Medication Use for OUD Low in Older Adults
The rate of medication use for opioid use disorder (MOUD) was found to be low in older adults, according to a recent research brief published in the American Journal of Preventive Medicine.
“The disparity in MOUD use underscores the need for improved access to comprehensive opioid treatment programs and increased MOUD coverage,” authors noted.
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Researchers used 20% national Medicare data to find beneficiaries over the age of 65 who had been diagnosed with OUD between 2017 and 2022. Researchers examined trends and types of MOUD use including methadone, buprenorphine, or naltrexone. A multivariable logistic regression model was used to examine the factors associated with MOUD use and analyses were performed in 2024. A total of 69,380 people were included in the study.
MOUD use among older adults increased from 4.8% in 2017 to 15.0% in 2022, with a significant rise following the implementation of a Medicare policy covering methadone for OUD. Most OUD patients (79%) had chronic pain and arthritis, while half also had anemia, depression, or anxiety. “The lower MOUD use among OUD patients with chronic pain and arthritis may relate to unclear guidelines on treating pain in OUD settings and concerns for possible MOUD misuse,” authors said.
Males, Black and Latino patients, older individuals, and rural residents were less likely to receive MOUD, whereas those with dual Medicaid coverage had higher odds of access. Patients with substance use disorders, anxiety, depression, or liver disease were more likely to receive MOUD, while those with non-Alzheimer dementia, cancer, kidney disease, stroke, chronic pain, or arthritis were less likely to receive it.
“Additional study of provider- and health system-level factors affecting MOUD prescribing and qualitative studies of prescriber and patient perspectives can provide data to guide policy making and clinical guideline development aimed at increasing MOUD use,” authors concluded.
