Opioid use among Ontario seniors an ‘overlooked and evolving crisis’: study

A new report in Ontario shows there is an “overlooked and evolving crisis” of older adults using opioids.

About 1 in 350 older Ontarians was identified as having opioid use disorder (OUD) – an 81 per cent increase from 2017, according to a report released Wednesday by the Toronto-based Catholic hospital network, Unity Health.

“We hope that our findings will bring to light the nature of this often overlooked and evolving crisis among older adults and help inform programs and policies to prevent deaths in the future,” the Ontario Drug Policy Research Network said in its report.

The report highlighted some of the most common opioids being prescribed, including hydromorphone, oxycodone, codeine, morphine and methadone.

Between 2017 and 2025, the report showed the number of older adults 55-plus seeking care for OUD doubled from 7,116 to 15,231.

“We have really seen this consistent climbing not only in the rates of people with opioid use disorders and who are accessing treatment, but also the opioid-related harms within those who are in these older age brackets,” said Tara Gomes, an epidemiologist and author of the report.

The rate of opioid-related deaths among older adults has also risen, jumping from 1.1 per 100,000 people in 2013 to 1.8 per 100,000 in 2024.

Gomes said opioid prescriptions were given at high rates during the 1990s and early 2000s, but as those prescriptions waned in the 2010s, that same age group started transitioning to an illicit drug supply.

“So we have this population of people who developed opioid use disorder many decades ago, who are now aging and reaching the ages of 50s and 60s and having these health-care needs,” Gomes said.

She added the increase also could be due to better awareness and screening of OUD and among older adults.

The Unity Health report isn’t the first to highlight more older adults are using opioids.

Dr. Samir Sinha also documented an increase in Canada in a 2023 report by the National Institute on Ageing, which found older adults have  the “highest rate of prescription opioid consumption” and the highest rates of opioid overdoses, side effects and mortality.

Sinha’s report showed, citing global studies, roughly three out of every four deaths associated with drug use among people aged 65 and older are linked to opioids.

“As we get older, we’re less likely to metabolize medications, break them down as easily as say younger people would,” Sinha said in an interview.

He said older adults may also take more medications due to chronic health issues, which could increase the risk of drug interactions that could cause further problems, including more emergency department visits.

It’s why Sinha said he encourages doctors to look at “all other options” before prescribing opioids to treat issues like chronic pain, including other medications, massage therapy or even forms of exercise.

The well-being of people in long-term care is also a concern, Gomes said.

“We heard very clearly that long-term care homes are understaffed and may not have the staffing to observe treatment doses and make sure that people are safe when taking their medications for more complicated situations like opioid use disorder,” Gomes said.

That includes support for older people living in their own homes, potentially in isolation. Gomes’ report found 78 per cent of the deaths associated with opioid use disorder were people who died in their own homes.

Awareness of older adults using opioids is on the rise, but Sinha said public perception of the drugs still needs to change, especially as Ontario and Canada’s population continue to get older.

“When politicians and even clinicians characterize or think about the opioid epidemic, we tend to think about younger people who are illicitly using medications as opposed to older people who are legitimately using medications that have been prescribed to them and yet still running into trouble,” he said.

—with files from Global News’ Katherine Ward