Effect of Age on Opioid Prescribing, Overdose, and Mortality in Massachusetts, 2011 to 2015

Adam J. Rose*, Ryan McBain, Megan S. Schuler, Marc R. LaRochelle, David A. Ganz, Vikram Kilambi, Bradley D. Stein, Dana Bernson, Kenneth Kwan Ho Chui, Thomas Land, Alexander Y. Walley, Thomas J. Stopka

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Objectives: To examine the effect of age on the likelihood of PIP of opioids and the effect of PIP on adverse outcomes. Design: Retrospective cohort study. Setting: Data from multiple state agencies in Massachusetts from 2011 to 2015. Participants: Adult Massachusetts residents (N=3,078,163) who received at least one prescription opioid during the study period; approximately half (1,589,365) aged 50 and older. Measurements: We measured exposure to 5 types of PIP: high-dose opioids, coprescription with benzodiazepines, multiple opioid prescribers, multiple opioid pharmacies, and continuous opioid therapy without a pain diagnosis. We examined 3 adverse outcomes: nonfatal opioid overdose, fatal opioid overdose, and all-cause mortality. Results: The rate of any PIP increased with age, from 2% of individuals age 18 to 29 to 14% of those aged 50 and older. Older adults also had higher rates of exposure to 2 or more different types of PIP (40–49, 2.5%; 50–69, 5%; ≥70, 4%). Of covariates assessed, older age was the greatest predictor of PIP. In analyses stratified according to age, any PIP and specific types of PIP were associated with nonfatal overdose, fatal overdose, and all-cause mortality in younger and older adults. Conclusion: Older adults are more likely to be exposed to PIP, which increases their risk of adverse events. Strategies to reduce exposure to PIP and to improve outcomes in those already exposed will be instrumental to addressing the opioid crisis in older adults. J Am Geriatr Soc 67:128–132, 2019.

Original languageAmerican English
Pages (from-to)128-132
Number of pages5
JournalJournal of the American Geriatrics Society
Issue number1
StatePublished - Jan 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society


  • aged
  • mortality
  • opioid overdose
  • potentially inappropriate prescribing


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