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Area of Science:

  • Pharmacology and Geriatric Medicine
  • Public Health and Pharmacy Practice
  • Opioid Use Disorder and Overdose Prevention

Background:

  • Older adults (≥65 years) are more vulnerable to opioid-related harm due to physiological changes, polypharmacy, and comorbidities.
  • The Opioid and Naloxone Education (ONE) Program utilizes pharmacy-based screening to identify risks for opioid-use disorder (OUD) and opioid overdose (OD).
  • Pharmacists deliver patient-specific education and interventions based on screening outcomes.

Purpose of the Study:

  • To compare OUD and OD risks between adults aged 65 and older and those younger than 65 receiving opioid medications.
  • To evaluate and compare opioid harm reduction interventions provided to these distinct age groups.
  • To assess the effectiveness of a community pharmacy-based screening program in mitigating opioid-related harm across age demographics.

Main Methods:

  • A voluntary, paper-based screening tool was administered to patients presenting opioid prescriptions.
  • Data from 15,025 screenings (2022-2023) were analyzed, including demographics, risk assessment results, and pharmacist interventions.
  • Statistical analysis and age stratification were performed to compare outcomes between patients 65 and older versus those under 65.

Main Results:

  • Patients aged 65 and older demonstrated a 36% higher risk of opioid overdose (OD), whereas patients under 65 showed a 51% higher risk of developing opioid-use disorder (OUD).
  • The older age group received significantly more naloxone education and dispensed naloxone compared to the younger group.
  • Younger patients had higher concurrent use of benzodiazepines and muscle-relaxants, while older patients reported nearly double the frequency of taking multiple opioids.

Conclusions:

  • Significant differences in OUD/OD risk and intervention uptake were observed between older adults and younger patients.
  • Community pharmacy-based opioid risk screening is an effective strategy for identifying at-risk patients.
  • Tailored interventions delivered through pharmacies can significantly contribute to opioid harm reduction across different age groups.