URMC / Medicine / Geriatrics & Aging / Finger Lakes Geriatric Education Center / Opioids & Older Adults

Older Adults & Opioids

PURPOSE

In collaboration with the Monroe County Department of Public Health and Lifespan, the Finger Lakes Geriatric Education Center (FLGEC) at the University of Rochester is directly addressing the opioid epidemic for older adults and what it means for their families. This call to action was made possible through supplemental funding received from the Health Resources and Services Administration (HRSA). This funding opportunity will allow the FLGEC to:

Prepare health care professionals through regional health professionals workshops on opioid training that addresses prevention, assessment, management, and treatment in older adults
Develop outreach programs focused on opioid education for older adults and caregivers at Lifespan and at Senior Centers in Rochester, New York
Work in tandem with the Opioid Action Plan of Monroe County to coordinate regional data collection on opioid abuse in older adults, and provide education and overdose prevention efforts.

RESOURCES

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the U.S. Department of Health and Human Services agency that leads public health efforts to reduce the impact of substance abuse and mental illness on America’s communities. The Treatment Improvement Protocol (TIP) series contributes to SAMHSA’s mission by providing science-based, best-practice guidance to the behavioral health field. TIPs refect careful consideration of all relevant clinical and health service research, demonstrated experience, and implementation requirements. The Treatment Improvement Protocol (TIP) 26: Treating Substance Use Disorder in Older Adults, updated in 2020, is designed to help providers and others better understand how to identify, manage, and prevent substance misuse in older adults.
HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics - In response to concerns that patients are being abruptly cut off of prescription opioids, the US DHHS announced this new guide yesterday. In light of the opioid crisis, providers have been responding to guidelines from the Centers for Disease Control and Prevention (CDC) to limit opioid prescribing, but rapid discontinuation can lead to opioid withdrawal and other problems for patients. The new guide seeks to balance effective pain management with risks of opioid addiction.
The Evidence-based Practice Center (EPC) Program at the Agency for Healthcare Research and Quality (AHRQ) has posted the protocol for Prevention, Diagnosis, and Management of Opioids, Opioid Misuse and Opioid Use Disorder in Older Adults. The protocol is available at the Effective Healthcare Web site or here as a pdf.
Managing Opioid Use in Long Term Services and Supports - created by the Utah Geriatric Education Consortium, these interprofessional online modules for students, health care providers and LTSS staff are centered around opioid use. Each module takes about 20 minutes to complete and provides instruction on how to present the material to a group.
The Baystate GWEP created an interactive module on Opioid Use in Older Adults. Direct Care Workers and/or educators can sign up for an account on the Massachusetts Direct Care Worker website to take this course and receive a certificate https://madirectcare.com/. Anyone can use this following link to view the interactive module.
The Western New York Rural Area Health Education Center (WNY R-AHEC), funded by the Health Resources and Services Administration (HRSA), provides educational initiatives in 12 rural counties in upstate New York. The WNY R-AHEC offers the Opioid Prevention Education Project (OPEP) to expand training related to opioid diagnosis, use, treatment and prevention for current health professionals, future practitioners, and the general population in New York State. The Opioid Prevention Education Project focuses on two key components: (1) High School and College Student Awareness, and (2) Community Engagement and Outreach. Find out more here: https://www.r-ahec.org/education/opep/
The New York State Office of Addiction Services and Supports (NYS OASAS) provides a comprehensive system of addiction services for prevention, treatment, harm reduction and recovery for all New Yorkers, including older adults.
Medications for Opioid Use Disorder (MOUD) in Long Term Care (LTC) was created by the Massachusetts Department of Public Health in response to data from 2019-2020 indicating MA was one of four US state with a significant increase in stimulant-related overdose deaths. This toolkit will assist in caring for people with SUD in LTC settings. See the report here.
National Alliance on Mental Illness (NAMI) Peer to Peer Support is a free, eight-session educational program for adults with mental health conditions who are looking to better understand themselves and their recovery. Find a location near you: https://www.nami.org/Support-Education/Mental-Health-Education/NAMI-Peer-to-Peer

Screening Tools

MAST-G: The MAST-G (Michigan Alcoholism Screening Test - Geriatric Version) varies from the MAST in that the questions highlight the special employment and social situations of someone who is retired and how that can relate to alcohol abuse. The tool consists of 24 questions. MAST-G
AUDIT: The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item screening tool developed by the World Health Organization (WHO) to assess alcohol consumption, drinking behaviors, and alcohol-related problems. AUDIT

2024 Older Adults & Opioids Webinar Series

Registration link: https://redcap.urmc.rochester.edu/redcap/surveys/?s=4KL7FM88LCEWTF34
Registration Flyer: 2024 Flyer

A Public Health Approach to the Overdose Epidemic

Presenter: Chinazo Cunningham, MD, MS, Commissioner, NYS Office of Addiction Services and Supports (NYS OASAS)
Date: Friday January 26, 2024, 12pm—1pm ET

Perceptions of Substance Use with Older Adults

Presenter: Diana Padilla, MCPC, CARC, CASAC-T, Research Project Manager, NYS Psychiatric Institute, Columbia University Medical Center, Opioid Response Network, Region 2
Date: Thursday February 15, 2024, 12pm—1pm ET

Opioid Use Disorder in Older Adults

Presenter: Abhilash Desai, MD, Adjunct Associate Professor, Department of Psychiatry, University of Washington School of Medicine, Idaho Track
Date: Friday March 15, 2024, 12pm—1pm ET

Medical Marijuana and Older Adults

Presenter: Timothy J. Holahan, DO, Assistant Professor of Medicine, University of Rochester Medical Center
Date: Tuesday April 23, 2024, 12pm—1pm ET
This presentation will review the use of medical marijuana and CBD in older adults in multiple care settings and outline the benefits and cautions while considering its use in older adults. We will also discuss appropriate dosing, formulations, and review the current literature regarding medical marijuana use.

Aging, the Opioid Epidemic, and Care Considerations for Native Communities

Presenters: Savannah Gene, CHES, Program Director for the Community Health Education Resiliency Program, Albuquerque Area Indian Health Board, and Benjamin H. Nguyễn, MSW, LCSW, CPH, Public Mental Health Consultant; Private Practice Psychotherapist; Managing Director, Westside Pacific Villages
Date: Tuesday May 21, 2024, 12pm —1pm ET
The presentation will look at the prevalence of opioid use among older people. A broad biopsychosocial framework and sociohistorical lens will be utilized to analyze risk factors and vulnerabilities for substance use among older people. The presentation will conclude with care considerations that integrate psychosocial aspects of well-being.

Opioid Overdose Prevention - Narcan Training (with free Narcan kit)

Presenter: Charlotte Crawford, RN, MSN, MBA, Consultant
Date: Friday June 14, 2024, 12pm—1pm ET
The opioid epidemic continues to exist, stressing the importance of early recognition of an individual experiencing an overdose. Now more than ever the importance of having Narcan readily available and the knowledge on the use of Narcan can and will save lives. Understanding how the Good Samaritan Law will impact those administering the medication will alleviate the fear in providing care. Understanding the importance in calling 911 for all overdoses, as this is frequently the individual’s first introduction to potential care for their substance use disorder. Reporting the use of Narcan will provide important data to the State, which in turn can turn into increased funding to address this issue.

2024 Older Adults and Opioids Webinar Series registration: registration link

Questions: LauraM_Robinson@urmc.rochester.edu

This project is sponsored by the Finger Lakes Geriatric Education Center funded by the Health Resources and Services Administration (HRSA), Department of Health and Human Services (DHHS) under the Geriatric Workforce Enhancement Program # U1QHP28738. This information or content and conclusions are those of the authors/speakers and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, DHHS, or the U.S. Government.