsa-logo.pdf

  • Zolopa, C., Høj, S. B., Minoyan, N., Bruneau, J., Makarenko, I., & Larney, S. (2022). Ageing and older people who use illicit opioids, cocaine or methamphetamine: A scoping review and literature map. Addiction, 117(8). https://doi.org/10.1111/add.15813