Senator Susan Collins used a committee hearing Wednesday to highlight one aspect of the opioid epidemic that she thinks deserves more attention: addiction in older adults.
Collins presented two bills to address the issue. While they're receiving support from some Maine physicians, others say the proposals don't target the most effective solutions.
Picture a person with opioid use disorder. More likely than not, says Senator Susan Collins, the image is that of a young adult.
"The epidemic, however, intersects just as much with older adults," she says.
Speaking before the Senate Aging Committee on which she serves, Collins emphasized the need to target this age group to help stop the opioid epidemic. Joining her to make the case was Dr. Charles Pattavina, the former chief of emergency medicine at St. Joseph Hospital in Bangor. Pattavina says federal data support what he has witnessed in the ER.
"Recent CDC data shows an increase of about one-third in opioid overdose emergency department visits by Americans over the age of 55 in a period barely more than a year," says Pattavina.
Pattavina says problems can arise when older adults who have become dependent on opioids are tapered off too quickly without alternative pain management. Maine was among the first states to set limits on opioid prescriptions in recent years.
"And it's just an indication that great care and time must be taken to taper anyone's dose so that people don't go outside the system seeking pain medication," he says.
Pattavina says older adults are also at risk for having their medications stolen and diverted by caretakers, family members and others. Collins is proposing a bill that she thinks will help with that issue. It would allow hospice workers to dispose of potent painkillers in a patient's residence after they have died.
Collins is also proposing a bill to create peer support networks, to prevent relapse once someone is in treatment.
Dr. Cliff Singer, the chief of Geriatric Mental Health at Eastern Maine Medical Center, says the bill that targets diversion is a smart idea. “Diversion is a bigger issue than misuse of the medications by the older adults themselves,” Singer says.
Singer also thinks creating peer support groups would help, especially if they target specific age groups, including older adults.
“Because they're dealing with issues – life issues, life transition issues and health issues that are often very different than younger adults,” he says.
Not everyone agrees.
“I don't know if we need to expand peer support,” says Dr. Meredith Norris, a specialist in addiction medicine in southern Maine.
“Peer support is already out there,” Norris says. “It's all the other interventions.”
Norris says the real need right now is access to medication-assisted treatment, which can be hard to get, even for those who have health insurance.
“Usually, even if people do have insurance, they don't have insurance that covers treatment in a real way,” she says. “Or they don't have access to treatment. Or MaineCare is getting cut.”
Collins agreed at the hearing that access to treatment is an issue. She noted to the Aging Committee that the recent budget agreement allocated $6 billion to address the opioid crisis.
“I am concerned, however, that, in some places, it is taking far too long for those funds to reach local health care providers, treatment and recovery organizations, and groups and schools involved with prevention and education efforts,” Collins says.
Dr. Norris says in addition to funding medication assisted treatment, lawmakers should also take steps to expand access to a wider array of health care services.
“What I would love is if people had really good treatment for trauma, for PTSD, etcetera, which is not as much medication as it is really good therapy, but no one can access that,” Norris says. “Or access is very limited. Or the wait is three months.”
Improving access to that that care for more people, Norris says, would help prevent them from developing substance use disorders.
This story was originally published May 23, 2018 at 3:11 p.m. ET.