A new study has found that overdose deaths among adults aged 65 and older from fentanyl mixed with drugs like cocaine and methamphetamine have skyrocketed by 9,000% in just eight years.
The findings were presented at the ANESTHESIOLOGY 2025 annual meeting and reveal a growing and deeply troubling trend among older Americans.
The research, which analyzed U.S. Centers for Disease Control and Prevention (CDC) data, shows that older adults are increasingly part of the ongoing fentanyl crisis—something that was once thought to primarily affect younger populations.
Adults over 65 are especially at risk because many have chronic health problems, take multiple medications, and process drugs more slowly due to aging.
The opioid epidemic in the U.S. has unfolded in four major waves. It began in the 1990s with prescription painkillers, followed by a surge in heroin use around 2010. Fentanyl, a synthetic opioid 50 times stronger than heroin, drove the third wave starting in 2013.
The fourth wave began in 2015, marked by the deadly combination of fentanyl with stimulants such as cocaine and methamphetamine.
“A common misconception is that opioid overdoses mainly affect young people,” said Gab Pasia, M.A., lead author of the study and a medical student at the University of Nevada, Reno.
“Our findings show that older adults are also being caught up in this latest wave of the opioid crisis.”
The team examined more than 400,000 death certificates that listed fentanyl as a cause of death between 1999 and 2023. Of these, about 17,000 were older adults aged 65 and up, while nearly 388,000 were younger adults aged 25 to 64.
Between 2015 and 2023, fentanyl-related deaths among older adults rose from 264 to 4,144—a 1,470% increase. For younger adults, deaths jumped from 8,513 to 64,694, a 660% rise.
What’s especially concerning is the sharp increase in deaths involving fentanyl mixed with stimulants.
Among older adults, such deaths grew from just 8.7% in 2015 to nearly 50% in 2023—a stunning 9,000% increase. In younger adults, fentanyl-stimulant deaths also surged from 21% to nearly 60% during the same period.
The researchers found that stimulant-related fentanyl deaths among older adults began climbing sharply in 2020. Cocaine and methamphetamine were the most common stimulants involved, surpassing alcohol, heroin, and prescription sedatives like Xanax or Valium.
These combinations make overdoses much harder to treat because stimulants and opioids affect the body in opposite ways—one speeds up the nervous system while the other slows it down.
Because this was a national study using existing CDC data, the researchers couldn’t determine why stimulant use is rising so fast in older adults. But the results clearly show that most fentanyl overdoses in this age group involve multiple drugs, not fentanyl alone.
The researchers stressed that doctors, particularly anesthesiologists and pain specialists, need to be aware of these changing patterns. They recommend being cautious when prescribing opioids to older patients, carefully checking medication lists, and considering non-opioid treatments when possible.
They also encourage involving caregivers in overdose prevention—such as learning how to use naloxone, a medication that reverses opioid overdoses, and ensuring that medication instructions are simple and easy to follow.
Dr. Richard Wang, an anesthesiology resident at Rush University Medical Center and a co-author of the study, said it’s crucial for older adults and their caregivers to ask doctors about overdose prevention.
“With these trends in mind, it’s more important than ever to minimize opioid use in this vulnerable group and use other pain control methods when appropriate,” he said. “Proper education and regular medication reviews could help stop this deadly trend.”
This study paints a grim picture of how the opioid epidemic has evolved. Once focused on younger adults, it now threatens older generations who may not even realize they’re at risk. As fentanyl continues to flood the illegal drug supply, the combination with stimulants creates an especially deadly mix.
The findings highlight the urgent need for better awareness, safer prescribing practices, and stronger public health interventions to protect older adults from becoming the next victims of this ongoing crisis.
If you care about mental health, please read studies about Middle-aged women with no kids may have this mental issue and findings of scientists find a cause of mental illnesses induced by childhood abuse.
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